Healthcare Systems Engineering

PAUL M. GRIFFIN, PHD, is the Joseph C. Mello Chair and Professor of Industrial Engineering at Georgia Tech. HARRIET B. NEMBHARD, PHD, Is a Professor of Industrial Engineering at Pennsylvania State University. She is Director of the Center for Integrated Healthcare Delivery Systems. CHRISTOPHER J. DEFLITCH, MD, is the Chief Medical Information Officer and an Associate Professor of Emergency Medicine at the Pennsylvania State University Hershey Medical Center. NATHANIEL D. BASTIAN, PHD, is a Healthcare Operations Research Analyst in the United States Army Medical Department. HYOJUNG KANG, PHD, is a Research Assistant Professor of Systems and Information Engineering at the University of Virginia. DAVID A. MUÑOZ, PHD, is a consultant at McKinsey & Company.

• Acknowledgments xiChapter 1 The Healthcare Delivery System 1Overview 11.1 Healthcare Delivery Components 21.2 Major Stakeholders 61.3 Global Issues in Health 61.4 Drivers for Healthcare Systems 13Questions and Learning Activities 22References 23Chapter 2 Complexity and Systems in Healthcare 25Overview 252.1 Taking a Systems Approach to Healthcare 252.2 Complex Adaptive Systems 28Case Study 2A: Complexity in Chronic Kidney Disease 312.3 Systems Thinking and System Dynamics 34Case Study 2B: Systems Thinking and Causal Loop Diagrams in CKD 40Case Study 2C: System Dynamics and Stock Flow Diagrams in CKD 45Questions and Learning Activities 48References 49Chapter 3 Patient Flow 53Overview 533.1 Healthcare Settings and Clinical Workflows 533.2 Patient Flow through a Hospital 643.3 Care Transitions 713.4 Process Mapping 753.5 Queuing 78Case Study 3: ED Crowding – A Patient Flow Solution 80Questions and Learning Activities 83References 83Chapter 4 Healthcare Financing 91Overview 914.1 Financing Models for Health Services 914.2 Compensation Models for Providers 954.3 Cost Allocation and Charges 974.4 Capital Budgeting 103Questions and Learning Activities 107References 108Chapter 5 Health Data and Informatics 111Overview 1115.1 Healthcare Data 1165.2 Electronic Health Records 1215.3 Health Information Exchange 1305.4 Publicly Reported Healthcare Data 132Case Study 5: Health Informatics at a Hospital—A 10-Year Journey 136Questions and Learning Activities 139References 140Chapter 6 Lean 141Overview 1416.1 Lean Philosophy and Methods 1416.2 Drivers for Lean Healthcare Systems 1436.3 A Toolset for Eliminating Wastes 1466.4 Value Stream Mapping 1486.5 A3 1506.6 5S 1576.7 Kanban 1606.8 Lean Implementations 1646.9 Lean Thinking 165Questions and Learning Activities 166References 166Chapter 7 Six Sigma 169Overview 1697.1 Six Sigma Philosophy 1697.2 Six Sigma Quality 170Case Study 7A: Quantifying Complexity in Translational Research 201Case Study 7B: Evaluating Collaboration in Translational Research 205Case Study 7C: Resource Allocation in Translational Research 208Questions and Learning Activities 210References 212Chapter 8 Reliability and Patient Safety 217Overview 2178.1 Human Reliability 2178.2 Errors in Healthcare 2188.3 Medication Errors 2208.4 Patient Falls 2228.5 Human Factors and Ergonomics for Patient Safety 227Questions and Learning Activities 236References 237Chapter 9 Health Analytics 245Overview 2459.1 Data Mining 245Case Study 9A: Predicting Parkinson’s Disease Using Data Mining 2519.2 Data Visualization 255Case Study 9B: Data Visualization in Obesity Counseling 2699.3 Social Network Analysis 271Case Study 9C: SNA in a Pediatric Intensive Care Unit (PICU) 2779.4 Data Envelopment Analysis 280Case Study 9D: Using DEA for Finding Best-in-Class Hospitals in a Network 2859.5 Multicriteria Decision Making 287Case Study 9E: Use of GP to Optimize Helicopter Emplacement at Medical Treatment Facilities 291Questions and Learning Activities 292References 293Chapter 10 Capacity Management 297Overview 29710.1 Capacity Management Challenges 29710.2 Managing Nursing Units 29910.3 Managing Operating Rooms 31010.4 Managing Diagnostic Units 31610.5 Nurse Staffing and Scheduling 317Questions and Learning Activities 320References 321Chapter 11 Healthcare Logistics 323Overview 32311.1 Facility Location 323Case Study 11: Location of Federally Qualified Healthcare Centers 33711.2 Home Healthcare Routing and Scheduling 341Questions and Learning Activities 347References 349Chapter 12 Health Supply Chains 351Overview 35112.1 Forecasting Demand 35112.2 Inventory Control 35712.3 Healthcare Distribution 36312.4 Coordinating Activities in the Supply Chain 369Questions and Learning Activities 375References 377Chapter 13 Infection Control 379Overview 37913.1 Historical Perspective 37913.2 Infection Control Classification 38113.3 Checklists for Infection Control 38313.4 The Case of Sepsis 38513.5 Mathematical Modeling of Hospital Infection Control 388Case Study 13: Impact of Interventions on TB Infection in a Clinic 398Questions and Learning Activities 402References 403Index 405

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