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Systems approach to health care modeling

Systems approach to health care modeling. IE497B Spring 2007 Chapter 2 from Building a Better Delivery System: A New Engineering/Health Care Partnership. Agenda. Structure Players Interactions Tools/IT. Structure of Medical care – four level model. The patient

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Systems approach to health care modeling

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  1. Systems approach to health care modeling IE497B Spring 2007 Chapter 2 from Building a Better Delivery System: A New Engineering/Health Care Partnership

  2. Agenda • Structure • Players • Interactions • Tools/IT

  3. Structure of Medical care – four level model • The patient • The care team (Physicians, pharmacists, Med techs, …) • Organization (hospital, clinic, nursing home, …) • Environment (Economic, regulations, …)

  4. Patients Care Team Front-line providers Organization Infrastructure/resources Environment Regulation, market, policy, .. Structure

  5. The Patient • Consumer-driven systems • Patient-centered care • Types of patients • Critical-care (Trauma victims, heart attacks, …) • Chronic-care (Diabetes, arthritis, heart disease, …) • Assisted-care (Elderly, handicapped, …) • Informed needs • Participate in decision-making • Patient assessable

  6. The care team • Clinical micro-system • Standard, evidence-based, patient-stratified “best practice”

  7. The organization • Decision-making systems • Information systems • Operating system • Processes

  8. The political and economic environment • Regulation • Finance • Payment • Entities that influence the structure and performance of health care (Medicare/Medicaid, …)

  9. A Systems View • Process mapping/modeling • Symbolic and mathematical models • Systems theory • Atomic elements • Hierarchical components • Interactions

  10. Lean Methods • Today most hospitals/health providers have some form of Lean activity • Most perform in a two step manner • Process flow mapping • Waste identification and elimination

  11. PROCESS FLOW CHARTING Operation /process Transport/move Store Delay Inspect

  12. Waste “Anything that adds Cost to the product without adding Value”

  13. 7 Types of Muda • Excess (or early) production • Delays • Transportation (to/from processes) • Inventory • Inspection • Defects or correction • Process inefficiencies and other non-value added movement (within processes)

  14. 7 Forms of Waste CORRECTION MOTION Repair or Rework WAITING Any wasted motion to pick up parts or stack parts. Also wasted walking Any non-work time waiting for tools, supplies, parts, etc.. Types of Waste PROCESSING OVERPRODUCTION Producing more than is needed before it is needed Doing more work than is necessary INVENTORY CONVEYANCE Maintaining excess inventory of raw mat’ls, parts in process, or finished goods. Wasted effort to transport materials, parts, or finished goods into or out of storage, or between processes.

  15. An Emergency Department Patent arrives To registr Register Triage Treat room Diagnosis Treat Release

  16. Systems approach • Design/plan • Analyze • Control • Manage

  17. Tools/modeling techniques • Deterministic • Man-power planning • Resource allocation • Budget • Stochastic • QC • Queueing • Analytical • Simulation

  18. How do we plan health systems? • Historic data • Expected growth

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