Acknowledgments xi
Chapter 1 The Healthcare Delivery System 1
Overview 1
1.1 Healthcare Delivery Components 2
1.2 Major Stakeholders 6
1.3 Global Issues in Health 6
1.4 Drivers for Healthcare Systems 13
Questions and Learning Activities 22
References 23
Chapter 2 Complexity and Systems in Healthcare 25
Overview 25
2.1 Taking a Systems Approach to Healthcare 25
2.2 Complex Adaptive Systems 28
Case Study 2A: Complexity in Chronic Kidney Disease 31
2.3 Systems Thinking and System Dynamics 34
Case Study 2B: Systems Thinking and Causal Loop Diagrams in CKD 40
Case Study 2C: System Dynamics and Stock Flow Diagrams in CKD 45
Questions and Learning Activities 48
References 49
Chapter 3 Patient Flow 53
Overview 53
3.1 Healthcare Settings and Clinical Workflows 53
3.2 Patient Flow through a Hospital 64
3.3 Care Transitions 71
3.4 Process Mapping 75
3.5 Queuing 78
Case Study 3: ED Crowding – A Patient Flow Solution 80
Questions and Learning Activities 83
References 83
Chapter 4 Healthcare Financing 91
Overview 91
4.1 Financing Models for Health Services 91
4.2 Compensation Models for Providers 95
4.3 Cost Allocation and Charges 97
4.4 Capital Budgeting 103
Questions and Learning Activities 107
References 108
Chapter 5 Health Data and Informatics 111
Overview 111
5.1 Healthcare Data 116
5.2 Electronic Health Records 121
5.3 Health Information Exchange 130
5.4 Publicly Reported Healthcare Data 132
Case Study 5: Health Informatics at a Hospital—A 10-Year Journey 136
Questions and Learning Activities 139
References 140
Chapter 6 Lean 141
Overview 141
6.1 Lean Philosophy and Methods 141
6.2 Drivers for Lean Healthcare Systems 143
6.3 A Toolset for Eliminating Wastes 146
6.4 Value Stream Mapping 148
6.5 A3 150
6.6 5S 157
6.7 Kanban 160
6.8 Lean Implementations 164
6.9 Lean Thinking 165
Questions and Learning Activities 166
References 166
Chapter 7 Six Sigma 169
Overview 169
7.1 Six Sigma Philosophy 169
7.2 Six Sigma Quality 170
Case Study 7A: Quantifying Complexity in Translational Research 201
Case Study 7B: Evaluating Collaboration in Translational Research 205
Case Study 7C: Resource Allocation in Translational Research 208
Questions and Learning Activities 210
References 212
Chapter 8 Reliability and Patient Safety 217
Overview 217
8.1 Human Reliability 217
8.2 Errors in Healthcare 218
8.3 Medication Errors 220
8.4 Patient Falls 222
8.5 Human Factors and Ergonomics for Patient Safety 227
Questions and Learning Activities 236
References 237
Chapter 9 Health Analytics 245
Overview 245
9.1 Data Mining 245
Case Study 9A: Predicting Parkinson’s Disease Using Data Mining 251
9.2 Data Visualization 255
Case Study 9B: Data Visualization in Obesity Counseling 269
9.3 Social Network Analysis 271
Case Study 9C: SNA in a Pediatric Intensive Care Unit (PICU) 277
9.4 Data Envelopment Analysis 280
Case Study 9D: Using DEA for Finding Best-in-Class Hospitals in a Network 285
9.5 Multicriteria Decision Making 287
Case Study 9E: Use of GP to Optimize Helicopter Emplacement at Medical Treatment Facilities 291
Questions and Learning Activities 292
References 293
Chapter 10 Capacity Management 297
Overview 297
10.1 Capacity Management Challenges 297
10.2 Managing Nursing Units 299
10.3 Managing Operating Rooms 310
10.4 Managing Diagnostic Units 316
10.5 Nurse Staffing and Scheduling 317
Questions and Learning Activities 320
References 321
Chapter 11 Healthcare Logistics 323
Overview 323
11.1 Facility Location 323
Case Study 11: Location of Federally Qualified Healthcare Centers 337
11.2 Home Healthcare Routing and Scheduling 341
Questions and Learning Activities 347
References 349
Chapter 12 Health Supply Chains 351
Overview 351
12.1 Forecasting Demand 351
12.2 Inventory Control 357
12.3 Healthcare Distribution 363
12.4 Coordinating Activities in the Supply Chain 369
Questions and Learning Activities 375
References 377
Chapter 13 Infection Control 379
Overview 379
13.1 Historical Perspective 379
13.2 Infection Control Classification 381
13.3 Checklists for Infection Control 383
13.4 The Case of Sepsis 385
13.5 Mathematical Modeling of Hospital Infection Control 388
Case Study 13: Impact of Interventions on TB Infection in a Clinic 398
Questions and Learning Activities 402
References 403
Index 405
