I'm a new MSHS student and will also be working at Emory Healthcare as a GRA this semester. I graduated from UNC-Chapel Hill with a degree in Mathematical Decision Sciences. The Health Systems program was attractive because I was looking for a career where I could use operations research methods to improve processes that would provide for the well-being of people. I spend my spare time watching my beloved Green Bay Packers, hanging out with my wife, and learning photography.
I was impressed by the complexity of the healthcare system today, even though we only had a brief introduction. My father is a dermatologist, so I grew up only experiencing the specialized domain of healthcare on a regular basis. I was particularly struck by how Emergency Department doctors essentially have to be generalist specialists in many areas of healthcare at once. In terms of simple economics, it would seem that doctors are at a distinct disadvantage trying to provide such different types of care simultaneously instead of gaining a comparative advantage by only focusing on a few. There was brief mention by some of the faculty that they believe healthcare is broken in significant ways. I am interested in which areas they refer to and what they believe could be possible solutions.
After doing a small group exercise with our closet photos, I was struck by how each member of our team had a different idea of what the "optimal" way of organizing a closet was. There were many ways of organizing observations into different categories. The exercise made me think about optimizing a room layout or process in healthcare. As someone that is quantitatively driven, I always view optimization in terms of values rather than preferences, but I think that preferences of caregivers have to be taken into consideration and a compromise be made. By including preferences, there really is no "one size fits all" in designing a system or layout because employee preferences may change over time. I'm interested to see if there is anyway to create a system or organizational method that may be adapted easily to preference.
Dr. Ackerman gave a brief overview of a typical workflow of the ER and the process involved. I've been fortunate not to have to endure the process, but it's easier for me to see now that the system is quite dynamic and not linear in fashion. I think it would be quite difficult to analyze from an operations research perspective comprehensively, and much analysis would probably lead to models that lacked enough precision to be of any practical use. Rather, it would make more sense to focus intently for improvement on the various parts of the ER system (Pre-hospital, Triage, Evaluation, etc.).
My main thoughts during the course of Dr. Doo's presentation of past projects primarily centered on the feasibility of implementing such projects. Granted, this course is hypothetical in the sense that we are designing improvements for future hospital settings. However, while many of the structurally-based projects (those that involve major structures of the hospital building itself) certainly provided advantages, I think hospitals may hesitate to implement them because of the cost of wide-scale implementation. Perhaps the best projects are those that can be obtained cheaply, but provide an obvious advantage to healthcare delivery.
As Dr. Zimring outlined briefly evidence-based design, I was intrigued by the field in general. It would seem that operations research training coupled with architecture could provide very useful collaborations. In particular, the system analysis procedures could serve as a large portion of the "evidence" in evidence-based design. I don't know enough about the field to know whether it would be advantageous for architects to have a bit of ops research training, but I wonder if designers of future hospitals will consult with both fields when they create building plans.
9/6/2012 Mr. Cowan gave a brief presentation on how engineers view problems in organizations and systems. It really resonated with how I was brought up to solve problems (my father is very similar), even though I was not trained in industrial engineering. I can certainly see the value of such an approach, but this sort of thinking typically disregards more subjective areas that others highly value I have come to find. I imagine any married man will know what I'm talking about :).
9/11/2012, 9/13/2012 - Pecha Kucha Presentations
This week we presented our pecha kucha presentations over our observations of our Grady ER visit. I was very interested to see that each person's observations had a unique flavor. My own focused primarily on processes and organization (or perceived lack thereof) whereas others focused more on policies, visual clutter, or human dispositions. I think it was a good exercise for presenting your observations succinctly in addition to understanding the value of working in inter-disciplinary teams.
Since last month we have formed teams. I am on a team with an industrial design student in addition to an industrial engineering. Over the last couple of weeks I've found how difficult it is to narrow down a specific problem focus because a lot of problems that we observed in the ER overlap with so many different areas of healthcare before, during, and after a visit to the ER. I've found that most of the problems stated by people in everyday life aren't exactly problems, but rather solution assumptions of a problem.