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:
W. T. Grant
Purpose
The Adoption and Foster Care Analysis and Reporting System estimates 720 children enter foster care every day in the United States. Approximately 90% of these children have experienced trauma, which lead to a federal mandate in 2011 requiring trauma informed screening and services to be available for all children in this population. Although each state is required to provide these services, there is a high level of variability in how policies were created and which tools were selected to implement the mandate. HSyE has partnered with a mixed methods team from Rutgers University to examine the use of research evidence among people that create foster care policies across US states.
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The members of the team from Rutgers University conduct interviews with policy makers from different states on a rolling basis. After the interviews have been transcribed and deidentified, they are shared with the HSyE team. The HSyE team works together to extrapolate data from the interviews, and applies systems engineering tools that ‘fit’ the interview based on the information provided. These systems engineering tools- including swim lane diagrams, System Theoretic Process Analysis (STPA), Influence Diagrams and Functional Resonance Analysis Method (FRAM)- are applied to multiple states, and presented back to the Rutgers team to assess validity and utility of the tool. Presenting the tools also guides changes in the interview approaches for the Rutgers team, leading to analysis improving with each iteration.
Methods
Partners & Research Team
PI: James Benneyan, PhD, HSyE
Annie Shutt, HSyE​
Ashley Holmes, MS, HSyE
Katie Smith, HSyE
Nicole Nehls, HSyE
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PI: Tom Mackie, PhD, MPH, Rutgers University
Erick Rojas, JD, Rutgers University
Ana Cotroneo, Rutgers University
Results
Through use of a multidisciplinary team, the mixed methods specialist and systems engineers continue to learn from each other and come up with inventive ways to present information about policy making. Although the utility of each tool varies from state to state, they all provide insight into different ways to influence policy makers, and what considerations must go in to making sustainable policy.