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:
VERC Personnel
About Us
NE-VERC’s operations are organized and managed as illustrated below, consisting of executive and engineering committees, and are deeply connected to VISN 1 and VA Boston operations and leadership structures. Overall day-to-day operations are directed by an Executive Committee, meeting weekly, comprised of the Executive Director, Co-Directors from VA Boston Healthcare System (VABHS) and VISN 1, Associate Directors for Education and Systems Redesign, and the Administrative Officer. Strategic implementation is guided by the Executive and Systems Engineering Committee, meeting every two weeks, including all Directors and leaders from our organizational partners (COLMR, MAVERIC, MIT, Quality Scholars, WPI). Engineering activities such as project monitoring, seed proposal reviews, student project oversight, and educational activities are coordinated by the directors and Systems Engineering committee. Operations are coordinated with VISN improvement activities through shared leadership with the VISN 1 Network Improvement Resource Office (J. Schlosser, Acting Director). Integration with VABHS occurs through the direct oversight of project activities by their Systems Redesign Committee which reports to its Governing Board.
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The VERC Center Team is divided into three main groups: the Leadership Team, the Lead Faculty Partners, and the VA Partners.
2012 VERC Leadership Team
James C. Benneyan, Ph.D.
Director, Healthcare Systems Engineering Institute
Professor of Industrial Engineering
Northeastern University
Dr. James Benneyan is a Professor of Industrial Engineering at Northeastern University, director of Northeastern’s Healthcare Systems Engineering Institute, senior fellow at the Institute for Healthcare Improvement, elected fellow of the Institute for Industrial and Systems Engineers, fellow and faculty of the Institute for Healthcare Improvement, and former Senior Systems Engineer for Harvard Community Health Plan. His primary research interests are in healthcare systems engineering, quality control, simulation, flow and access, adverse event and public health surveillance, and patient safety and risk-benefit models. Benneyan has published over 100 papers in these areas and has received many teaching, service, and research awards. Funding sources include the National Science Foundation, National Institute of Health, and Agency for Healthcare Research and Quality.
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Professor Benneyan is the former vice president of the Institute for Industrial and Systems Engineers, past president of the Society for Health Systems (SHS), former board member of the Health Applications Section of the Institute for Operations Research and Management Science (INFORMS). He is a fellow of SHS and Healthcare Information and Management Systems Society (HIMSS), and serves as editor or editorial board member of Health Care Management Science, IISE Transactions, and Patient Safety and Quality Healthcare. Benneyan also is actively involved in workshops and publications by the National Academy of Engineering, Institute of Medicine, and National Science Foundation to define the national research agenda for healthcare systems engineering.
Lynne Cannavo, RN, MSN
Associate Director, Quality
VA Boston Healthcare System
Lynne Cannavo, RN, MSN is currently the Associate Director of Quality for the VA Boston Healthcare System where as a member of the executive team she provides strategic leadership for organizational improvement. She currently serves on the New England Healthcare System Performance Improvement Council. She has extensive experience in patient safety, quality improvement and team building. She has consulted with staff at a local, regional, and national level on improvement initiatives.
Janis S. Hersh, BSN, MBA
Project Manager
VISN 1 Network Improvement Resource Office
Janis Hersh has contributed to numerous Systems Redesign activities over her three-year tenure with the VA. She directed the Colorectal Cancer Treatment and Improvement Collaborative, 2007–2008 and provided interim support to the current Systems Redesign Cancer Collaborative. Her background includes management roles in clinical departments, information systems, and research settings at several Boston teaching hospitals, including Massachusetts General Hospital and Cambridge Health Alliance. She has extensive experience in quality improvement and coaching teams, and has a special interest in patient centered care. She has facilitated lean workshops in primary care, human resources, and inpatient settings, and developed and taught improvement concepts. She has presented VA work at meetings of the Association of VA Hematology and Oncology and the Office of Quality and Performance.
James E. Schlosser, MD, MBA
Acting Director, VISN 1 Network Improvement Resource Office
James E. Schlosser, MD, MBA is currently the Acting Director of the VISN 1 Network Improvement Resource Office where he provides strategic leadership for organizational improvement. He currently serves on the VA Systems Redesign Outpatient Subcommittee and the VA Primary Care New Leadership Integration workgroup. Dr. Schlosser previously served as Associate Chief of Staff for Ambulatory Care at the Bedford VA Medical Center. Prior to coming to the VA, he served as a Senior Fellow at the Institute for Healthcare Improvement in Boston, MA where he helped developed a national improvement faculty network. Dr. Schlosser also has served (1991-2001) and was a founding board member of the Institute for Healthcare Improvement. He has extensive experience in quality and strategic planning, including serving as a Senior Examiner for the Baldridge National Quality Award. He has designed and led quality training efforts focused on practical strategies for clinical systems improvement.
Vince Watts, MD, MPH
Director VA Patient Safety Fellowship Program
Acting Director/Senior Scholar White River Junction (WRJ) VA Quality Scholar Programs
Dr. Watts received his medical degree from the University of Oklahoma and completed a Psychiatric Residency at Duke University Medical Center. He joined the WRJ VA Medical Center (VAMC) and Dartmouth Medical School faculty in 1998 as Associate Residency Training Director and Director of Inpatient and Acute Psychiatric Services at the WRJ VAMC. He completed a Masters in Public Health at Dartmouth College. He served as the Associate Director of the WRJ site of VA Quality Scholar program for four years before becoming Acting Director in 2008. In addition, he is the national Director of the VA Patient Safety Fellowship. His research interests include patient safety, suicide prevention, and provision of patient centered advanced access care.
2012 VERC Lead Faculty Partners
Sharon A. Johnson, Ph.D.
Director of the Industrial Engineering Program and an Associate Professor of Operations and Industrial Engineering in the Department of Management at Worcester Polytechnic Institute.
Dr. Johnson teaches courses in process and operations management, and facility layout and design. She received her Ph.D. from Cornell University in Operations Research and Industrial Engineering in 1989. Dr. Johnson’s research interests include lean process design and modeling, health care delivery processes, enterprise systems, and curriculum development and student learning. Currently, she is working on a project funded by the National Science Foundation to explore hands-on approaches for teaching lean process design, as well as project exploring the effects of electronic health record systems on care delivery processes, again funded through NSF. Her work has appeared in Operations Research, the Business Process Management Journal, the Case Research Journal and Water Resources Research. She is a member of the Institute of Industrial Engineers (IIE), the Institute for Operations Research Management Science (INFORMS), the Production and Operations Management Society (POMS), and the American Society for Engineering Education (ASEE).
Deborah J. Nightingale, Ph.D.
Professor of the Practice of Aeronautics and Astronautics and Engineering Systems
Co-Director of the Lean Advancement Initiative
Massachusetts Institute of Technology
Professor Deborah Nightingale has over 35 years of broad-based experience with academia, the private sector and the government. Professor Nightingale joined the MIT faculty in 1997 and holds a dual appointment in the Dept. of Aeronautics and Astronautics and the Engineering Systems Division. At MIT she serves as the Co-Director of the Lean Advancement Initiative, a joint industry, government, and MIT consortium. Her research interests are focused on lean enterprise integration, enterprise architecting, and organizational transformation. She has led several executive lean transformation engagements in both industry and government.
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Prior to joining MIT, Professor Nightingale headed up Strategic Planning and Global Business Development for AlliedSignal Engines. She is a member of the National Academy of Engineering and a Past-President and Fellow of the Institute of Industrial Engineers. She is a co-author of the book “Lean Enterprise Value: Insights from MIT’s Lean Aerospace Initiative”. Prof. Nightingale serves on a number of boards and national committees, where she interacts extensively with industry, government and academic leaders.
2012 VERC VA Partners
Leonard D'Avolio, Ph.D.
Associate Center Director of Biomedical Informatics
Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC)
Leonard D’Avolio, Ph.D., is the Associate Center Director of Biomedical Informatics for the VA’s Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC). In his role as Associate Center Director, Dr. D’Avolio is responsible for developing and implementing several initiatives to expand the biomedical informatics capabilities of the Veteran’s Health Administration. Among these initiatives is the Genomic Informatics System for Integrative Science (GenISIS). GenISIS is the VA Office of Research and Development’s new platform for bioinformatics that will support the storage, integration, and analysis of various types of patient data including clinical, specimen, case report form data, genomic, and proteomic data. Dr. D’Avolio’s research interests include natural language processing, information extraction, software development, data quality, machine learning and data mining. Current projects include several Health Services Research and Development (HSR&D) and NIH initiatives with researchers across the VA as well as at UCLA, Brigham and Women’s, Dana Farber, and Mass General. He is also the Boston site-Principal Investigator (PI) for HSR&D’s recently launched Consortium for Healthcare Informatics Research (CHIR) as well as an investigator on the HSR&D/OIT Clinical Data Warehouse initiative designing processes to facilitate researcher access to clinical data. His current research involves the development and application of informatics techniques to analyze and improve the quality of care in the domains of prostate cancer, breast cancer, colorectal cancer, MRSA, and suicide prevention.
Wildon R. Farwell, MD, MPH
Research Faculty
Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC)
Wildon R. Farwell, MD, MPH, is an instructor in Medicine at Harvard Medical School and the Division of Aging, Department of Medicine, Brigham and Women’s Hospital, Boston, MA. He is also Research Faculty at MAVERIC, the Massachusetts Veterans Epidemiology Research and Information Center. Prior to his work in Boston, Dr. Farwell performed research in Indianapolis, IN, under the mentorship of William Tierney, MD, at the Regenstrief Institute and Indiana University. At MAVERIC, Dr. Farwell has extensive experience creating and using large administrative databases for research purposes. He is the PI for a Department of Defense Physician Research Training Award that is investigating the relationship between statins and prostate cancer incidence using the large pharmacoepidemiology research database at the MAVERIC. Dr. Farwell is also the local PI for the ATHENA-HTN project. This project is investigating the utility of a computerized tool to help primary care providers manage their patients with hypertension. Dr. Farwell also teaches medical students and residents from Harvard University and Boston University Schools of Medicine. He is also the Associate Director of the Harvard Faculty Development and Fellowship Program in General Internal Medicine at the VA Boston Healthcare System.
Anand Kartha, MD, MSc
Hospitalist
Boston VA Healthcare System
Anand Kartha, MD, MSc is a hospitalist at Veterans Administration Boston and an Assistant Professor of Medicine at Boston University. He is the Director for the Inpatient Medicine Consult service and Physician Extender service at VA Boston. He is the Rotation Director for the VA Boston Patient Safety/Quality Improvement Ambulatory Rotation. His academic focus includes medical education, patient safety and quality of inpatient care. His research has explored the impact of PTSD and depression on hospitalizations and readmissions, medication reconciliation and the quality of care delivered by Nurse Practitioners in inpatient medicine. He is co-investigator on a multi-site VA study to evaluate organizational characteristics that affect the quality of inpatient care.
Michael F. Mayo-Smith, MD, MPH
Network Director, VA New England Healthcare System
Previously, Dr. Mayo-Smith served as the national Chief Consultant, Primary Care and Director, Primary Care Service Line, VA New England Healthcare System. His VA career began in 1987 at the Manchester VA Medical Center where he held positions including: Medical Director for the Hospital Based Home Care Program, Director of the Substance Abuse Treatment Program, and Associate Chief of Staff for Ambulatory Care.
He received his Bachelor's degree in Science from Amherst College, his medical degree from Hahnemann University, and he received a Masters in Public Health from Harvard University School of Public Health. Dr. Mayo-Smith is board certified in Internal, Emergency, Geriatrics and Addiction Medicine. He has been on the faculty at Harvard and Dartmouth Medical Schools and has published numerous research articles related to clinical epidemiology and primary care. Dr. Mayo-Smith is involved in the following committees: VHA National Leadership Board (NLB), VHA Systems Redesign Steering Committee, and the VHA Performance Management Workgroup (co-chair).
Carol VanDeusen Lukas, Ed.D
Senior Investigator, COLMR
Clinical Associate Professor of Health Policy and Management, Boston University School of Public Health
Dr. VanDeusen Lukas brings to NE-VERC research expertise in organizational change, implementation of clinical innovations and program evaluation. Dr. VanDeusen Lukas currently leads an organizational intervention study working with 3 VISNs and 17 VA medical centers to strengthen their abilities to regularly adopt innovative and evidence-based clinical practices to improve the quality of patient care. At BU, she directs the BU Safety Net ACTION Partnership, a coalition of researchers and healthcare service delivery systems selected to participate in the Agency for Healthcare Research and Quality's initiative, Accelerating Change and Transformation in Organizations and Networks (ACTION); ACTION's objective is to develop strategies to translate research into practice quickly to improve healthcare quality and efficiency. She was an investigator on the evaluation of the Robert Wood Johnson Foundation’s Pursuing Perfection, a major initiative of to transform healthcare systems to provide perfect care to patients; the evaluation produced a model for moving organizations from short-term, isolated performance improvements to sustained organization-wide evidence-based improvements in patient care.