Learning in the health care enterprise

Rouse, William B.; Johns, Michael M.; Pepe, Kara

doi:10.1002/lrh2.10024

Cited by 13 publications

(4 citation statements)

References 47 publications

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“…The adaptive management strategy establishes processes that feedback learnings based on experiences of running the program and have mechanisms to enable change that reflects these learnings. It is applied in complex adaptive systems, such as healthcare 18 , so that programs can operate in situations of uncertainty 19 . This program model was selected as genomics is a discipline experiencing fast technological changes and an evolving knowledge base.…”

Section: Program Structure and Processesmentioning

confidence: 99%

Queensland Genomics: an adaptive approach for integrating genomics into a public healthcare system

et al. 2021

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The establishment of genomics in health care systems has been occurring for the past decade. It is recognised that implementing genomics within a health service is challenging without a system-wide approach. Globally, as clinical genomics implementation programs have matured there is a growing body of information around program design and outcomes. Program structures vary depending on local ecosystems including the health system, politics and funding availability, however, lessons from other programs are important to the design of programs in different jurisdictions. Here we describe an adaptive approach to the implementation of genomics into a publicly funded health care system servicing a population of 5.1 million people. The adaptive approach enabled flexibility to facilitate substantial changes during the program in response to learnings and external factors. We report the benefits and challenges experienced by the program, particularly in relation to the engagement of people and services, and the design of both individual projects and the program as a whole.

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Section: Program Structure and Processesmentioning

confidence: 99%

Queensland Genomics: an adaptive approach for integrating genomics into a public healthcare system

et al. 2021

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“…Population health involves integration of health, education and social services to keep a defined population healthy, to address health challenges holistically and to assist with the realities of being mortal (Rouse, Johns, & Pepe, 2017, 2019. Thus, the concern is health, not just healthcare.…”

Section: Population Healthmentioning

confidence: 99%

Understanding the complexity of health

Rouse

2020

Syst Res Behav Sci

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The complexity of health cannot be adequately explained with a representation that only captures one level of abstraction of the ecosystem. Multiple levels of abstraction are needed to comprehend the full range of forces that affect the health of a population. These levels are outlined and run the gamut from cells to society, ranging from aberrations of immune system signalling to society's values and norms. Computational modelling of this multilevel system can enable both understanding and managing the complexity of health. This is illustrated in contexts that include Washington, DC, and New York City.

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“…Elsewhere, we have elaborated concepts of learning in the health care enterprise, with particular emphasis on single‐ versus double‐loop learning . Learning depends, of course, on feedback.…”

Section: Ecosystem Integrationmentioning

confidence: 99%

Service supply chains for population health: Overcoming fragmentation of service delivery ecosystems

Rouse

Johns

Pepe

2019

Learning Health Systems

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Introduction Population health involves integration of health, education, and social services to keep a defined population healthy, to address health challenges holistically, and to assist with the realities of being mortal. The fragmentation of the US population health delivery system is addressed. The impacts of this fragmentation on the treatment of substance abuse in the United States are considered. Innovations needed to overcome this fragmentation are proposed. Approach Treatment capacity issues, including scheduling practices, are discussed. Costs of treatment and lack of treatment are considered. Models of integrated care delivery are reviewed. Potential innovations from systems science, behavioral economics, and social networks are considered. The implications of these innovations are discussed in terms of information technology (IT) systems and governance. Conclusions Enormous savings are possible with more integrated treatment. Based on a range of empirical findings, it is argued that investments of these resources in integrated delivery of care have the potential to dramatically improve health outcomes, thereby significantly reducing the costs of population health.

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Learning in the health care enterprise

Abstract: Introduction The overall enterprise of health care delivery is considered. The 4 levels of the

Cited by 13 publications

References 47 publications

Queensland Genomics: an adaptive approach for integrating genomics into a public healthcare system

Queensland Genomics: an adaptive approach for integrating genomics into a public healthcare system

Understanding the complexity of health

Service supply chains for population health: Overcoming fragmentation of service delivery ecosystems

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