Full Center Proposal (Phase I) for an I/UCRC for Health Organization Transformation
0832439 Texas A&M University System (lead institution); Larry Gamm 0832390 Georgia Institute of Technology; Eva Lee
Texas A &M Health Science Center and Georgia Tech propose a center "Center for Health Organization Transformation"(CHOT)to conduct mixed methodology, applied research on the antecedents, execution, and effects of transformational interventions and strategies that combine evidence-based management, clinical and information technology innovations, and ongoing organizational learning and cultural change. The proposed work can result in improved health care quality and more effective use of financial and system resources in the delivery of health care. The research is designed to produce transformation in a critical industry, and the proposed team makes a credible case that the scope of the problem indicates a need for whole-system, transformative change.
Since the health care sector is a significant segment of the US economy, enabling more effective use of resources within this sector could positively impact the economy. More specifically, the proposed research will benefit quality of patient care, operations efficiency of the healthcare delivery systems, and workforce transformation. These successes will be propagateda cross the practicing health systems in the nation through the center's industrial partners as well as the center directors and investigators.Research teams for the proposed center are made up of a diverse set of research faculty and graduate students,working closely with health system leaders. The center activities will support improvements in both masters' and doctoral level education and research. Broader dissemination will occur via professional and academic associations and conferences,and other mechanisms. Both schools are committed to inclusion of a diverse faculty and student body.
This project focuses on transformative research in four major healthcare areas: patient safety and quality, health information technology and meaningful use of electronic medical records, clinical care and quality outcome, and optimal delivery and care coordination. Our approaches involve systems advances focusing on these multifaceted problems with prospective, multi-disciplinary, and multi-level research strategies that also take advantage of quasi-experimental designs and natural experiments, where feasible. In five years the engineers and computational scientists work along with health service, management, and clinical teams to achieve sustained organizational innovation. The work advances the frontiers of knowledge in operations research, systems engineering, and big data analytics in several areas. Specifically, large-scale simulation-optimization models, predictive models and computational engines, and risk-decision and optimization algorithms are developed and advanced. Process mapping and time-motion study are designed and performed for complex clinical and patient processes. Large-scale clinical data have been extracted and analyzed for outcome prediction. The work advances engineering, computational science, and healthcare methodologies. The work advances and transforms healthcare delivery towards safe, effective, efficient, timely, equitable and patient centered. Specifically, the readmission and optimal clinical workflow study results in 30% reduction in length of stay, 70% reduction in wait time, 28% in readmission, 30% reduction in left-without-being-seen, 10% reduction in hospital admission. The work also increases 19% of emergency department patients seen, reduces 32% non-urgent visits, increases trauma volume and referral from outside hospitals, and decreases door to care access for stroke patients (decreases disability). The surgical site infection study reduces from 23% infection in 2011 to 0% infection in 2012 and 2013 for cardiovascular bypass graft. This amounts to reduce mortality and improve quality of life of patients. Beyond improving quality and timeliness of care, and efficiency of delivery, our work also contributes to financial savings as a result of reducing penalties and reducing wastes of critical hospital resources (bed, labor, time for care). The models and methodologies developed are generalizable and have been applied to other sites (outside the IAB health systems) and industry domain, thus asserting greater global impact. Results from our studies contribute significantly to the efficiency and quality of care offered by our industry partners as a result of effective implementation of transformational strategies and interventions. It has helped the participating health systems to meet consensus aims for health care established by the Institute of Medicine. It supports the health systems' more effective use of organizational technologies and personnel to meet increased demands for accountability and to be viewed as an economic driver and service leader and not as a drain on the larger economy. Because of the specific demographics served by our health systems leaders, our center work has contributed to reduce health disparities, an important roadmap to the healthcare delivery in this country. Educational training and hands-on experience of students in these multi-disciplinary collaborative effort help to produce future young leaders in this cross-boundary field. The organizational transformation resulted from our studies is recognized by the INFORMS Daniel H. Wagner Prize for Excellence in Operations Research Practice, and the Franz Edelman Award, the world’s most prestigious recognition for excellence in applying advanced analytics to benefit business and humanitarian outcomes.
