Engineering a Learning Healthcare System: A Look at the Future

This book focuses on current major healthcare system challenges and what the field of engineering has to offer in the redesign of the system toward a learning healthcare system.



Improving our nation's healthcare system is a challenge which, because of its scale and complexity, requires a creative approach and input from many different fields of expertise. Lessons from engineering have the potential to improve both the efficiency and quality of healthcare delivery. The fundamental notion of a high-performing healthcare system–one that increasingly is more effective, more efficient, safer, and higher quality–is rooted in continuous improvement principles that medicine shares with engineering. As part of its Learning Health System series of workshops, the Institute of Medicine's Roundtable on Value and Science-Driven Health Care and the National Academy of Engineering, hosted a workshop on lessons from systems and operations engineering that could be applied to health care.

Building on previous work done in this area the workshop convened leading engineering practitioners, health professionals, and scholars to explore how the field might learn from and apply systems engineering principles in the design of a learning healthcare system.

Contents
SUMMARY
1 ENGINEERING A LEARNING HEALTHCARE SYSTEM
Introduction
Learning Opportunities for Health Care - Brent C. James
Teaching Opportunities from Engineering: Learning by Example - W. Dale Compton
Observations on Initiating Systems Change in Health Care: Challenges to Overcome - Donald M. Berwick
2 ENGAGING COMPLEX SYSTEMS THROUGH ENGINEERING CONCEPTS
Introduction
Can We Afford Technological Innovation in Health Care? - William B. Rouse
Operations Research for the Operating Room and Much More!- Richard C. Larson
On Designing an Integrated and Adaptive Healthcare System - James M. Tien and Pascal J. Goldschmidt
Engaging Complex Systems Through Engineering Concepts: A Methodology for Engineering Complex Systems - Harold W. Sorenson
3 HEALTHCARE SYSTEM COMPLEXITIES, IMPEDIMENTS, AND FAILURES
Introduction
Healthcare Culture in the United States - William W. Stead
Diagnostic and Treatment Technologies - Rita F. Redberg
A Look at the Future of Clinical Data Systems and Clinical Decision Support - Michael D. Chase
Care Coordination and Linkage - Amy L. Deutschendorf
Transforming Hospitals Through Reform of the Care Process - Ralph W. Muller
A Perspective on Patient-Centric, Feed-Forward “Collaboratories” - Eugene C. Nelson, Elliott S. Fisher, and James N. Weinstein
4 CASE STUDIES IN TRANSFORMATION THROUGH SYSTEMS ENGINEERING
Introduction
Airline Safety - John J. Nance
Alcoa’s Reorientation: Streamlining the Financial Close Process - Earnest J. Edwards
Veterans Health Affairs: Transforming the Veterans Health Administration - Kenneth W. Kizer
The Clinical Transformation of Ascension Health - David B. Pryor, Ann Hendrich, Sanford F. Tolchin, Robert J. Henkel, James K. Beckmann, Jr., and Anthony R. Tersigni
5 FOSTERING SYSTEMS CHANGE TO DRIVE CONTINUOUS LEARNING IN HEALTH CARE
Introduction
Chasing the Rabbit: What Healthcare Organizations Can Learn from the World’s Greatest Organizations - Steven J. Spear
Knowledge Management for Clinical Care - Donald E. Detmer
Technology Management - Stephen J. Swensen and James Dilling
A Learning System for Implementation of Electronic Health Records - David C. Classen, Jane B. Metzger, and Emily Welebob
Breakout Session: Capturing More Value in Health Care
6 NEXT STEPS: ALIGNING POLICIES WITH LEADERSHIP OPPORTUNITIES
Introduction
Process Standardization and Improvement
Leveraging People for Healthcare Improvement
Recurring Themes for Roundtable Attention
Areas for Innovation and Collaborative Action
APPENDIXES
A Workshop Agenda
B Biographical Sketches of Participants
C Workshop Attendee List