This book makes a strong case for taking advantage of the best of two disciplines--health care and operational systems engineering (a combination of science and mathematics to describe, analyze, plan, design, and integrate systems with complex interactions among people, processes, materials, equipment, and facilities)-to improve the efficiency and quality of health care delivery, as well as health care outcomes.

Those most interested in pursuing this approach include leaders in the U.S. Department of Defense (DOD) and Department of Veterans Affairs, who are committed to finding ways of improving the quality of care for military personnel, veterans, and their families. Intrigued by the possibilities, DOD decided to sponsor a series of workshops to explore the potential of operational systems engineering principals and tools for military health care, beginning with the diagnosis and care of traumatic brain injury (TBI), one of the most prevalent, difficult and challenging injuries suffered by warriors in Iraq and Afghanistan.

Contents

• THE NATIONAL ACADEMIES
• WORKSHOP STEERING COMMITTEE ON SYSTEMS ENGINEERING HEALTH CARE: TOOLS AND TECHNOLOGIES TO MAXIMIZE THE EFFECTIVENESS OF MEDICAL MISSION SUPPORT TO DOD
• [Dedication]
• Preface
• Acknowledgments
• Acronyms/Abbreviations
• Summary
• 1. Introduction
  • HEALTH CARE QUALITY AND COST CHALLENGES FACING THE MILITARY HEALTH SYSTEM
  • THE OPERATIONAL SYSTEMS ENGINEERING IMPERATIVE FOR THE MILITARY HEALTH SYSTEM
  • GOALS OF THE WORKSHOP
  • THE CHALLENGE OF TRAUMATIC BRAIN INJURY CARE
  • ORGANIZATION OF THE WORKSHOP SUMMARY
  • REFERENCES
• 2. Medical Aspects of Traumatic Brain Injury
  • DEFINITION AND CATEGORIZATION OF TRAUMATIC BRAIN INJURY
  • TRAUMATIC BRAIN INJURY IN THE MILITARY ENVIRONMENT
  • DIAGNOSIS AND TREATMENT
  • REFERENCES
• 3. Traumatic Brain Injury and the Military Health System
  • THE MAGNITUDE OF THE CHALLENGE
  • COMPONENTS OF AN EFFECTIVE CARE DELIVERY SYSTEM
  • RESEARCH QUESTIONS AND INITIATIVES
  • REFERENCES
• 4. Examples of Operational Systems Engineering Applications Relevant to Traumatic Brain Injury Care
  • EXAMPLE 1 DYNAMIC INFLUENCE DIAGRAMS FOR MEDICAL DECISION MAKING
  • EXAMPLE 2 SCREENING BLOOD FOR THE HUMAN IMMUNODEFICIENCY VIRUS ANTIBODY
  • EXAMPLE 3 POLICY DECISION MODELING OF THE COSTS AND RESULTS OF MEDICAL SCHOOL EDUCATION
  • EXAMPLE 4 THE HEALTHCARE COMPLEX MODEL
  • EXAMPLE 5 A MIXED-INTEGER PROGRAMMING MODEL TO LOCATE TRAUMATIC BRAIN INJURY TREATMENT UNITS IN THE VA
  • CONCLUSION
  • REFERENCES
• 5. Case Study Vanderbilt’s Journey Toward System-Supported Practice
• 6. Suggestions for Analysis Plans by Working Groups
  • WORKING GROUP A: DEVELOPMENT OF NEW TBI KNOWLEDGE
  • WORKING GROUP B: DETECTION AND SCREENING OF TBI CONDITIONS
  • WORKING GROUP C: COORDINATION AND COMMUNICATION FOR TBI CARE
  • WORKING GROUP D: MEASURING AND FORECASTING THE DEMAND FOR TBI CARE
  • WORKING GROUP E: CAPACITY, ORGANIZATION, AND RESOURCE ALLOCATION FOR A TBI CARE SYSTEM
  • SUMMARY
  • REFERENCES
• Appendixes
  • Appendix A Biographical Information
  • Appendix B Issues Raised by Stakeholders about the Military Care of Patients with Traumatic Brain Injury
  • Appendix C Operational Systems Engineering Applications Based on Issues Raised by TBI Stakeholders
  • Appendix D National Academy of Engineering/ Institute of Medicine Preliminary Information-Gathering Meeting: TBI Care System Mapping
  • Appendix E Workshop Agenda
  • Appendix F Workshop Attendees
  • Appendix G Working Groups
  • Appendix H Definitions and Examples of Operational Systems Engineering Tools and Concepts

Support for this project was provided by the U.S. Army (Award No. W81XWH-07-P-0979). Any opinions, findings, or conclusions expressed in this publication are those of the workshop participants and do not necessarily reflect the view of the organization that provided support for the project.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Science, the National Academy of Engineering, and the Institute of Medicine.