Paul M. Griffin & Harriet B. Nembhard 
Healthcare Systems Engineering [PDF ebook] 

Chapter 1 The Healthcare Delivery System
Overview
1.1 Healthcare Delivery Components
1.2 Major Stakeholders
1.3 Global Issues in Health
Global Spending
Global Outcomes
Unique Challenges
1.4 Drivers for Healthcare Systems
Financial
Population Health and Wellness
Equity
Quality–First, Do No Harm
Electronic Health Records
Point of Care
Personalized Medicine
Questions and Learning Activities
References
Chapter 2 Complexity and Systems in Healthcare
Overview
2.1 Taking a Systems Approach to Healthcare
2.2 Complex Adaptive Systems
Defining Characteristics of Complex Adaptive Systems
Complexity in Healthcare
Case 2a: Complexity in Chronic Kidney Disease
2.3 Systems Thinking and System Dynamics
Dimensions of Systems Thinking
Linear vs. Feedback Perspectives
Methodologies
Causal Loop Diagrams
Case 2b: Systems Thinking and Causal Loop Diagrams in CKD
Stock Flow Model
Case 2c: System Dynamics and Stock Flow Diagrams in CKD
Questions and Learning Activities
References
Chapter 3 Patient Flow
Overview
3.1 Healthcare Settings and Clinical Workflows
Primary Ambulatory Care
Specialty Ambulatory Care
Emergency Care
Outpatient Surgical Center
Operating Room Care
Inpatient Care
Long-Term Care
3.2 Patient Flow through a Hospital
Admission and Discharge
ED Capacity and Crowding
Boarding
OR Scheduling
Variability
3.3 Care Transitions
Transfers within a Hospital
Patient Transfer from the ED to Inpatient
Primary Care to Specialty Care
Inpatient Setting to Long-Term Care Facilities
Inpatient Setting to Home
3.4 Process Mapping
Benefits of Process Mapping
Creating a Process Map
3.5 Queuing
3.6 Case Study: ED Crowding–A Patient Flow Solution
Questions and Learning Activities
References
Chapter 4 Healthcare Financing
Overview
4.1 Financing Models for Health Services
Insurance and Third-Party Payment
Agency Issues
Government-Provided Insurance
Universal Healthcare
4.2 Compensation Models for Providers
Fee for Service
Bundled Payments–Diagnostic-Related Groups
Pay-for-Performance Plans
Shared Savings Plans
Capitation
4.3 Cost Allocation and Charges
Costs
Setting Charges
Cost Shifting
4.4 Capital Budgeting
Net Present Value
Project Selection
References
Chapter 5 Health Data and Informatics
Overview
5.1 Healthcare Data
5.2 Electronic Health Records
Computerized Physician Order Entry
Clinical Decision Support Systems
Meaningful Use
5.3 Health Information Exchange
5.4 Publicly Reported Healthcare Data
Hospital Compare
Health, United States
Medicare Provider Charge Data
State Departments of Health
5.5 Case Study
Health Informatics at a Hospital–a 10-Year Journey
Questions and Learning Activities
References
Chapter 6 Lean
Overview
6.1 Lean Philosophy and Methods
6.2 Drivers for Lean Healthcare Systems
Driver 1: Define Value Based on the Voice of the Patient (Customer)
Driver 2: Create an Environment That Supports the Staff
Driver 3: Eliminate All Forms of Waste
Driver 4: Deliver Excellent Clinical Quality
6.3 A Toolset for Eliminating Wastes
6.4 Value Stream Mapping
6.5 A3
6.6 5S
6.7 Kanban
6.8 Lean Implementations
6.9 Lean Thinking
Questions and Learning Activities
References
Chapter 7 Six Sigma
Overview
7.1 Six Sigma Philosophy
7.2 Six Sigma Quality
Six Sigma Costs and Benefits
Six Sigma DMAIC Methodology
Define Phase Concepts and Tools
Critical to Quality (CTQ) Flowdown
SIPOC
Measure Phase Concepts and Tools
Cause-and-Effect Diagram
Pareto Chart
Analyze Phase Concepts and Tools
Failure Modes and Effects Analysis
Improve Phase Concepts and Tools
Lean Thinking and Lean Tools
Comparative Experiments
Design of Experiments
Control Phase Concepts and Tools
Statistical Process Control
Control Plan and Documentation
Six Sigma Implementations
Leading Change
Strategy and Strategic Management
Change Management
Health Organization Transformation
Six Sigma in Translational Research
Questions and Learning Activities
References
Chapter 8 Reliability and Patient Safety
Overview
8.1 Human Reliability
8.2 Errors in Healthcare
8.3 Medication Errors
Poor Prescription
Illegible Handwriting
Wrong Medication Administration
8.4 Patient Falls
Risk Factors
Risk Mitigation Strategies
Risk Factor Assessment and Screening
Individual Interventions
System Redesign (Environmental Interventions)
8.5 Human Factor and Ergonomics for Patient Safety
Individuals
Situation Awareness
Decision-Making Support
Methods for Better Medical Decision Making
Technology
Medical Device Design
Organization
Communication
Questions and Learning Activities
References
Chapter 9 Health Analytics
Overview
9.1 Data Mining
Definition and Methodologies
Preprocessing
Data Mining
Interpretation/Evaluation
Medical Data Mining
Mining Claims Data
Mining Clinical Trial Data
Mining Adverse Drug Reaction Incidents
Mining Healthcare Market Segments
Case 9.1: Predicting Parkinson’s Disease Using Data Mining
Data Acquisition and Preprocessing
Data Mining and Knowledge Discovery
Results
9.2 Data Visualization
Definition and Function of Data Visualization
Brief History of Data Visualization
Data Visualization Techniques Today
The Data Visualization Process
Perception
Human Factors in Data Visualization
Data Visualization in Healthcare Practice
Technique 1: Icon Arrays
Technique 2: Magnifier Risk Scale
Technique 3: Risk Scale
Technique 4A: Timeline
Technique 4B: Timeline Belt
Technique 5: Heatmap
Technique 6: Kaleidomaps by Bale et al.
Technique 7: Timeline Browser by Cousins and Kahn
Technique 8: Glyph
Technique 9: Overlaps and Interconnections
Case 9.2: Data Visualization in Obesity Counseling
Questions and Learning Activities
Social Network Analysis
Network Representation
Descriptive Network Properties
Case 9.3: SNA in a Pediatric Intensive Care Unit (PICU)
Data Envelopment Analysis
DEA Models
Model Formulations
Case 9.4: Using DEA for Finding Best-in-Class Hospitals in a Network
Multicriteria Decision Making
MCDM Terms and Concepts
Goal Programming
Case 9.5: Use of GP to Optimize Helicopter Emplacement at Medical Treatment Facilities
Questions and Learning Activities
References
Chapter 10 Capacity Management
Overview
10.1 Capacity Management Challenges
10.2 Managing Nursing Units
Boarding
Diversion
Transferring Patients
10.3 Managing Operating Rooms
Determining Block Times
Block Scheduling
Block Scheduling in Practice
10.4 Managing Diagnostic Units
10.5 Nurse Staffing and Scheduling
References
Chapter 11 Healthcare Logistics
Overview
11.1 Facility Location
Basic Location Models
Location of Healthcare Facilities
Willingness-to-Travel Constraints
Choice Constraints
Equity Modeling
Model Formulation
11.2 Home Healthcare Routing and Scheduling
HHC Routing/Allocation
HHC Heuristics
References
Chapter 12 Health Supply Chains
Overview
12.1 Forecasting Demand
Time Series Models
Forecast Error
12.2 Inventory Control
Deterministic Models
Stochastic Models
Newsvendor Model
12.3 Healthcare Distribution
Distribution Requirements Planning
Transportation Planning
Vendor Management Inventory
Cold Chains for Healthcare Products
12.4 Coordinating Activities in the Supply Chain
Pooling
Information Sharing
Supply Chain Contracting
References
Chapter 13 Infection Control
Overview
13.1 Historical Perspective
13.2 Infection Control Classification
13.3 Checklists for Infection Control
13.4 The Case of Sepsis
13.5 Mathematical Modeling of Hospital Infection Control
Compartment Models
Compartment Model Applied to Hand Washing
Tuberculosis Infection Control
References

PAUL M. GRIFFIN, PHD, is the Joseph C. Mello Chair and Professor of Industrial Engineering at Georgia Tech.
HARRIET B. NEMBHARD, PHD, Is a Professor of Industrial Engineering at Pennsylvania State University. She is Director of the Center for Integrated Healthcare Delivery Systems.
CHRISTOPHER J. DEFLITCH, MD, is the Chief Medical Information Officer and an Associate Professor of Emergency Medicine at the Pennsylvania State University Hershey Medical Center.
NATHANIEL D. BASTIAN, PHD, is a Healthcare Operations Research Analyst in the United States Army Medical Department.
HYOJUNG KANG, PHD, is a Research Assistant Professor of Systems and Information Engineering at the University of Virginia.
DAVID A. MUÑOZ, PHD, is a consultant at Mc Kinsey & Company.