Update on the UT System Initiative Systems Engineering in Healthcare
Victoria Jordan, PhD
Director, Quality Measurement and Engineering – MDACC
UT Health Services Fellow for Systems Engineering
October 27, 2011
Industrial and Systems Engineering
• Industrial and Systems Engineers deal with
systems. They design, implement, or
improve integrated systems comprised of
people, material, information, and/or energy.
• Industrial and Systems Engineering focuses
on developing a better way of doing just
about anything.
• Industrial and Systems Engineering makes
things better, faster, safer, cheaper
Components of Systems Engineering
• Frontline Improvement Methods • Human Factors
 Six Sigma
 Lean
 Standardization
• Quality Engineering Methods
 Statistical Quality Control
 Reliability
 Engineering Economics
• Process Optimization Methods
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Operations Research
Scheduling
Simulation
Staffing Models
 Error Proofing
 Safety
 Ergonomics
• Logistics
 Facility Design Layout
 Supply Chain / Inventory
Management
• Data Mining and Analytics
 Clinical Informatics
 Clinical Decision Making
 Reporting
Systems Engineering in Healthcare
• Clinical Operations (Efficiency, Safety, Value
of Patient Care Delivery)
• Business Operations (Efficiency, Value of
business systems such as administrative
requests, research approvals systems,
inventory management)
• Therapeutic Optimization
Systems Engineering in Healthcare
• Make health care safe, timely, effective, efficient,
equitable, and patient centered
• Design / layout new facilities
• Reduce patient wait times
• Increase efficiency so we can deliver the same
quality of care without increasing staff
• Eliminate non-value-added steps to improve
efficiency, reduce cost
• Simulation to try new processes
• Make care safer for patients
• Identify when we need to add resources (staff or
equipment or rooms)
Example: Virginia Mason
In two years (2002-2004) Va Mason showed the
following improvements:
• Inventory down 53% ($1.35 million)
• Productivity up 36% (158 FTE’s deployed to other,
value-added, jobs)
• Floor space required down 41% (22,200 sf)
• Lead time down 65% (23,082 hours)
• People – Distance traveled down 44%
• Product – Distance traveled down 72%
• Set up time down 82%
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UT Example –
Nurse Scheduling Problem in OR
• Develop two integer programming nurse scheduling models
 Nurse Assignment Model (NAM)
 Nurse Lunch Model (NLM)
• Consider nurse scheduling attributes in an operating suite
 Case specialties
 Procedure complexities
 Nurse skill levels
• Consider different aspects of goals
 Minimizing nurse over times and idle times
 Maximizing surgery case demand satisfactions
• Provide efficient schedule for each nurse
Link Between Systems Engineering and
Clinical Safety and Effectiveness Course
Optimization
Heuristics
Mathematical Programming
Systems Thinking
Forecasting
Data Mining
Queuing
Constraint Base Scheduling
Operations Research
Human Factors Analysis
Decision Analysis
Scheduling
System Dynamics
Complexity
Facility Design Layout
Network Analysis
Discrete Event Simulation
Inventory Modeling
Human Factors Analysis Classification System
Statistical Analysis
Ethnography
Six Sigma
Fault Tree Analysis
Quality Function Deployment
Root Cause Analysis
Usability
Decision Trees
Evidenced Based Medicine
Lean
QI Leadership
Process Mapping
Failure Mode Effect Analysis
Statistical Process Control
Patient Safety
Plan-Do-Study-Act
Basic Quality Tools
Decision Making
Current
CS&E
Content
Clinical Variation
Time/Motion Study
Project Management
Qualitative
Created by: Office of Performance Improvement, UT MDAnderson Cancer Center
Quantitative
What Others Are Doing
• Johns Hopkins ($30 million Systems Institute)
• Brigham and Women’s ($30 million for Systems View of
Primary Care)
• Mayo Clinic (Systems Engineering Group)
• Geisinger (Operations Research)
• VA Engineering Resources Centers
• Virginia Mason (Lean)
• Charleston Area Medical Center, WV (Six Sigma)
• Banner (Relationship with Academia)
• Academic Centers (CHOT - Center for Healthcare Operations
Transformation, others)
• Institute for Industrial Engineers (IIE) – Society for Healthcare
Systems (SHS)
UT Systems Engineering Mission
Apply industrial and systems
engineering tools and methods to further
advance clinical effectiveness and
safety and improve operations across
the health institutions of The University
of Texas System.
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UT System - Systems Engineering
Steering Committee
Steering Committee includes members from across
the UT System:
 UT Southwestern, UTMB, UT MD Anderson, UT Tyler,
UTHSC – San Antonio, UTHSC – Houston
 UT Austin – McCombs School of Business, Cockrell
School of Engineering; UTSA – Ind Engr, UT-Arlington –
Ind Engr; UT-Dallas-Ind Engr; UT Medical School
 UT Physicians
 UT Health Services – Vice Chancellor’s Office
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Our Expected Deliverables
• Develop a whitepaper to serve as a recommendation
for Dr. Shine to the UT System and Board of Regents
(presented Aug, 2011)
• Provide educational sessions for academic, business,
and clinical leaders on the role of Systems
Engineering in healthcare (increase awareness) and
courses in frontline methodology
• Coordinate grants for transformational efforts using
Systems Engineering
• Explore the possibility of a Systems Engineering
internship program among the UT health institutions
• Initiate an annual conference to share success
stories
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Board of Regents – August 2011
• Approved $4 million to fund the initiative for
three years
 Approx $1 million for infrastructure support
 Approx $3 million for grants for transformational
change using Systems Engineering tools and
techniques
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Next Steps
• Communication across UT System - Present
plan to Presidents, Deans, CMO’s, and CQO’s
• Develop plan for embedding frontline training
and application of Lean tools - Target Feb start
for Lean and Systems Engr Overview courses
• Launch RFP process for grants and initiate
projects; Grant solicitation and approval – MarMay; approvals in June
• First (to be annual) conference in Galveston,
April 13, 2012
• Plan for internships and sabbaticals to begin
Summer and Fall 2012
We need your help …
• Support the effort – learn more about it
• Spread the word at your institution
• Attend the April 13 conference and invite
others
• Look for opportunities to apply for grants –
talk with UT Ind Engrs in your area
• Identify opportunities for system
transformation at your institution
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