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Suggested Citation:"Appendix E: Workshop Agenda." 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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Suggested Citation:"Appendix E: Workshop Agenda." 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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Suggested Citation:"Appendix E: Workshop Agenda." 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 155
Suggested Citation:"Appendix E: Workshop Agenda." 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 156
Suggested Citation:"Appendix E: Workshop Agenda." 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 157
Suggested Citation:"Appendix E: Workshop Agenda." 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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Appendix E Workshop Agenda Harnessing Operational Systems Engineering to Improve Traumatic Brain Injury Care in the Military Health System June 11–12, 2008 Keck Center of the National Academies, Room 201 500 Fifth Street, N.W. Washington, DC 20001 Workshop Goal: To demonstrate the potential value of operational systems engineering (OSE) to improve the care of traumatic brain injury (TBI) in the Military Health System (MHS). DAY 1 8:00 Welcome and Introductions Norman Augustine, M.S.E., Lockheed Martin Corp (ret.) and Plan- ning Committee Co‑Chair (NAE) Judith Salerno, M.D., M.P.H., Executive Officer, Institute of Medi- cine S. Ward Casscells, M.D., Assistant Secretary of Defense for Health Af- fairs 153

154 Systems Engineering to Improve Traumatic Brain Injury CARE Session I: background and overview Session Objective: To provide a general background on the goals of the workshop, the current system of care for traumatic brain injury in the military, and general utility of operational systems engineering tools and techniques in other health care areas. Session Moderator: Norman Augustine 8:20 Traumatic Brain Injury Case Histories from the Military: “Survive, Thrive, Alive” Video 9:00 Medical Aspects of Traumatic Brain Injury Robert Labutta, COL, M.D., Medical Corps, US Army, TBI Senior Executive (Interim) Defense Center of Excellence for Psychological Health & Traumatic Brain Injury 10:15 The “As Is” System for TBI Management in the Military Health System Michael S. Jaffee, COL. (s), M.D., (USAF) National Director, Defense and Veterans Brain Injury Center 11:15 Operational Systems Engineering Examples from Other Health Areas William P. Pierskalla, Ph.D., Anderson Graduate School of Manage- ment University of California, Los Angeles (NAE) Session II: working groups formulate Analysis Plans for identified MhS TBI CARE System analysis issues Session Objective: To demonstrate the kinds of approaches, methods, and information that can be developed by OSE practitioners to assist TBI care providers and managers. After receiving guidance from the planning committee, five multidisci- plinary working groups will convene to develop analysis plans for future OSE studies that could advance understanding of selected major chal- lenges facing the TBI care delivery system. 11:45 Target TBI Care System Analysis Issues for Working Groups Seth Bonder, Ph.D., The Bonder Group (NAE)

appendix E 155 1:15 Working Groups Session 1 Each working group will be asked to develop brief analysis plans for future operational systems engineering studies that could be used to assist providers and managers address important challenges facing the TBI care delivery system. Each working group will work on pre-selected challenges in one of five major categories of TBI care analysis issues identified by the planning committee: (A) new TBI knowledge; (B) detection and screen- ing of TBI conditions; (C) TBI care coordination and com- munication; (D) TBI care demand; and (E) TBI care system capacity, organization, and resource allocation. Working Group Meeting Rooms: Working Group A: Developing New TBI Knowledge [Keck 206] Working Group B: Detection and Screening of TBI Conditions [Keck 207] Working Group C: TBI Care Coordination and Communication [Keck 208] Working Group D: TBI Care Demand [Keck 213] Working Group E: TBI Care System Capacity, Organization, and Resource Allocation [Keck 201] 4:30 Working Group Interim Reports and Discussion Moderator: Norman Augustine 5:30 Adjourn to Reception and Working Dinner 5:45 Reception and Working Dinner Keck Center Atrium Keynote: Insights from Vanderbilt’s Journey toward System- S ­ upported Practice William Stead, M.D., Associate Vice Chancellor for Strategy/Trans- formation and Director of the Informatics Center at Vanderbilt University Medical Center (IOM)

156 Systems Engineering to Improve Traumatic Brain Injury CARE DAY 2 8:00 Welcome and Recap of the First Day Denis Cortese, M.D., Mayo Clinic and Planning Committee Co-Chair (IOM) Norman Augustine, M.S.E., Lockheed Martin Corp (ret. ) and Plan- ning Committee Co‑Chair (NAE) Session II (Cont’d): working groups formulate Analysis Plans for identified MhS TBI CARE System ANALYSIS issues Session Objective: The five multidisciplinary working groups will recon- vene to formulate “analysis plans” for two or more identified TBI care system analysis issues. 8:15 Working Groups Session 2 (in Breakout Rooms) Working Group Meeting Rooms: Working Group A: Developing New TBI Knowledge [Keck 206] Working Group B: Detection and Screening of TBI Conditions [Keck 205] Working Group C: TBI Care Coordination and Communication [Keck 208] Working Group D: TBI Care Demand [Keck 213] Working Group E: TBI Care System Capacity, Organization, and Resource Allocation [Keck 201] Session III: Report out of BReAKOUT group discussions 1:00 Working Group Reports and Discussion [Convene in Keck 201] Moderator: Denis Cortese

appendix E 157 Session IV: panel discussion Issues, opportunities, and potential next steps Session Objective: To identify the most valuable analysis plans set forth by the working groups that would, if implemented, significantly im- prove the care of TBI in the military. Session Moderator: Denis Cortese 3:30 Provider/Policy-Maker Perspectives on Working Group Outcomes: Panel and Moderated Discussion Michael S. Jaffee, COL. (s), M.D., (USAF) National Director, Defense and Veterans Brain Injury Center Michael Dinneen, Director, Office of Strategy Management, Military Health System 4:30 Concluding Summary Remarks and Adjournment Norman Augustine and Denis Cortese Planning Committee: Norman R. Augustine, M.S.E. (NAE/NAS), Co-Chair, Lockheed Mar- tin Corporation (ret.) Jerome H. Grossman, M.D. (IOM), Co-Chair (November 2007 to April 2008) Denis Cortese, M.D. (IOM), Co-Chair, Mayo Clinic (Beginning April 2008) Seth Bonder, Ph.D. (NAE), The Bonder Group Patricia Flatley Brennan, Ph.D. (IOM), University of Wisconsin- Madison Thomas F. Budinger, M.D., Ph.D. (IOM/NAE), University of Califor- nia, Berkeley Barrett S. Caldwell, Ph.D., Purdue University Michael P. Dinneen, M.D., Ph.D., Military Health System Paul M. Horn, Ph.D. (NAE), New York University Michael S. Jaffee, COL (s), M.D., USAF, National Director, Defense and Veterans Brain Injury Center

158 Systems Engineering to Improve Traumatic Brain Injury CARE William P. Nash, M.D., CAPT, Medical Corps, USN (ret.), USMC/ USN Liaison to the Defense Center of Excellence for Psychological Health and TBI Alexander K. Ommaya, Sc.D., Department of Veterans Affairs David T. Orman, M.D., COL (ret.), HQ, U.S. Army MEDCOM Ronald Poropatich, M.D., COL, Medical Corps, U.S. Army, Telemedi- cine and Advanced Technology Research Center (TATRC) William B. Rouse, Ph.D. (NAE), Georgia Institute of Technology Nina A. Sayer, Ph.D., LP, Department of Veterans Affairs Health Ser- vices Research & Development Center for Excellence This workshop is dedicated to Jerome H. Grossman, M.D., a long-time member, friend, and leader in the work of the National Academies. By nature and profession, Jerry was a bridge builder. He was the liaison between the Institute of Medicine and the National Academy of Engineering and the primary motivator and intellectual compass for this workshop and its focus on harnessing systems engineering tools, techniques, and knowledge to improve the quality of traumatic brain injury care in the Military Health System. He passed away suddenly on April 1, 2008.

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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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