Healthcare Systems Engineering

Griffin, Paul M.; Nembhard, Harriet Black; DeFlitch, Christopher J.; Bastian, Nathaniel D.; Kang, Hyojung; Muñoz, David A.

doi:10.1002/9781119174639

Cited by 20 publications

(19 citation statements)

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“…While there are many different approaches that may be taken, continuous quality improvement (CQI) has received considerable attention within health care [5] as a way to enhance the quality of care and reduce costs [6][7][8][9]. The use of CQI in health care has evolved since the 1990s, using quality control techniques and management theories employed in the industrial and manufacturing sectors [10][11][12][13][14]. In its earliest form, CQI was based on five main principles, specifically: a focus on organizational process and systems, rather than on individuals within the system; the use of statistically and methodologically robust structured problem-solving approaches; the use of multi-disciplinary team working; empowerment of employees to help identify problems and action improvement opportunities; and, a focus on "customers" (i.e., public) through an emphasis on creating the best possible patient experience and outcomes [13,15,16].…”

Section: Introductionmentioning

confidence: 99%

The effectiveness of continuous quality improvement for developing professional practice and improving health care outcomes: a systematic review

Hill¹,

Stephani²,

Sapple³

et al. 2020

Implementation Sci

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Background: Efforts to improve the quality, safety, and efficiency of health care provision have often focused on changing approaches to the way services are organized and delivered. Continuous quality improvement (CQI), an approach used extensively in industrial and manufacturing sectors, has been used in the health sector. Despite the attention given to CQI, uncertainties remain as to its effectiveness given the complex and diverse nature of health systems. This review assesses the effectiveness of CQI across different health care settings, investigating the importance of different components of the approach. Methods: We searched 11 electronic databases: MEDLINE, CINAHL, EMBASE, AMED, Academic Search Complete, HMIC, Web of Science, PsycINFO, Cochrane Central Register of Controlled Trials, LISTA, and NHS EED to February 2019. Also, we searched reference lists of included studies and systematic reviews, as well as checking published protocols for linked papers. We selected randomized controlled trials (RCTs) within health care settings involving teams of health professionals, evaluating the effectiveness of CQI. Comparators included current usual practice or different strategies to manage organizational change. Outcomes were health care professional performance or patient outcomes. Studies were published in English. Results: Twenty-eight RCTs assessed the effectiveness of different approaches to CQI with a non-CQI comparator in various settings, with interventions differing in terms of the approaches used, their duration, meetings held, people involved, and training provided. All RCTs were considered at risk of bias, undermining their results. Findings suggested that the benefits of CQI compared to a non-CQI comparator on clinical process, patient, and other outcomes were limited, with less than half of RCTs showing any effect. Where benefits were evident, it was usually on clinical process measures, with the model used (i.e., Plan-Do-Study-Act, Model of Improvement), the meeting type (i.e., involving leaders discussing implementation) and their frequency (i.e., weekly) having an effect. None considered socioeconomic health inequalities.

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Section: Introductionmentioning

confidence: 99%

The effectiveness of continuous quality improvement for developing professional practice and improving health care outcomes: a systematic review

Hill¹,

Stephani²,

Sapple³

et al. 2020

Implementation Sci

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“…In an SSA context, the widespread adoption and diffusion of mobile phones as well as advances in Information and communication Technology (ICT) infrastructure are examples of important enablers [32][33][34][35]. There are however also significant ICT-related challenges, which include high failure costs [21], levels of regulatory control, data sensitivity, interoperability challenges [36,37] and data governance [38]. These barriers are underpinned by a number of challenges related to platform implementation in the SSA health context, for example:…”

Section: The Nature Of Technology Platformsmentioning

confidence: 99%

“…Existing or planned support structures such as the proposed National Health Insurance (NHI) to be implemented in SA, where interoperability challenges and compliance to industry standards are important [36,39,40,42,43]. Data collection challenges including the lack of standardisation and interoperability incentives and the need for data quality control [38,39,42,43].…”

Section: The Nature Of Technology Platformsmentioning

confidence: 99%

The design and development of technology platforms in a developing country healthcare context from an ecosystem perspective

Herman

Grobbelaar

Pistorius

2020

BMC Med Inform Decis Mak

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Background: Research on the development and functioning of technology platforms specifically for health applications in sub-Saharan Africa (SSA), is limited. The healthcare sector has also been resistant to platform adoption due to characteristics such as sensitive data and high cost of failure. A framework for the design, development and implementation of technology platforms in the South African health context could therefore contribute to the gap in research as well as provide a practical tool that platform owners could use to potentially increase the adoption of platforms in this context. Methods: The research design for this study was based on the Grounded Theory Conceptual Framework Analysis process. The process focused on mapping and investigating data sources, categorising and integrating concepts, synthesising these concepts into a framework and iteratively evaluating the framework. The first stage of the evaluation process was a preliminary evaluation exploring an existing Health platform in South Africa (MomConnect). The second evaluation stage included local and international interviews with nine experts to identify any missing concepts in the framework. Stage three included a case study and case study interviews which led to the formulation of the final framework and management tool. Results: The developed and evaluated framework comprised three components, namely the pre-use component, which includes considerations the platform owner should be aware of prior to using the framework. The framework comprises of two dimensions, 1) an ecosystem dimension to guide the platform owner to consider different ecosystem actors before embarking on designing a platform 2) a platform development dimension that include typical platform development components and presents an interpretation of the viewpoints included in the ecosystem levels. Conclusions: The final framework can be used by platform owners as a management tool. A unique contribution of this study is that the framework draws from two platform perspectives, namely the engineering and the economic perspectives to provide a holistic understanding of platforms. Finally, a contribution of this article is the tailoring of the framework for the South African health context.

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“…In such contexts, complexity also presents management challenges that must be overcome in order to successfully navigate the delivery of such systems 21–23 . Further, several systems engineering contexts confront additional domain‐specific challenges, for example, working with novel and cutting‐edge technologies in the defense and space domains, 24 or having to meet exacting certification demands in the aerospace and healthcare domains 25–28 …”

Section: Introductionmentioning

confidence: 99%

Evaluating the complexity of engineered systems: A framework informed by a user case study

Potts

Johnson

Bullock

2020

Systems Engineering

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Evaluating the complexity of an engineered system is challenging for any organization, even more so when operating in a System‐of‐Systems (SoS) context. Here, we analyze one particular decision support tool as an illustratory case study. This tool has been used for several years by Thales Group to evaluate system complexity across a variety of industrial engineering projects. The case study is informed by analysis of semistructured interviews with systems engineering experts within the Thales Group. This analysis reveals a number of positive and negative aspects of (i) the tool itself and (ii) the way in which the tool is embedded operationally within the wider organization. While the first set of issues may be solved by making improvements to the tool itself, informed by further comparative analysis and growing literature on complexity evaluation, the second “embedding challenge” is distinct, seemingly receiving less attention in the literature. In this paper, we focus on addressing this embedding challenge, by introducing a complexity evaluation framework, designed according to a set of principles derived from the case study analysis; namely that any effective complexity evaluation activity should feature collaborative effort toward building an evaluation informed by a shared understanding of contextually relevant complexity factors, iterative (re‐)evaluation over the course of a project, and progressive refinement of the complexity evaluation tools and processes themselves through linking project evaluations to project outcomes via a wider organizational learning cycle. The paper concludes by considering next steps including the challenge of assuring that such a framework is being implemented effectively.

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Healthcare Systems Engineering

Cited by 20 publications

References 0 publications

The effectiveness of continuous quality improvement for developing professional practice and improving health care outcomes: a systematic review

The effectiveness of continuous quality improvement for developing professional practice and improving health care outcomes: a systematic review

The design and development of technology platforms in a developing country healthcare context from an ecosystem perspective

Evaluating the complexity of engineered systems: A framework informed by a user case study

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