Closing the Loop by Operationalizing Systems Engineering and Design (CLOSED)
Motivation:
Specific Aims :
Aim 1:​Use systems engineering and patient engagement to design, develop, and refine a highly reliable “closed loop” system for diagnostic tests and referrals that ensures diagnostic orders and follow-up occur reliably within clinically- and patient-important time-frames.
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Aim 2: Use systems engineering and patient engagement to design, develop, and refine a highly reliable “closed loop” system for symptoms that ensures clinicians receive and act on feedback about evolving symptoms and physical findings of concern to patients or clinicians.
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Aim 3: Design for generalizability across health systems more broadly so that the processes created in Aims 1 and 2 are effective in (1) a practice in an underserved community, (2) a large tele-medicine system, and (3) a representative range of simulated other health system settings and populations.
Partners:
Sunday, June 2, 2019
Sunday, June 2, 2019
Approach:
Sunday, June 2, 2019
Results to Date:
Research >> NSF Research Center
Reducing unnecessary pre-operative testing
About
Unnecessary services are a significant burden on the US healthcare system, with an annual cost over $200 billion and no clear patient benefits. Overuse of pre-operative tests alone reaches $18 billion per year, despite evidence-based guidelines against routine screening of healthy patients undergoing low-risk surgeries. This project aimed to reduce pre-operative electrocardiogram (ECG), pre-operative hematocrit (Hct), coagulation, and/or complete blood count (CBC) testing to for low-risk procedures.
Results
We reduced unnecessary ECG from 43% to 6% in one hospital and from 51% to 4% in the second one. Unnecessary blood tests were reduced from 81% to 63% in one hospital and from 93% to 60% in the second. The reductions lead to an estimated annual savings of $100,000 as well as total staff time savings of 55 hours per month.