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Systems Engineering to Improve Traumatic Brain Injury Care in the Military Health System: Workshop Summary (2009)

Chapter: Appendix D: National Academy of Engineering/Institute of Medicine Preliminary Information-Gathering Meeting: TBI Care System Mapping

« Previous: Appendix C: Operational Systems Engineering Applications Based on Issues Raised by TBI Stakeholders
Suggested Citation:"Appendix D: National Academy of Engineering/Institute of Medicine Preliminary Information-Gathering Meeting: TBI Care System Mapping." National Academy of Engineering and Institute of Medicine. 2009. Systems Engineering to Improve Traumatic Brain Injury Care in the Military Health System: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12504.
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Page 147
Suggested Citation:"Appendix D: National Academy of Engineering/Institute of Medicine Preliminary Information-Gathering Meeting: TBI Care System Mapping." National Academy of Engineering and Institute of Medicine. 2009. Systems Engineering to Improve Traumatic Brain Injury Care in the Military Health System: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12504.
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Page 148
Suggested Citation:"Appendix D: National Academy of Engineering/Institute of Medicine Preliminary Information-Gathering Meeting: TBI Care System Mapping." National Academy of Engineering and Institute of Medicine. 2009. Systems Engineering to Improve Traumatic Brain Injury Care in the Military Health System: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12504.
×
Page 149
Suggested Citation:"Appendix D: National Academy of Engineering/Institute of Medicine Preliminary Information-Gathering Meeting: TBI Care System Mapping." National Academy of Engineering and Institute of Medicine. 2009. Systems Engineering to Improve Traumatic Brain Injury Care in the Military Health System: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12504.
×
Page 150
Suggested Citation:"Appendix D: National Academy of Engineering/Institute of Medicine Preliminary Information-Gathering Meeting: TBI Care System Mapping." National Academy of Engineering and Institute of Medicine. 2009. Systems Engineering to Improve Traumatic Brain Injury Care in the Military Health System: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12504.
×
Page 151
Suggested Citation:"Appendix D: National Academy of Engineering/Institute of Medicine Preliminary Information-Gathering Meeting: TBI Care System Mapping." National Academy of Engineering and Institute of Medicine. 2009. Systems Engineering to Improve Traumatic Brain Injury Care in the Military Health System: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12504.
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Page 152

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Appendix D National Academy of Engineering/ Institute of Medicine Preliminary Information-Gathering Meeting: TBI Care System Mapping December 20, 2007 11:00–16:00 Keck Center of the National Academies, Room 204 500 Fifth Street N.W. Washington, D.C. WORKING PLAN (All times at the discretion of the co-chairs) Goal: Generate critical input for the February 2008 planning commit- tee meeting for the Workshop on Harnessing Operational Systems Engineering to ImproveTraumatic Brain Injury Care in the Military Health System. Means: Bring together TBI care experts from the Military Health System (MHS) with different perspectives on the “system” of care delivery to work together with systems engineering experts to begin to characterize, model, and identify potentially high-yield opportunities for improving (and possibly redesigning) the MHS system of TBI care delivery. 147

148 Systems Engineering to Improve Traumatic Brain Injury CARE Tasks: • Task 1: Discuss the overall objectives of the project/workshop. • Task 2: Reach a shared understanding of – the boundaries, structure, dynamics, and constraints of the current MHS TBI care system (clinical/work processes, work flow, patient flows, information, logistics flows, and the like), including the taxonomy of TBI and its implications and the major challenges facing patients, providers, and administra- tors with respect to system performance – the MHS TBI care system in the context of the universe of services for TBI-injured military personnel—the TRICARE system (including civilian care providers), the VA care and benefits system, private-sector health and insurance, fed- eral Supplemental Security Income/Social Security Disability I ­ nsurance (SSI/SSDI) programs, et al. • Task 3: Perform – initial assessment of the potential of systems engineering tools and technologies to maximize the effectiveness of MHS medi- cal mission support, including the range of analysis, modeling, and design tools – initial identification of the MHS TBI care provision prob- lems that can best be addressed using systems engineering principles • Task 4: Identify potential case studies or scenarios that address challenges and opportunities for bringing systems engineering and information technologies to bear to improve TBI care.

appendix D 149 National Academy of Engineering/Institute of Medicine TBI Care System Mapping Meeting December 20, 2007 Room 204, Keck Center 500 Fifth Street, N.W., Washington, D.C. ATTENDEES Norman Augustine (co-chair) (NAE) Retired Chairman and CEO Lockheed Martin Corporation Jerome Grossman, M.D. (co-chair) (IOM) Senior Fellow and Director Harvard Health Care Delivery Project William Bograkos, M.D. Colonel, Medical Corps, U.S. Army Chief Warrior Transition Division Clinical Operations, NARMC Patricia Brennan, M.D., M.S.N. (IOM) [by phone] Chair, Industrial and Systems Engineering College of Engineering and Moehlman-Bascom Professor School of Nursing University of Wisconsin-Madison Paul Casinelli, M.D. Brigadier General, U.S. Army Lynda C. Davis, Ph.D. Deputy Assistant Secretary of the Navy for Military Personnel Policy U.S. Navy Michael Dinneen, M.D. Director, Office of Strategy Management Military Health System Office of the Assistant Secretary of Defense for Health Affairs

150 Systems Engineering to Improve Traumatic Brain Injury CARE Randall Gay Navy Lean Six Sigma (LSS) Master Black Belt DASN (MPP) Katherine Helmick, M.S.N. Deputy Director Clinical and Educational Affairs Defense and Veterans Brain Injury Center Michael Jaffee, M.D. LTC., Medical Corps, USAF Interim National Director Defense and Veterans Brain Injury Center Walter Reed Army Medical Center Donald Jenkins, M.D. (by phone) Colonel, Medical Corps, USAF Director, Joint Theater Trauma System Robert Labutta, M.D. Colonel, Marine Corps, USA Army Office of the Surgeon General Leon Moores, M.D. Colonel, Medical Corps, U.S. Army Deputy Commander for Integration National Naval Medical Center William Nash, M.D. Captain, Medical Corps, USN Combat/Operational Stress Control Coordinator Headquarters, Marine Corps (MR, M&RA) David Orman. M.D. (by phone) Chief, PTSD-TBI/BH Integration HQ U.S. Army Medical Command

appendix D 151 Ronald Poropatich, M.D. Colonel, Medical Corps, U.S. Army Deputy Director Telemedicine and Advanced Technology Research Center William Rouse. Ph.D. (NAE) Executive Director and Professor Tennenbaum Institute Georgia Institute of Technology Jamie Sinks Nurse Practitioner National Naval Medical Center William J. Tanner Commander, Marine Corp USN Major Clifford Trott, Ph.D. Chief Mental Health Officer Office of the Chief Surgeon, NGB-ARS NAE/IOM Staff David Butler, Ph.D. Senior Program Officer IOM Medical Follow-Up Agency Rick Erdtmann, M.D., M.P.H. Director IOM Board on Military and Veterans Health Proctor Reid, Ph.D. Director NAE Program Office

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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.

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