CHEPS News

Bagian November 13, 2017:

On November 13, 2017, the Providing Better Healthcare through Systems Engineering seminar featured Center for Healthcare Engineering and Patient Safety Director, James Bagian. In addition to his position as Director here at CHEPS, Dr. Bagian is a Professor in the Department of Anesthesiology in the Medical School and in the Department of Industrial and Operations Engineering in the College of Engineering at the University of Michigan. Previously, he served as the first Director of the VA National Center for Patient Safety (NCPS) and the first Chief Patient Safety Officer for the Department of Veterans Affairs from 1999 to 2010 where he developed numerous patient safety related tools and programs that have been adopted nationally and internationally. Presently, he is applying systems engineering approaches to the analysis of medical adverse events and the development and implementation of systems-based corrective actions that will enhance patient safety primarily through preventive means.

In his presentation on “Patient Safety: Challenges and Ways to Overcome Them,” Dr. Bagian discussed how patient safety has become a commonly recognized challenge among not only care providers but also among patients throughout the world. Its rise to prominence was spurred by the Institute of Medicine’s (now called the National Academy of Medicine) landmark report titled ‘To Err Is Human.’ While initially, there was a good deal of denial in the medical profession that the level and frequency of harm to patients was not as high as the report contended, 44,000 to 98,000 annually, there was general agreement that the number by any accounting was too high. More recently, there have been reports that put the annual number of deaths as high as 250,000 making it the 3rd leading cause of death in the USA. This increase in the reported number of patients harmed may be more a result of the methods used in the counting process rather than an increase in the risk of harm due to care but reinforces the reality that the risk is still one that can benefit from corrective action.

Dr. Bagian discussed some of the barriers to improvement. Obstacles to improvement range from a failure to acknowledge that the problem exists, to who is responsible, to an over-simplistic and superficial perspective that seldom goes past the determination of proximate cause and implementation of siloed symptom-based corrective actions. The failure to routinely take a systems-based approach to the identification of vulnerabilities that place the patient at risk and failure to formulate and implement corrective actions that address these foundational vulnerabilities are the principal challenges that the patients and healthcare faces today. Dr. Bagian ended his seminar with a discussion of potential approaches to overcome the barriers to improvement.

Please join us on Monday, November 20th, 2017 to hear Dr. Geoffrey Barnes discuss “Health Systems Engineering and Implementation Science: Using the Best of Both Worlds to Standardize Periprocedural Anticoagulation.”

symposium
symposium
symposium
November 6, 2017:

On Monday November 6th, 2017 over 120 guests gathered for the annual Healthcare Engineering and Patient Safety Symposium. Posters were on display representing a variety of research and projects from inside and outside of the university. Attendees came from throughout the university, representing Engineering, the School of Public Health, the Health System, the Medical School, the School of Nursing, and the Institute for Healthcare Policy and Innovation. Several, like returning alumni and local corporate representatives, also attended from outside the university. Attendees mingled throughout the poster rooms, learning about the research students and faculty are doing, and connecting with new and old friends.

This year’s poster winner was “A Dynamic Approach to Improve Chemotherapy Pre-mix Policies” presented by Donald Richardson, Hwon Tak, Matthew See, and Amy Cohn. Lauren Steimle also took home some treats after winning the raffle for tweeting about the symposium!

For the second time this year, alumni didn’t just attend the symposium and the traditional reunion dinner held the Friday before, several also took the time to hold a panel discussion for current CHEPS students. The panel focused on allowing participants to share their experiences in the healthcare field and answer questions about the industry.

One of the best parts of the symposium is seeing how big the CHEPS community has grown over the past year, and this year we had quite an impressive crowd. The energy and passion for collaboration and healthcare improvement was evident throughout the night. Thank you to everyone who joined us!

Burke October 30, 2017:

On October 30, 2017, Dr. David Burke presented a seminar titled, “‘Deep Monitoring’ Chronic Disease in Underserved and Remote Populations” as part of the Providing Better Healthcare through Systems Engineering seminar series. His seminar reviewed initiatives led by University of Michigan faculty and external partners to address the growing challenge of chronic disease throughout the world, an issue exacerbated by a global healthcare workforce shortage.

Dr. Burke discussed how his team is co-opting technologies to aid in monitoring and patient education of chronic disease, especially in underserved populations. His team uses parallel technology strategies that rely on high-volume manufacturing of digital electronics and standardized transportation. Dr. Burke provided examples of applications, including coopting digital cameras and a video game system to use in remote health monitoring, as well as a renovated shipping container that can be used as a setting for providing vision or dental exams. His team’s impressive work is already making a difference in several areas including Jamaica; a short video about the team’s innovative eye clinic can be found here: https://www.youtube.com/watch?v=_qfhuoYZoIY.

The work of Dr. Burke and his colleagues is providing great value to the University of Michigan, as well as external communities, through their impact on service, education, and research.

Please note: There will be no seminar on Monday November 6. In its place, please join us from 5-7:30PM in the 3rd and 4th floors of the Robert H. Lurie Engineering Center for the 2017 Healthcare Engineering & Patient Safety Symposium, RSVP here!

informs
informs
October 25, 2017:

The Center for Healthcare Engineering and Patient Safety (CHEPS) made a strong appearance at the Institute for Operations Research and the Management Sciences (INFORMS) Conference in Houston, Texas from October 22 – 25, 2017. This conference is one of the largest for those in operations research.

CHEPS brought a dedicated healthcare research presence, with each attendee presenting their research, either orally or by poster. Specifically, the CHEPS presentations at the conference were as follows:

  • Amy Cohn: Analysis of Patient Access for a Specialty Endocrinology Clinic
  • Rachel Moeckel: Challenges With Data Collection In Methods To Reduce Clinic Wait Times
  • Billy Pozehl: Algorithms to Generate Annual Rotation Schedules for Medical Residents
  • Donald Richardson: Predicting Patient Treatment Deferrals/no-shows To Improve Chemotherapy Pre-mix Policies
  • Bassel Salka: Night Team Scheduling For Pediatric Inpatient Residents
  • Karmel Shehadeh: Patient-centered and Personalized Scheduling of Colonoscopy Appointment
  • Hwon Tak: A Dynamic Approach To Improve Chemotherapy Pre-mix Policies

Rachel Moeckel, a second year Master’s student at CHEPS, stated the following of her experience: “I feel so grateful to have been able to attend INFORMS this year! It was exciting to be a part of this event, surrounded by thousands of people who are excited by some of the same things I am. It felt connecting relationally to spend time with those who attended from CHEPS. I also thought my poster presentation went well. I intentionally started conversations with those who would glance at my poster, hoping to make it easier to transition into presenting. Through engaging with people, I received many suggestions, possible connections, related research, and pertinent questions.”

Students gained exposure to companies looking for candidates with industrial engineering education and to a great deal of research that others were doing in this field. They also participated in networking/social events held on Monday evening: “Michigan Nite” and the Women in OR/MS Social.

And in the midst of all this, the group was able to enjoy Houston, exploring the underground tunnel system connecting many of the skyscrapers and visiting Space Center Houston for a tram tour of NASA Johnson Space Center.

Prosser October 9, 2017:

On October 9, 2017, our Providing Better Healthcare through Systems Engineering seminar featured Dr. Lisa Prosser from the Department of Pediatric and Communicable Diseases as well as the Department of Health Management and Policy at the University of Michigan. Dr. Prosser is also the director of the Child Health Evaluation and Research Center (CHEAR). Here, her research focuses on measuring the comparative effectiveness and cost-effectiveness of childhood health interventions using methods of decision sciences and economics.

In her presentation on “Using Decision Modeling to Inform Newborn Screening Policy Decisions for Pompe Disease: A Case Study,” Dr. Prosser introduced the audience to the applications and advantages of using decision analysis in healthcare, specifically determining various newborn screening policies. She highlighted how these models allow for an extension of the time horizon beyond any clinical trials, allow the researcher to simulate both actual and hypothetical scenarios, as well as require that all assumption be explicitly defined and agreed on by experts in the field. Subsequently, these models also result in identifying sources of uncertainty which help prioritize future research.

Next, she introduced her case study on the process for introducing newborn screening for infantile Pompe disease. Any new condition suggested for screening must first be approved by the Advisory Committee on Heritable Disorders in Newborns and Children. While this committee has met since 2004, decision modeling has only been incorporated in the last 5 years to better inform the committee on which conditions to approve for newborn screening. Dr. Prosser stressed the importance of avoiding the use of very complex models due to them being perceived as a “black box” and therefore disregarded by policymakers.

She then presented her decision model for infantile Pompe disease screening and clinical identification. Focusing on a 3-year time horizon, the model projected the key health benefits and harms if the newborns were screened for a particular condition. Considering the predicted 4 million US newborns each year, her model projected that screening methods will identify 134 cases of the Pompe disease and anticipated 13 averted deaths with 26 additional children who will not require invasive ventilation. While life-saving for the onset cases, there is also the consideration of overdiagnosis for a patient who would have never shown symptoms otherwise. Even with no symptoms, these children potentially can be denied by certain life or health insurances due to their pre-existing condition on record. Dr. Prosser uses this point to motivate her future research by expanding the 3-year time horizon to a lifetime model. This will allow her to capture the potential harms of a late onset diagnosis. She also plans to perform a cost-effectiveness analysis which includes both the cost of screening as well as long-term treatment cost.

Following the presentation, Dr. Prosser continued the discussion over Q&A on her decision analysis model as well as challenges posed by the nature of a problem involving federal policymakers, pharmaceutical companies, patients, providers, and insurances companies.

Please come back and join us on Monday, October 30th, 2017 to hear Dr. David Burke discuss his work on “Deep Monitoring Chronic Disease in Underserved and Remote Populations.”

Yang October 2, 2017:

Our first Providing Better Healthcare through Systems Engineering seminar in the month of October took place on October 2, 2017 and featured Dr. Xi Jessie Yang from the Department of Industrial & Operations Engineering at the University of Michigan. Dr. Yang joined U of M in 2016 as an assistant professor after completing a postdoctoral fellowship at MIT. She earned a PhD (2014) and a MEng (2009) in Human Factors Engineering and a BEng from Electrical and Electronic Engineering (2006), all from Nanyang Technological University, Singapore. Her research interests include human-robot interaction and human factors in healthcare. Please refer to http://icrl.engin.umich.edu/ for more information.

In her presentation on “Robotic Assistance in Coordination of Patient Care,” Dr. Yang introduced three studies that investigated the use of automated, embodied systems in healthcare settings in order to enhance efficiency and reduce cost. The first study evaluated the degree of trust of robotic assistance on bed allocation and personnel the healthcare providers have in comparison to a computer-based program. The study found higher rates of trust in the assistive device recommendation when the device is more sociable (in this case the robot) and when the proposed recommendations are of quality.

The second study, on the other hand, investigated the irrationality in trust assessment. Dr. Yang explained that trust in automated decision support systems is not rational as people are more likely to trust a decision support system if the decision is more difficult for them to make on their own. She added that the study found that the magnitude of trust loss is larger than the magnitude of trust gain.

She strengthened her earlier findings with a final study that investigated trust evolution & stabilization. The study had participants pilot drones and showed them two displays to aid in threat detection: a binary display and a likelihood display. They then used benchmark surveys and questionnaires to quantify the trust levels, which showed that trust evolves over time, eventually stabilizes, and can be modeled as a first-order LTI system.

The lecture concluded with a very thought-provoking discussion as research in healthcare automation continues to pose engaging questions. Of main interest were social behaviorism and technology, ethics, and regulations.

Join us next week for a seminar on “Using Decision Modeling to Inform Newborn Screening Policy Decisions for Pompe Disease: A Case Study” by Lisa Prosser on October 9, 2017.

Centeno September 25, 2017:

The third lecture in the 2017 Providing Better Healthcare through Systems Engineering Seminar Series took place on September 25, 2017 and featured Dr. Grisselle Centeno, an Associate Professor in the Department of Industrial and Management Systems Engineering at the University of South Florida. Her research and teaching interests include optimization-based modeling for the planning and control of operations in healthcare, transportation, and manufacturing industries. She possesses experience in working with large-scale mathematical programming models and building decision support systems. Her research work has been supported by the National Science Foundation (NSF), the Florida Department of Transportation (FDOT), and the Office of Naval Research (ONR), among other sources. Dr. Centeno is also highly involved in conducting research in engineering education and promoting the growth of a diverse engineering workforce. Dr. Centeno’s talk titled “The Bloodmobile Routing Problem” delved into how blood centers must determine on a daily basis a set of locations among a group of potential sites to route bloodmobiles for blood collection so as to avoid shortages for health interventions.

Dr. Centeno began her talk with some general background on blood donations in the US by asking the audience a few questions:

  • How often does someone in the US need blood? (Every 2 seconds)
  • How many blood donations are needed every day? (41,000+ donations needed/day)
  • How many components are transfused each year in the U.S.? (21 million)
  • For a single car accident victim, up to how many pints of blood might be needed? (~100 pints)
  • What percentage of the U.S. population is eligible to donate? (38%)
  • What percentage of the population donates each year? (~10%)

Considering how blood is such a scarce commodity, Dr. Centeno then spoke about the differences between a traditional supply chain and a blood supply chain and noted that the structure is in reverse since platelets, red blood cells, and plasma are all extracted separately. She also noted the potential threat to human life if a shortage were to occur.

Dr. Centeno then when on to discuss the integer programming models used to model the problem in a way to incorporate variable durations in bloodmobile visits, uncertainty in blood potentials and multiple bloodmobile types. She demonstrated how small instances of the problem (up to 30 locations to visit) were solved to optimality using the branch-and-price algorithm, and CPLEX was used to solve larger-scale settings of the problem.

The study showed that as demand increases, a higher number of bloodmobiles must be operated but if there are more donation locations to select from, fewer bloodmobiles are required and the distance traveled to satisfy the blood demand is shorter. It also showed that the total distance traveled is highly dependent on random donation locations.

Please join us on Monday, October 2 to hear Xi Jessie Yang present on “Nurses’ Trust in Robotic Assistance on the Labor Floor.”

heps dinner September 20, 2017:

On Wednesday September 20th, after a long day of classes, the old and the new students of the Healthcare Engineering and Patient Safety (HEPS) Masters program came together for a nice dinner at Cardamom, a casual eatery serving up modern & traditional Indian cuisine. While eating delicious curry, students got to know each other a lot better as they conversed and shared stories about their own undergraduate experiences. Some even realized that they shared the same classes together! Needless to say, it was a great time for everyone.

johnson September 18, 2017:

The second lecture in the 2017 Providing Better Healthcare through Systems Engineering Seminar Series featured Dr. Sharon Johnson, a Professor of Operations and Industrial Engineering in the Foisie School of Business at Worcester Polytechnic Institute (WPI). Dr. Johnson recently served as Faculty Director of the Healthcare Delivery Institute (HDI) at WPI and is currently a member of HDI’s Faculty Steering Committee. She is also currently a visiting professor at the University of Michigan. Dr. Johnson’s talk titled, “Secure Messaging and Patient Portals: Designing Customer-Facing Processes,” explored process impacts and design guidelines for patient-facing, secure messaging (SM) systems.

In her talk, Dr. Johnson discussed two different studies. The first centered on the characteristics of SM use at two Veterans Health Administration (VHA) facilities, while the second dealt with patient portal use at a multi-specialty clinic. Dr. Johnson began her talk by getting audience members to think about the role of patient-facing technologies in healthcare, before presenting them with examples of real messages encountered by clinics and asking them to think about the steps and workflow involved in resolving the issues at hand.

Dr. Johnson then further discussed the purpose of her project in the context of garnering a greater understanding of the types of messages flowing through a secure messaging system as well as the tasks, activities, and resources involved in addressing patient needs through this medium. To this end, Dr. Johnson and her team analyzed a total of 1000 message threads from ten different patient care teams from different parts of the country. Messages were analyzed for content, and team workflow in addressing secure messages was also captured. Site visits were then performed and semi-structured interviews conducted in order to gain a richer understanding of how SM was used within a particular care team and how the technology was perceived among team members. Dr. Johnson and her team then created a process map of how decisions were made when messages were received and identified major workflow patterns around SM use. Future work aims to better understand variation in flow through the system with the ultimate goal of influencing design processes. Future work aims to better understand variation in flow through the system with the ultimate goal of influencing design processes.

The second study Dr. Johnson highlighted concerned patient portal use in a multi-specialty group medical practice. Dr. Johnson and her team collected clickstream data, encounters, and patient surveys for 632 patients over the course of two years, looking for patterns and predictors in portal use and health status. She found portal usage to be proportional to clinical encounters and that patients with poorer health tended to use the portal more. Additionally, perceived ease of use and perceived usefulness of the patient portal were found to have a significant effect on perceived health management.

From this study, Dr. Johnson and her team drew broad conclusions about process design guidelines for the creation of patient portals and other patient-facing technologies.
Upon the conclusion of her presentation, Dr. Johnson entertained several questions from audience members.

Please join us on September 25th for a talk titled, “The Bloodmobile Routing Problem,” presented by Dr. Grisselle Centeno.

cicchese September 11, 2017:

The Providing Better Healthcare through Systems Engineering Seminar Series kicked off on Monday, September 11, featuring a talk from Joseph Cicchese titled, “Identifying Optimal Antibiotic Regimens Regimens for Tuberculosis Tuberculosis Treatment.” Joseph is a PhD candidate in Chemical Engineering at the University of Michigan and works with Dr. Jennifer Linderman. The seminar was attended by members from across the University community, including the College of Engineering, Medical School, and School of Public Health.

In his talk, Joseph shared an optimization-driven approach to modeling tuberculosis (TB) antibiotic treatment. He first provided background on TB, including its global impact of 1.8 million deaths per year and review of how TB interacts with granulomas in the body. Joseph also discussed inherent challenges in investigating TB treatment, like insufficient animal models and an extremely wide range of potential therapies for consideration.

When considering how to model TB, Joseph introduced the basic multi-scale model used to understand granuloma formation and function. This multi-scale model links an agent-based model, a receptor trafficking/signaling model, and a soluble molecule diffusion model. Joseph demonstrated this model’s functioning using a simulation to model infection and granuloma development.

Joseph then discussed how he is using an optimization model to incorporate pharmacokinetic and pharmacodynamic elements of antibiotic therapy. The key question of this optimization model is to understand “what is the best antibiotic regimen for TB?” by investigating the regimen design space. Joseph compared a genetic algorithm versus surrogate-assisted optimization to understand each method’s accuracy and efficiency. He presented the results of this optimization model for isoniazid and rifampin, with emphasis on results from surrogate-assisted optimization.

Following the presentation of his work, Joseph entertained several questions from the crowd on drug interactions and modeling methods.

Please join us on September 18 for a talk titled “Secure Messaging and Personal Health Records: Designing Customer-Facing Processes” by Sharon Johnson.

fall kick-off
fall kick-off
September 7, 2017:

As the new semester starts, CHEPS is welcoming students, old and new, back to campus. This past Thursday, September 7th, the annual fall kickoff meeting took place at the SI North CHEPS office. As usual, Associate Director Amy Cohn sat down with a full room of excited students to extend the warmest welcome to all of them.

Additionally, we are glad to be hosting Professor Sharon Johnson from Worcester Polytechnic Institute at CHEPS this year. Professor Johnson said hi to all the students and says she is looking forward to working with the team. During the meeting, important policies, processes, and expectations were discussed. For the past several years, CHEPS has continued growing at a healthy pace and standards have been gradually established for more efficient operations of the center.

After the official meeting, the CHEPSters had time to socialize and mingle with new friends and catch up with the old over delicious Mexican food kindly arranged by Gene Kim. CHEPSters had a great time playing board-games as the evening went on. Sharing cheerful laughs and board-game victories, students at CHEPS definitely knew how to get the semester off to a great start!

This semester, CHEPS students come from a diverse academic background again, ranging from Chemical Engineering senior to IOE PhD. Many students have conducted research with CHEPS during the summer and decided to continue their work in the fall because of the unparalleled opportunities and awesome people. Several students were away for summer internships but were glad to re-join the CHEPS family.

Wesley Chen, a new HEPS master student, has been with CHEPS since last summer and was in Jacksonville this summer. “My internship was nice this summer but there is nothing quite like working on a meaningful project with these cool kids,” he said. Bill Zhang, a third- year HEPS master student, was delighted to be back as well after a summer interning at Cleveland Clinic. Bill said, “It was a privilege to work at the #2 hospital in the country and learn so much about healthcare operations. However, coming back to CHEPS is special to me because this is where I feel at home.”

With a great kickoff event in the book, the CHEPS family is definitely ready for another semester of improving the safety and quality of healthcare delivery!

discover September 1, 2017:

Congratulations to CHEPS collaborator and Associate Professor in The Department of Industrial and Operations Engineering, Mariel Lavieri, who has been named the IOE Department Richard Wilson Faculty Scholar for a two-year period beginning September 1, 2017. She is an outstanding teacher, researcher, mentor, and colleague. This honor follows several other major awards that Mariel and her students have won in the past 12 months.

discover August 1, 2017:

On Tuesday, August 1st, students and faculty gathered to hear from Adam VanDeusen, a new IOE PhD student. Adam walked us through his post undergrad adventures and shared some insights from his multidisciplinary experiences. After completing his bachelors in IOE from the University of Michigan, Adam went on to get his MPH in Chronic Disease Epidemiology from Yale School of Public Health. His research work and professional career took him from Ghana to Washington DC, and then to Minnesota before returning home to Ann Arbor. Throughout the last few years he’s worked on a variety of projects, including cost-effectiveness research, healthcare leadership consulting, and ED operations analyses. Adam described some benefits and challenges of sometimes being the only engineer in a healthcare setting and provided concrete advice to students entering the workforce. Adam brings a range of skills and experiences to the CHEPS team, and we are looking forward to working with him this fall!

discover
discover
July 28, 2017:

CHEPS Associate Director Amy Cohn as well as several students who collaborate with CHEPS attended the 2017 INFORMS Healthcare Conference in Rotterdam, Netherlands from July 26th to the 28th. The theme of this year’s conference was “optimizing operations and outcomes.”

Amy Cohn chaired a panel and presented a talk titled “Multi-objective Criteria Scheduling in Healthcare.” She said of the panel, “I particularly liked that there were people from all over the world and so we weren’t just focusing on the rules and the customs of the U.S. healthcare system but we could hear how other countries had similar or different problems.” Both her talk and panel generated a lot of good questions and lively discussion. In addition, she enjoyed getting the chance to catch up with colleagues. “I really liked getting to see folks from INFORMS and healthcare that I only see every so often. I got to get caught up with Julie Ivy and Harriet Nembhard,” she said, mentioning that they even had a little time to enjoy exploring the city.

Lauren Steimle, and IOE PhD student who attended presented a talk titled, “Optimizing Medical Treatment Decisions For The Prevention Of Heart Attack And Stroke.” Her session was chaired by IOE PhD student, Selin Merdan, who presented a talk on “Robust Optimization Framework to Account for Prediction Errors for Cancer Diagnosis.”

Lauren said, “I particularly enjoyed Dimitris Bertsimas’ plenary talk ‘Personalized Medicine: A Vision for Research and Education.’ He argued that using models that are interpretable by physicians, even if they do not perform quite as well as more complex models, is worth it if this makes the results more likely to be adopted in practice. Also, before the conference, I attended the Healthcare Operations Research summer school put on by the Center for Healthcare Operations and Improvement Research at the University of Twente. The summer school was a great opportunity to learn more about current methods and meet other students using operations research to solve problems in healthcare.”

Another IOE PhD student in attendance, Emily Tucker, presented a talk titled “Incentivizing Supply Chain Resiliency To Prevent Drug Shortages.” She said of her conference experience, “I spent about 2 weeks in the Netherlands and had a great experience at the Healthcare Operations Research Summer School (hosted by CHOIR) and the INFORMS Healthcare conference. I met folks from all over the world, and based on a group project at the summer school, a group of us (currently PhD students in the Netherlands, Denmark, Germany, Canada, and the US) are planning to start piloting a project to teach herd immunity. It was also great to discuss and present my work – I connected with several researchers interested in drug shortages (my dissertation topic), and I look forward to future conversations with them. And of course, the Netherlands is a beautiful country! It was fun to see windmills, museums, and eat lots of cheese.”

discover
discover
July 28, 2017:

On Thursday and Friday July 27-28th, students between the 8th and 10th grade were given the opportunity to learn more about different engineering majors at the annual Michigan Discover Engineering event. CHEPS Junior Bassel Salka took the lead in organizing and instructing the IOE session of the program by introducing students to Industrial and Operations Engineering, discussing examples of IOE in the real world, completing the Resident Shift Scheduling Game, and giving a mini lesson on optimization methods. CHEPSters Dale Mallette and Anna Learis also helped out with the event by guiding the students through the Resident Shift Scheduling Game and answering any questions they may have. When asked what the most satisfying part of the event was, Anna replied, “I loved seeing how excited the kids became when they learned about the different aspects of IOE and saw its effect on their daily lives.”

discover
discover
July 21, 2017:

Karmel Shedah, CHEPS and IOE PhD student, and Billy Pozel, CHEPS Research Area Specialist, traveled to Quebec from July 17 – 21, 2017 for The International Federation of Operational Research Societies (IFORS) Conference.

“This was my first opportunity to attend and present at an international conference,” Billy said. “I am so fortunate that CHEPS affords me the opportunity to travel to experience a different culture and share our work with a global audience.”

IFORS was also Karmel’s first international conference with CHEPS. In addition to enjoying the beauty of Quebec City, she said she was amazed by the quality of the conference, research presentations, and educational sessions.

“A large body of professionals, from academic and industrial backgrounds, attended our research presentation on developing a decision support tool to optimize colonoscopy appointment scheduling (for colorectal cancer screening),” said Karmel. “There was a consensus among the audience that our approach will improve the quality of colonoscopy appointment scheduling and procedure, and is of significant theoretical contribution as well. Additionally, some research groups, who work on closely related problems, shared research experience and discussed opportunities for future collaboration. It was rewarding to have professionals, from different backgrounds, confirming the impact of the work we do at CHEPS in improving the safety and quality of healthcare delivery.”

In addition to the conference, Karmel and Billy had the chance to visit some historical places in Quebec City. Both agree the trip was a wonderful experience.

hong July 11, 2017:

Young-Chae Hong successfully defended his PhD thesis, titled “Using Dominance in Solving Complex, Combinatorial Optimization Problems: Applications from Healthcare Provider Scheduling and Vehicle Routing,” on Tuesday, June 11. Young-Chae’s dissertation focused on the study of healthcare provider scheduling with multiple conflicting metrics and a column generation approach to solving vehicle routing problem based on dynamic programming. In his research, he utilized dominance to generate Pareto-dominant solutions for the multi-criteria optimization problem. Also, he analyzed the role of dominance in the column generation approach to solving the vehicle routing problem. He developed the mathematical approach to finding a Pareto point and mathematically proved that the approach can find the complete Pareto Frontier. He demonstrated both the tractability and the practicality of our approach as applied to the University of Michigan Pediatric Emergency Department. Congratulations, Dr. Hong!

lemay July 11, 2017:

Brian Lemay’s paper titled, “New Methods for Resolving Conflicting Requests with Examples from Medical Residency Scheduling” was awarded the 2017 Murty Prize for being the best research paper on Optimization by an IOE student. The paper proposes an optimization based method that identifies maximally-feasible and minimally-infeasible sets of time-off requests which can then be used by decision makers to select their preferred schedule. Although the paper focuses on a residency scheduling problem, the proposed method is applicable to any problem involving conflicting requests. A version of the paper co-authored by Prof Amy Cohn, Prof Marina Epelman, and Dr. Stephen Gorga was recently accepted for publication in the Production and Operations Management (POM) Journal.

Brian earned his Ph.D. in May after successfully defending his dissertation titled, “Addressing Challenges in Healthcare Provider Scheduling.” During his time at Michigan, Brian worked closely with CHEPS students and faculty members for his research, with Prof Amy Cohn serving as his advisor and dissertation chair. Currently, Brian is working as the Analysis, Assessments, and Lessons Learned Division Chief for Air Force Special Operations Command.

lunch and learn June 29, 2017:

On Thursday, June 29th, Stephanie Castaing, a registered nurse and CHEPS alum, and Jeremy Castaing, a PhD in Industrial and Operations Engineering and also a CHEPS alum, spoke to CHEPS students and staff about their work. As described in the June 1, 2017 section, Stephanie and Jeremy developed a tool to create even patient assignments for nurses. Stephanie had the vision for the tool after she recognized that patient assignments created by hand by the charge nurse were incredibly time-consuming and inefficient. She partnered with Jeremy, who coded the Patient Assignment Tool, or PAT.

Stephanie and Jeremy showed CHEPS students and staff a demo of the PAT as well as the code behind the scenes of the tool. They also discussed several problems that they faced throughout the process of implementing the PAT and their subsequent tips in dealing with those situations. Stephanie described the difficulties in getting people on board with the new tool, specifically due to the fact that “people were comfortable with the old system of making the assignments by hand.” In working to convince her coworkers and managers of the advantages of the PAT, Stephanie stressed the importance of being prepared to highlight the tool’s major benefits, and in showcasing the tool by playing around with it at work.

Stephanie and Jeremy also discussed the importance of being persistent throughout the process with management and the nurses. When collecting pre and post-implementation surveys from the nurses, they said persistence was key. Stephanie made sure to relay the fact that the sooner the pre-implementation surveys were collected, the sooner the PAT could assist the charge nurses and other floor nurses in creating balances patient assignments.

Now that the PAT has been implemented, the time to create patient assignments has drastically reduced from over an hour to just minutes. It was received very well by Stephanie’s coworkers and management, as well as other departments in the hospital and the nursing dean. Jeremy may be busy in the future adjusting the PAT for other nursing programs!

summit
summit
June 28, 2017:

On Wednesday June 28, 2017, students and staff gathered at CHEPS for a lunch and learn with Dr. Vikram Tiwari. Dr. Tiwari is an Assistant Professor of Anesthesiology & Biomedical Informatics at the Vanderbilt University’s School of Medicine. He is also the Director of Surgical Business Analytics at the University Hospital. Dr. Tiwari’s two roles provide the ideal environment to research real problems, with real data, and apply solutions to operations within the health system.

He presented two recent projects, one focused on predicting surgical volume by day and another, managing operating room capacity at the physician level. Through statistical models and linear programing tools, Dr. Tiwari uses science to better manage processes and capacity within the health system. While the science is fascinating, the most valuable lesson from the day was how important visual analytics and presentation tools are. No matter how good an analysis is, if the analysis is not communicated effectively, the results do not matter. This lesson must be kept in mind as we strive to achieve our mission at CHEPS; to improve the safety and quality of healthcare delivery, we must remember the necessity of strong visual and communication skills.

gise June 23, 2017:

On June 23rd, several CHEPS students were able to help out with the Girls in Science and Engineering (GISE) summer day camp here at the University. The GISE program is a week long day camp for girls that have completed the 7th or 8th grades and that are interested in science and engineering. Participants meet women engineers and scientists at the University and engage in exciting activities to learn about the science fields.

One of these activities, the Emergency Department (E.D.) simulation, is a fun and active way for the girls to learn about the basics of Industrial and Operations Engineering (I.O.E.). CHEPS students, along with other engineering student volunteers, helped run the simulation and talk to the campers about engineering. The activity began with a brief presentation that gave the girls a broad definition of what an engineer is and provided some examples of real-world cases in which engineering is used. The girls were also introduced to a few basic I.O.E. terms, such as “objective,” “constraint,” and “bottleneck.”

With this engineering background in place, the E.D. simulation was underway! The girls were given roles: a triage nurse, an E.D nurse and physician, a lab technician, a hospitalist, a transporter, and of course the patients. They were then told the rules and objective of the E.D. simulation, the latter being to get as many healthy patients as possible leaving the E.D. in five minutes.

During the first round, the girls quickly became acclimated to their roles and were eager to have a well-running E.D. However, it became apparent that the current setup of the hospital had major drawbacks and was extremely chaotic. The girls paused to brainstorm ways to get more patients through the emergency department in the next round. They then voted on the change they thought would have the greatest impact on their E.D. and set off on round two to beat their previous number of discharged patients.

The campers grew very committed to making their E.D. run smoothly and effectively. The second round of the simulation ran much better than the first, and the third was the best. Each time, more healthy patients were discharged from the hospital and the girls were proud for beating their previous record. Not only did the campers have a blast and feel rewarded for their work in the E.D. simulation, they learned several fundamental principles of I.O.E. and saw how they were used in a real-world example. One camper noted “I didn’t realize that industrial operations engineering could be used in so many different scenarios, like in a hospital. This game was fun, too!”

summit
summit
June 8, 2017:

On Thursday, June 8th, CHEPS hosted four healthcare executives for a panel event, facilitated by James Molloy, a managing director at Citi Global Markets and IOE alumnus. The panel included Todd Hofheins, Former CFO at Providence Health & Services, Michael Hulefeld, COO at Ochsner Health System, Elliot Joseph, CEO at Hartford Healthcare, and Scott Nordlund, EVP Partnership, Growth & Innovation at Select Medical Corporation. Students, faculty, and industry professionals gathered to discuss issues currently challenging the healthcare industry and how industrial and operations engineering skills can be applied to the healthcare space.

The conversation began with some stage setting as the panelists discussed the history of the US’s reimbursement scheme and how this has driven operations and strategies of our healthcare systems. In a fee for service model, cost of services, value, quality, and consumer desires are not the motivators; organizations have been financially rewarded for volume, increasing throughput as much as possible. However, there has been a shift away from volume, towards value. Insurance companies are restructuring payment models to reimburse for services that are high quality and appropriate. Irrespective of political party, the industry agrees that healthcare is too expensive and the focus must be on keeping people healthy. These basic truths are encouraging organizations to focus on no-regret strategies, those that will support the business regardless of current policy changes. As Michael Hulefeld said, “Despite federal uncertainty, there are things that are just the right thing to do… we have to get costs down and improve safety, supporting patients across their care continuum.”

The conversation then shifted into variation across states and even within different local markets as Todd Hofheins discussed the variations he has seen through Providence’s markets. Provider recruitment, Medicare and Medicaid reimbursement models, the commercial plans’ market shares, even the density of consumers will have geographical differences. To be successful, an organization must understand these differences and adapt their strategies accordingly. Health systems must also react to the increasing consumer empowerment and organizations must deliver on cost and quality transparency demands.

As the event came to a close, the executives discussed the utility of a degree from the University of Michigan and provided advice to students as they entered their careers. Jim Molloy emphasized the importance of process-oriented thinking and how crucial sound statistics are. Scott Nordlund said, “There’s a ton of data, but no one knows how to use it effectively and strategically. Managing data and information is going to be just as important as managing patients.”

Each panelist stressed the importance of teamwork. As engineers, we will never be as knowledgeable about the clinical aspect of care as the clinical providers; therefore, it’s really important to work with the clinicians to understand the processes before putting together solutions. Luckily that’s one thing we do really well at CHEPS, working with multidisciplinary teams to develop innovative solutions! Elliot Joseph left the audience with one last piece of advice, something that we don’t often touch upon in our engineering curriculum as much as we should. He said, “Learn the art and science of change management. You can have all of the insights but without the softer, change management skills, you may never be able to effect change.”

As the participants filed out of the lecture hall, moving over to the reception area, you could feel the excitement in the air. At the reception, many project teams shared their research on posters which generated a great deal of discussion and excitement.

On Friday, panelists from the Healthcare Summit were invited back to the Lurie Engineering Building to speak with CHEPS students and staff. While enjoying the delicious breakfast, attendees happily discussed the previous day’s Summit and the panelists were given the opportunity to learn more about CHEPS and its ongoing projects. Scott Nordlund, one of the panelists, couldn’t help but comment on how great of an opportunity CHEPS is for University of Michigan students to get involved in healthcare management. After the breakfast, Bassel Salka, a pre-med student in IOE commented, “It was such a privilege to spend quality time with such accomplished professionals. I have never been more enthused about healthcare.”

Healthcare may be complicated, but it is full of opportunity. Those with an ability to systematically work through the complexities have a chance to make a real contribution to the industry, ultimately impacting people during their most vulnerable moments. Students at the University of Michigan have so many resources to cultivate the skills necessary to be successful within the healthcare industry. It will be exciting to see what the next generation of Wolverines is able to accomplish!

barnes
barnes
June 5, 2017:

On Monday, June 5, 2017, the Center for Healthcare Engineering and Public Safety (CHEPS) hosted a Lunch and Learn for Dr. Geoff Barnes to discuss his project, “Anticoagulation and Endoscopy – Making Logic from Chaos.” For many patients who take long-term anticoagulants, undergoing procedures (such as colonoscopy) requires complex management of their medications. In his talk, Dr. Barnes explored the current process for managing these medications and how IOE principals can be applied to design a better system.

Dr. Barnes received his undergraduate degree in biomedical engineering from Washington University in St. Louis in 2003, followed by medical school and fellowship at the University of Michigan. His areas of research include anticoagulation, venous thromboembolism, quality improvement, and shared decision making. Currently, Dr. Barnes co-directs the Michigan Anticoagulation Quality Improvement Initiative (MAQI2).

Attendees listened intently to the presentation from Dr. Barnes. One talk attendee, Diana, who is a rising sophomore starting her journey in IOE this coming fall, said, “I have always been interested in both math and biology, and research like this seems like the best of both worlds.”

Thank you to Dr. Barnes for an interesting an informative talk!

stephanie June 1, 2017:

Stephanie Castaing, CHEPS alum and registered nurse, was named a finalist in the University of Michigan’s 2017 President’s Staff Innovation Awards for her work on a tool that helps charge nurses create balanced patient assignments.

Stephanie saw charge nurses taking a significant amount of time creating assignments, making them unavailable to assist with patients during this time. Designed by Stephanie and coded by Jeremy Castaing, another CHEPS alum, the Patient Assignment Tool (PAT) was developed to balance patient assignments and save time. The tool includes an input tab that allows users to type-in patient variables such as acuity and isolation precautions and an output tab that reports the optimized patient assignments given those variables.

In addition to saving time and creating more balanced patient assignments, the tool allows charge nurses to visualize the location of patients and patient sets from the outputs. Additionally, sets are more balanced, meaning nurses do not have to come early to pick their patient assignments in fear of getting a heavy patient assignment. There has been nothing but positive feedback from the charge nurses using the tool since implementation in October 2016. Not only charge nurses have noticed a change, but staff nurses have also seen an improvement in terms of pre-assigned patients, distance between patients in a given set, and overall assignment fairness.

kickoff
kickoff
kickoff
May 12, 2017:

On Friday, May 12, 2017, the CHEPS team had their annual summer kickoff meeting. CHEPS Associate Director Amy Cohn sat down with the students and staff, old and new, to talk about policies, projects, and expectations for the summer. After the meeting, the CHEPSters had the opportunity to bond and get to know one another over pizza, wings, and salad provided by Gene Kim. With the mouthwatering smell of pizza and cheerful laughs of CHEPSters filling the halls of SI North, it was clear that the summer was off to a great start.

When asked what she will miss most about CHEPS when moving on to medical school, Anna Munaco, a recent graduate and CHEPS veteran, replied saying “I am going to miss the people the most, they are such an amazing group from all different backgrounds, there is no other place like this.” Anna’s sentiment is shared by many others here at CHEPS.

Justin Rogers, a student that just recently joined CHEPS last week says he can relate to Anna’s thoughts. Justin says the thing he is most excited about CHEPS is “Getting to know the people better. In my short time here they have all been amazing.”

The CHEPS family is ready for another productive summer!

lemay
lemay
May 4, 2017:

Brian Lemay successfully defended his PhD thesis, titled “Addressing Challenges in Healthcare Provider Scheduling”, on May 4, 2017. Brian’s dissertation focused on the study of several applications of assigning healthcare providers to various types of schedules (such as rooms, locations, services, and rotations) with the common goal of satisfying healthcare provider preferences. In his work, he examined specific examples from the healthcare industry including building surgical OR and clinic room schedules, assigning medical residents to block schedules, and scheduling medical residents with conflicting requests for time off. He developed several mathematical approaches to solving these problems and illustrated that there are trade-offs in each type of modeling. His work showed that adjusting the mathematical model to match the specifics of a scheduling problem can improve the generated schedules and lead to reduced solve times. Reduced solve times can then, in turn, allow schedulers to examine “what-if” scenarios in order to determine the schedule that works best for them and their personnel.

Congratulations, Dr. Lemay!

mcauliffe April 13, 2017:

HEPS masters student Andrea McAuliffe was recently awarded an AAMI-HSEA Health Systems Engineering Scholarship. This new annual scholarship, established by the AAMI Foundation in partnership with the Health Systems Engineering Alliance (HSEA), is intended to help build competencies and promote educational opportunities to support the adoption of a systems approach to healthcare technology and to support talented young professionals entering healthcare.

“I’m honored to receive the AAMI-HSEA scholarship,” Andrea said. “As a dual degree student, I hope to merge the fields of engineering and public health to pioneer solutions to improve healthcare delivery. Support from AAMI and HSEA will allow me to focus on my education and research while at the University of Michigan, and I am very grateful for this opportunity.”

mcauliffe April 7, 2017:

On Friday, April 7, 2017, CHEPS students joined BME students in a guest lecture of BME 499: Clinical Observation and Needs Finding led by Jonathan Cohn. Jonathan is a well-known journalist who is an expert in U.S. healthcare policy. In his lecture, he covered a brief history of the US Healthcare System to show how our system got to where it is today. Jonathan emphasized that in any decision involving healthcare, there are always tradeoffs that should be considered.

After the lecture, BME students and CHEPsters headed right next door to CHEPS for a reception of socializing and snacking. Multidisciplinary collaboration remains a strength of the CHEPS program and helps expose students to a broader range of knowledge and experience!

chaar February 22, 2017:

On Feb 22nd 2017, the Center for Healthcare Engineering and Patient Safety (CHEPS) had the pleasure of hosting Dr. Jarir Chaar for a lunch and learn talk. Dr. Chaar graduated from the University of Michigan with a PhD in Electrical Engineering and Computer Science in 1990. He then moved on to work at IBM where he leads multiple teams, executed research projects, and is currently working as the Director of IBM Watson Health.

During his talk, Dr. Chaar focused on how IBM research plays an important role in interfacing between the industry – whose business requirements are constantly evolving and academia – with whom they work collaboratively to answer some of the most complex questions and come up with disruptive technologies. The fact that IBM holds more patents than all the tech giants combined lays a testament to the huge push for innovation at IBM.

For the faculty, staff, and students at CHEPS, this was a great opportunity to learn about the forefront of today’s technology being used to carry out predictive analytics in healthcare and a multitude of its applications in areas like DNA sequencing, personalized drug recommendation, optimizing recovery and brain-inspired computer systems.

The students used this opportunity to understand Dr. Chaar’s view on some of the questions we’ve all been asking ourselves “What are some of the disruptive technologies one can expect in healthcare over the next couple of years”, “What is IBM Watson Health’s growth strategy?” , “Is the Bitcoin system going to gain substantial backing from tech companies?” etc.

Dr. Chaar ended the session by expressing his strong interest to continue engaging with CHEPS, work collaboratively on healthcare projects, and aid seamless transfer of the right talent into IBM.

rca February 14, 2017:

On Tuesday, February 14, 2017, Jim Bagian, CHEPS Director and Joe DeRosier, CHEPS Program Manager, presented a workshop on human factors, patient safety, and root cause analysis (RCA) for attendees from the University of Michigan Hospital as well as a few CHEPS students. Root Cause Analysis is a patient safety improvement activity that is focused on identifying and eliminating or controlling system vulnerabilities that can result in patient injury. Investigative tools such as flow diagramming, cause and effect diagramming, triggering questions, the five rules of causation, and the action hierarchy were covered in the workshop.

jeremy defense January 13, 2017:

Jeremy Castaing successfully defended his PhD thesis, titled “Scheduling Under Uncertainty: Applications to Aviation, Healthcare, and Aerospace,” on January 13, 2017. Jeremy’s dissertation focused on the study of several problems related to scheduling tasks under uncertainty of processing times or resource availability. In his work, he considered examples from the airline industry (gate assignment optimization and recovery from delay), healthcare (patient appointment scheduling) and aerospace (satellite download scheduling). He developed mathematical approaches to solve exactly or find good approximations to these complicated problems. The work showed that considering uncertainty in when scheduling projects can significantly increase the performance of the created plan by decreasing expected delays, costs and completion time of the project.

Jeremy, who is now working full time at LLamasoft as an applied research scientist in their Ann Arbor office, says his defense was a great experience. “I felt proud to share my work with my committee and many CHEPS students,” he said. He hopes to continue to stay involved in the CHEPS community.

“I entered the PhD program in 2012 and immediately joined CHEPS,” he said. “Over the past four and a half years, I had the chance to work on many projects including aviation, satellites, and chemo. I feel extremely lucky to have had the opportunity to interact with so many brilliant people. One of my favorite highlights is my first summer spent at CHEPS. We got so much work done while having a lot of fun!”

Congratulations, Jeremy!

choi January 9, 2017:

Sung Won Choi, M.D., a CHEPS collaborator and Associate Professor of Pediatrics and Communicable Diseases, has been recognized as the first Edith S. Briskin and Shirley K. Schlafer Foundation Research Professor of Pediatrics. Dr. Choi, who has been working in the University of Michigan Department of Pediatrics and Communicable Diseases since 2006, was recognized at an event on January 9, 2017. Congratulations, Dr. Choi!

Dr. Choi is studying how to better prevent and treat acute GVHD, and currently is investigating the role of histone deacetylase inhibition in GVHD prevention and translating exciting laboratory insights into a novel, proof-in-principal clinical trial. A member of the Blood and Marrow Transplantation (BMT) Program at the U-M, she is working to lower rates of GVHD to improve overall patient outcomes. She is also exploring innovative health information tools in the inpatient BMT setting to improve health care safety and outcomes.

choi January 6, 2017:

On Friday, the CHEPS team had their kick off meeting for the Winter 2017 semester. Thanks to a scheduling miracle and over 35 students and staff attended! Students greeted each other after the holiday break, and the ever-expanding group welcomed 8 new CHEPSters. The team discussed policies, procedures, and standard work for the semester and then bonded while scheduling a kick off meeting for every project with Amy Cohn for the following week, a much more challenging task than you’d imagine! With over 25 projects, it’s going to be a busy and exciting semester.

Following a great kickoff for the winter 2017 semester, a group of CHEPSters watched the movie Hidden Figures at Rave Cinemas. The movie reveals the little-known story of three brilliant African-American women mathematicians: Katherine Johnson (Taraji P. Henson), Dorothy Vaughan (Octavia Spencer) and Mary Jackson (Janelle Monáe). While working in the segregated West Area Computers division of Langley Research Center at NASA, the trio was instrumental in the United States catching up to and passing the Soviet Union in the Space Race, culminating in one of the greatest operations in history: the launch of astronaut John Glenn into orbit. The movie inspires individuals of all genders and races to dream big and work hard to achieve their aims. As an advocate for diversity, teamwork, and a big supporter for talented individuals, Professor Amy Cohn encouraged everyone to join her and watch movie following the kickoff event. A group of 15 enjoyed the movie with candies from the kickoff events and, motivated by the movie, are ready to resume the great work they do at CHEPS!

owen
mayo
epelman
December 12, 2016:

On December 12, 2016, our final and eleventh seminar of the “Providing Better Healthcare through Systems Engineering” series, presented by the Center for Healthcare Engineering and Patient Safety (CHEPS), featured a joint presentation by Marina Epelman, Chuck Mayo, and Dawn Owen. Attendees came from the Department of Industrial and Operations Engineering (IOE), the University of Michigan Health System (UMHS), the HEPS master’s program, and CHEPS.

Dr. Marina Epelman is an Associate Professor in the IOE department at the University of Michigan (UM). Her research focuses on many aspects of mathematical programming, including theory of linear, semidefinite and nonlinear optimization and development and analysis of algorithms. She received a B.A. in Mathematics from Cornell University in 1995 and a Ph.D. in Operations Research in 1999 from Massachusetts Institute of Technology (MIT).

Dr. Chuck Mayo is an Associate Professor in the Department of Radiation Oncology at UM. His research interests are focused on improving care for patients by developing analytics tools that automate providing quantitative and statistical measures to augment qualitative and anecdotal evaluation. He received a B.S. in Physics from Stony Brook University, as well as a Ph.D. in Physics from the University of Massachusetts.

Dr. Dawn Owen is a Clinical Assistant Professor in the Department of Radiation Oncology at UM. She is interested in the use of stereotactic body radiotherapy (SBRT) in oligometastatic disease, in addition to the long term efficacy and safety of SBRT in the treatment of spinal and liver metastases. She completed her undergraduate degree with high distinction in 1999 and a combined MD/PhD program in 2007 from the University of Toronto Faculty of Medicine.

In their presentation titled, “Multidisciplinary Teams Behind Radiation Treatment Planning,” the team highlighted the collaborative efforts of physicians, medical physicists, engineers, and mathematicians to treat cancer with radiation therapy. The goal of this work is to develop ways to maximize treatment to destroy tumors, while minimizing damage to adjacent organs. In other words, Dr. Chuck Mayo says that the team is essentially, “using science to sculpt dosage.” During this talk, they discussed treatment planning, and the mathematics behind it, using a commercial radiation planning software. This software uses CT scans and beams to pinpoint the areas that need treatment. Using this technology, they were able to view different anatomical perspectives and implement a method for restricting radiation dosages to parts of the body that should not receive treatment during the process. This research is critical because radiation treatment is effective for cancer, but the cost is side effects to the patient if physicians miss targets or overdose adjacent organs. Ultimately, the team illustrated how they captured clinical decision making with mathematical models in order to better understand the impact of a radiation plan on the patient. In this way, clinical information can be incorporated into a model for optimization of a dose distribution.

CHEPS would like to thank all presenters and attendees for joining us this semester for the “Providing Better Healthcare through Systems Engineering” series. We look forward to your participation next year!

lemay December 12, 2016:

CHEPS doctoral student Brian Lemay, in collaboration with Professor Amy Cohn, Professor Marina Epelman, and Doctor Stephen Gorga, has written a paper titled, “Scheduling Medical Residents with Conflicting Requests for Time Off.” In this paper, new algorithms are developed for identifying the exhaustive collection of maximally-feasible and minimally-infeasible sets of requests that can then be used by schedulers to select their preferred schedule. Computational results and a case study based on a real-world scheduling problem at C.S. Mott Children’s Hospital are also presented. The paper, available here, is under review for the Productions and Operations Management (POM) Journal.

seminar December 5, 2016:

On December 5, 2016, the tenth seminar of the “Providing Better Healthcare through Systems Engineering” series, presented by the Center for Healthcare Engineering and Patient Safety (CHEPS), featured a joint presentation by Mariel Lavieri, Joshua Stein, and Mark Van Oyen. Attendees came from the Department of Industrial and Operations Engineering (IOE), the University of Michigan Health System (UMHS), the HEPS master’s program, and CHEPS.

Dr. Mariel Lavieri is an Associate Professor in the IOE department at the University of Michigan. In her work, she applies operations research to healthcare topics. In particular, Dr. Lavieri has developed dynamic programming, stochastic control, and continuous, partially observable state space models to guide screening, monitoring and treatment decisions of chronic disease patients. She is the recipient of the 2016 National Science Foundation CAREER Award, the 2013 International Conference on Operations Research Young Participant with Most Practical Impact Award, and the 2006 Bonder Scholarship.

Dr. Joshua, a board-certified ophthalmologist and a fellowship-trained glaucoma specialist, has over 10 years of clinical experience caring for patients with different types and severities of glaucoma. In addition, as a health services researcher, he has extensive experience in designing and implementing studies involving cohorts of patients followed longitudinally over time. For the past 4 years, he has been collaborating with Drs. Lavieri and Van Oyen from to develop, calibrate, and validate an innovative novel algorithm which is capable of detecting glaucomatous progression more efficiently and requiring fewer resources than existing techniques. He is the recipient of a K23 Career Development Award from the National Eye Institute.

Dr. Mark Van Oyen is a Professor in IOE, which he joined in 2005. His interests include the analysis, design, control, and management of operational systems and queueing networks. His current research focuses on healthcare operations or medical decision making. He co-authored papers that won the 2016 Manufacturing and Service Operations Management (MSOM) Best Paper award, first prize in the 2012 MSOM Student Paper Competition (and two other finalist paper in other years) and the 2012 INFORMS “Doing Good with Good OR” first prize. In 2009, he received the IOE Department Faculty of the Year for the 2008-9 academic year.

In their presentation titled, “Forecasting and Control Methodology for Monitoring of Chronic Diseases” they highlighted that nearly 4,000,000 people in the U.S. suffer from glaucoma. The goal of this multidisciplinary work was to develop a forecasting tool that assists eye doctors by (a) helping to identify which patients will experience worsening of existing glaucoma, and at what pace, (b) recommending when the patient should next be assessed for possible disease worsening as well as which test to take, and (c) calculating the patient’s optimal intraocular pressure (IOP). The IOP is a vital measurement of eye pressure that can be controlled through carefully targeted treatment. These forecasts and recommendations which would be extremely difficult for an eye doctor to estimate using brain power alone. Using novel extensions of linear quadratic Gaussian (LQG) control and Kalman filtering, the forecasts and controls are calculated by incorporating detailed longitudinal testing information from two landmark clinical trials and data on the specific patient for whom the forecasts and recommendations are being made. This tool can produce schedules that are more efficient in tests per patient and more accurate in detecting progression. In turn, this work has the potential to greatly inform doctors’ decisions on who, when, and how to treat glaucoma patients in a personalized manner.

Please join us next week, on December, 12, 2016, for the eleventh and final talk of the year titled, “Multidisciplinary Teams behind Radiation Treatment Planning,” presented by Marina Epelman, PhD, UM IOE, Chuck Mayo, PhD and Dawn Owen, MD, UM Radiation Oncology.

singh November 28, 2016:

The ninth seminar of the “Providing Better Healthcare through Systems Engineering” series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS), on November 28th, featured co-presenters and graduate students in Industrial and Operations Engineering (IOE) Christine Barnett and Selin Merdan. Attendees came from the IOE Department, the University of Michigan Health System (UMHS), the HEPS master’s program, and CHEPS.

Christine Barnett is a PhD candidate in the IOE Department at the University of Michigan (UM). Her current research focuses on investigating the health and economic implications of new technologies for prostate cancer screening and treatment. She received a B.S. and Master of Engineering in Operations Research and Information Engineering from Cornell University. She is a recipient of the National Science Foundation Graduate Research Fellowship and the 2016 INFORMS Doing Good with Good OR award. She has served as the President of the UM INFORMS Student Chapter.

Selin Merdan is also a PhD candidate in the IOE Department at UM. Her research is in the area of machine learning and optimization for developing computational methods to help organize, process, and transform data into actionable knowledge in clinical settings such as detection and screening of chronic diseases. Selin received her Bachelor of Science from Marmara University, Istanbul, Turkey, and M.S.E. in IOE from UM. She is a recipient of Seth Bonder Departmental Fellowship and the 2016 INFORMS Doing Good with Good OR award.

In their presentation titled, “Data Analytics for Optimal Detection of Metastatic Prostate Cancer,” they emphasized that one of the most important aspects of cancer staging is to determine whether it has metastasized. In this work, they used data-analytics approaches to develop, calibrate, and validate predictive models to help urologists in a large state-wide collaborative make prostate cancer staging decisions. Bootstrapping and evaluation on out-of-sample data were used to validate their models, which helped to develop guidelines that optimally weigh the benefits and harms of radiological imaging for detection of metastatic cancer. The Michigan Urological Surgery Improvement Collaborative implemented their guidelines, which reduced unnecessary imaging by more than 40% and is predicted to limit the percentage of patients with missed metastatic disease to be less than 1%. These results were confirmed across the state. Both smartphone app & biopsy outcome calculator are practical and can be used to implement such methods in real life.

Please join us next week, on December, 5, 2016, for the tenth talk of the year titled, “Forecasting and Control Methodology for Monitoring of Chronic Diseases,” presented by Mariel Lavieri, PhD and Mark Van Oyen, PhD, UM IOE, and Joshua Stein, MD, UMHS.

singh November 21, 2016:

CHEPS’ Director, Jim Bagian, was the eighth featured speaker in the “Providing Better Healthcare through Systems Engineering” series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS). Attendees came to his talk on November 21, 2016 from areas including the Department of Industrial and Operations Engineering, the University of Michigan Health System (UMHS), the HEPS master’s program, and CHEPS.

Dr. James P. Bagian is the Director of CHEPS and a Professor in the Department of Anesthesiology in the Medical School, as well as in the Department of Industrial and Operations Engineering in the College of Engineering at the University of Michigan. Previously, he served as the first Director of the VA National Center for Patient Safety (NCPS) and the first Chief Patient Safety Officer for the Department of Veterans Affairs from 1999-2010. Dr. Bagian served as a NASA astronaut and is a veteran of two Space Shuttle missions and was an investigator of both the Challenger and Columbia Space Shuttle mishaps. Dr. Bagian received his B.S. in mechanical engineering from Drexel University and his M.D. from Jefferson Medical College at Thomas Jefferson University. Among his numerous awards, he is a Fellow of the Aerospace Medical Association, and a member of the National Academy of Engineering and of the Institute of Medicine

In his current position, Dr. Bagian applies systems engineering approaches to the analysis of medical adverse events and the development and implementation of systems-based corrective actions that will enhance patient safety primarily through preventive means. In his presentation titled, “Getting Real Improvement: Differentiating Work as Imagined vs. Work as Performed,” he highlighted that there are several reasons why many organizations observe unfavorable outcomes in spite of taking proactive countermeasures to overcome them: failure to appropriately and transparently prioritize the issues and interventions; lack of a thorough systems-based investigation that identifies exhaustively contributing factors; interventions that don’t strategically or tactically address the critical underlying contributing factors; lack of clarity and accountability for the implementation of countermeasures; and failure to accurately monitor the proposed interventions. Through numerous case studies, Dr. Bagian explained what the medical domain can learn from other complex environments, such as aviation, nuclear power plants, and space operations. He concluded by stating that properly designing tools will help to change behavior and attitude, and in turn, will ultimately lead to a change in culture.

Please join us next week, on November, 28, 2016, for the ninth talk of the year titled “Data Analytics for Optimal Detection of Metastatic Prostate Cancer,” presented by Christine Barnett and Selin Merdan, UM IOE.

cheps informs 2016 November 16, 2016:

A large contingent from The Center for Healthcare Engineering and Patient Safety (CHEPS) attended the 2016 INFORMS Conference in Nashville, Tennessee from November 13 – 16, 2016.

There were ample opportunities to collaborate and share research and insights. Henry Ballout, and Organizational Studies and Pre-Med student, enjoyed the opportunity to present a project he’s been working on. He said, “It was a great experience for me to take what I learned from the MEND project and to try to depict that information in a meaningful way so that others could gain insight into what we have been working on at CHEPS.”

Henry was one of several presenters from CHEPS. The CHEPS presentations at the conference were:

  • Henry Ballout: Patient Access to Specialty Endocrinology Care
  • Jeremy Castaing: Incorporating Downstream Disruptions in Robust Planning and Recovery
  • Amy Cohn: Struggles in Getting Data for Healthcare Research
  • Young-Chae Hong: Creating Resident Shift Schedules Under Multiple Objectives by Generating and Evaluating the Pareto Frontier
  • Brian Lemay: Using Maximally Feasible and Minimally Infeasible Request Sets to Construct Resident Schedules
  • Elizabeth Olin: Discrete Event Simulation of Outpatient Flow in a Phlebotomy Clinic
  • William Pozehl: A General Model for Medical Resident Rotation Scheduling
  • Donald Richardson: Determining the Optimal Schedule for Premixing Chemotherapy Drugs
  • Roshun Sankaran: A Linear Programming Model for Scheduling Medical School Clinical Experiences
  • Karmel Shehadeh: Considering No-shows and Procedure Time Variability When Scheduling Endoscopy Patients

There were also many opportunities for students in addition to presenting and attending research presentations. “This was my second INFORMs conference and it still amazes me the wide variety of applications being explored with OR. This year I was able to explore more of the additional resources INFORMs has to offer. I took part in the resume review session, visited the company exhibit hall, learned more about cutting edge scheduling software, and networked at various events such as the MIF poster session/reception,” said Donald Richardson, and Industrial and Operations Engineering PhD student.

In the midst of a busy and productive conference, the CHEPS group also had a chance to enjoy Nashville. CHEPS Research Area Specialist William Pozehl said, “Roshun, Henry and I had the chance to check out the Parthenon on Saturday and several CHEPSters watched the Michigan football game at the local alumni bar, Slider House.”

[view photos from the conference]

singh November 7, 2016:

Karandeep Singh was the seventh featured speaker of the “Providing Better Healthcare through Systems Engineering” series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS). Attendees came to his talk on November 7, 2016 from the Department of Industrial and Operations Engineering, the University of Michigan Health System (UMHS), the HEPS master’s program, and CHEPS.

Dr. Karandeep Singh is a physician, researcher, and educator interested in studying learning health systems, making new discoveries about disease, and improving patient care through technology. His research areas include natural language processing of clinical notes, risk prediction using high-dimensional data, and mobile health. He is an assistant professor of Learning Health Sciences in the Division of Learning and Knowledge Systems, as well as of Medicine in the Division of Nephrology at the UMMS. Dr. Singh completed his internal medicine residency at UCLA Medical Center. He completed his medical school at the UMMS and a master’s degree in Biomedical Informatics from Harvard Medical School. He is board certified in internal medicine and nephrology.

In Dr. Singh’s presentation, “Using Doctors’ Notes to Uncover Everyday Natural Experiments in Healthcare,” he explained that Genome-Wide Association Studies (GWAS) have made possible new discoveries of gene-disease relationships through a paradigm of simultaneous, unbiased testing of multiple associations. In this talk, the audience learned that clinical notes contain a rich description of numerous epidemiologic exposures that can be unlocked using natural language processing software. Uniquely, Dr. Singh presented a new methodology termed, Concept-Wide Association Study (CWAS) for examining relationships between several thousand concepts extracted from clinical notes with the development of two health outcomes: kidney failure and medication non-adherence. Using METAMAP software, doctors’ notes were ordered by most important factors. Findings revealed that compared to the performance of a traditional model, the new constructed model with 955 additional predictors was found to be more effective. In summary, using doctors’ notes show a promising means of improving current prediction models.

Due to the INFORMS conference next week, there will be no seminar on Monday, November 14. Please join us the following week, on November, 21, 2016, for the eighth talk of the year titled “Getting Real Improvement: Differentiating Work as Imagined vs. Work as Performed,” presented by Jim Bagian, MD, UM CHEPS.

pitts October 31, 2016:

Brandon Pitts was the sixth featured speaker in the “Providing Better Healthcare through Systems Engineering” series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS). Attendees came to the October 31st seminar from areas including the Department of Industrial and Operations Engineering, the University of Michigan Health System (UMHS), the HEPS master’s program, and CHEPS.

Dr. Brandon Pitts is a post-doctoral research fellow in CHEPS, as well as in The Human-Automation Interaction and Cognition (THInC) lab in the Center for Ergonomics at the University of Michigan. In January 2017, Dr. Pitts will begin as an assistant professor in the School of Industrial Engineering at Purdue University in West Lafayette, IN. His research focuses on using vision, hearing, and touch to support humans in data-rich, complex environments such as driving, aviation, and medicine. In particular, his work examines the perceptual abilities and challenges of older adult populations, and their implications for the development of adaptive interfaces. Dr. Pitts received a B.S. in Industrial Engineering from Louisiana State University (LSU) in 2010, and a M.S.E. and Ph.D. in Industrial and Operations Engineering (IOE) from UM in 2013 and 2016, respectively.

Dr. Pitts’ presentation titled, “Age-related differences in multimodal attention and their implications for display design in healthcare and beyond,” emphasized that currently 30% of all licensed physicians in the U.S. are 60+ years, with 10% being older than 70 years. However, in many data-driven environments, such as medicine, physicians are required to divide their attention among numerous tasks and sources of information, especially in the operating room. Multimodal displays that present information simultaneously in visual, auditory, and tactile forms have aided in supporting attention management. Yet, the limitations of this approach are ill-understood, especially with respect to older adult populations who are known to suffer from sensory deficiencies and experience difficulties with various forms of attention. Dr. Pitts presented three experiments in which he investigated the ability of older adults to process multiple concurrent and unrelated signals in different modalities, during a simulated driving task. He found that older adults took significantly longer to respond to multimodal signals, and also reported a higher error rate, compared to their younger counterparts. Adaptive displays, that can adjustment interface parameters such as timing, salience, and amount of information, represent a promising means of reducing the performance gap between younger and older adults. Through informed display design, this work will contribute to increased public safety in a wide range of complex domains.

Join us next week, on November, 7, 2016, for the seventh talk of the year titled “Using Doctors’ Notes to Uncover Everyday Natural Experiments in Healthcare” presented by Karandeep Singh, MD, MMSc, UMHS.

mendez October 24, 2016:

David Mendez was the fifth featured speaker of the “Providing Better Healthcare through Systems Engineering” series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS). Attendees came to his October 24th seminar from areas including the Department of Industrial and Operations Engineering, the University of Michigan Health System, the HEPS master’s program, and CHEPS.

Dr. David Mendez is an Associate Professor in the Department of Health Management and Policy at the University of Michigan where he teaches courses in Data Management, Quantitative Methods and Simulation Modeling applied to Health and Healthcare. Dr. Mendez received a B.S. in Civil Engineering from the Universidad Nacional Pedro Henriquez Urea, M.S. degrees in both Applied Statistics and Operations Research and a Ph.D. in Management Science, all from Michigan State University. His research focuses on building simulation and analytical models for the analysis of diverse health policy issues, particularly tobacco control. Currently, he serves as a consultant to the Academy of Medicine and the Food and Drug Administration (FDA) on modeling and analysis of potential smoking policy interventions.

Dr. Mendez’s presentation, “Examining the Influence of Peer Imitation on Smoking Initiation,” highlighted that cigarette smoking is the leading cause of preventable death in the United States. Reportedly, it kills nearly half a million people every year. Computational models have been very beneficial in helping to understand the expected path of the smoking epidemic and its potential consequences. But while useful in examining very general policy interventions that affect initiation, existing models are not set up to describe the process of smoking initiation in sufficient detail to accommodate interventions targeted to different groups of smokers.

In this talk, Dr. Mendez presented results from an ongoing research that aims to model teenage smoking initiation as driven in part by peer imitation, distinguishing between young men and women. Data from the National Survey on Drug Use and Health was used to calibrate the model. As a result of this work, a number of policy implications were formed that include different approaches for young men and women, even though smoking patterns between the groups are shrinking. In particular, women may benefit from interventions that help them cope with stress and low self-esteem where as young men may benefit from interventions that further de-normalize smoking and promote positive role models.

Join us next week, on Monday, October 31, 2016, for the sixth talk of the year titled “Age-related differences in multimodal attention and their implications for display design in healthcare” presented by Brandon Pitts, PhD, UM, Department of Industrial and Operations Engineering.

ayer October 10, 2016:

Turgay Ayer was the fourth featured speaker at the October 10th seminar of the “Providing Better Healthcare through Systems Engineering” series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS). Attendees came from the Department of Industrial and Operations Engineering, the University of Michigan Health System, the HEPS master’s program, and CHEPS.

Dr. Turgay Ayer is the George Family Foundation Assistant Professor of Predictive Health at Industrial and Systems Engineering, and is the research director for medical decision-making in the Center for Health & Humanitarian Systems at Georgia Tech. He also holds a courtesy appointment at Emory Medical School. Dr. Ayer received a B.S. in industrial engineering from Sabanci University in Istanbul, Turkey, and his M.S. and Ph.D. degrees in industrial and Systems Engineering from the University of Wisconsin – Madison. His research focuses on stochastic modeling and optimization, with applications in predictive health, medical decision making, healthcare operations, and health policy. Dr. Ayer has received several distinctions including, an NSF CAREER award, first place in INFORMS Doing Good with Good OR Student Paper Competitions, and Seth Bounder Foundation Research Awards.

During his presentation titled, “Prioritizing Hepatitis C Treatment Decisions in U.S. Prisons,” Dr. Ayer reported that one out of six inmates in the U.S. is infected with hepatitis C virus (HCV). He highlighted that new HCV treatment drugs are very effective, but providing treatment to all inmates is prohibitively expensive, which precludes universal HCV treatment in prison systems.

In this study, he proposed a restless bandit modeling framework to support hepatitis C treatment prioritization decisions in U.S. prisons. First, he proved index ability for the problem and derived several structural properties of the well-known Whittle’s index. In this stage, the research team derived a closed-form expression of the Whittle’s index for patients with advanced liver disease.

Second, he parameterized and validated a model using real-world data from Georgia state prison system and published studies. Then, he tested the performance of a proposed policy using a detailed, clinically-realistic simulation model and showed that this policy can significantly improve the overall effectiveness of the hepatitis C treatment programs in prisons compared with the current practice and other benchmark policies, including the commonly used Whittle’s index policy. The audience was enthralled by the presentation’s content, especially given the fact that this work focused on the prison system – a unique domain in healthcare research.

Due to the fall break holiday next week, there will be no seminar presentation on Monday, October 17. However, please join us the following week, on Monday, October 24, 2016, for the fifth talk of the year titled “Examining the Influence of Peer Imitation on Smoking Initiation” presented by David Mendez, PhD, UM, School of Public Health.

pooyan
mark
October 3, 2016:

On October 3rd, the third seminar of the “Providing Better Healthcare through Systems Engineering” series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS) featured a joint presentation by Dr. Mark Van Oyen and his former PhD student, Dr. Pooyan Kazemian. Attendees came from areas including the Department of Industrial and Operations Engineering (IOE), the University of Michigan Health System, the HEPS master’s program, and CHEPS.

Dr. Pooyan Kazemian is currently a research fellow in the Division of General Internal Medicine at the Massachusetts General Hospital (MGH) and Harvard Medical School (HMS). Prior, he worked at the Mayo Clinic as an operations research intern. He got his Ph.D. from the IOE department at the University of Michigan in April 2016, under the supervision of Dr. Mark Van Oyen. His research is focused on designing new data-driven optimization models for improving healthcare operations and disease management and aims to improve the quality of care, access, patient safety and health outcomes at lower cost. Dr. Kazemian’s research has been recognized by a number of awards including the INFORMS Bonder Scholarship for Applied Operations Research in Health Services, as well as a Rackham Predoctoral Fellowship.

Dr. Mark Van Oyen is a Professor in IOE at the University of Michigan, which he joined in 2005. His interests include the analysis, design, control, and management of operational systems and queueing networks. His current research focuses on healthcare operations or medical decision making. He co-authored papers that won the 2016 Manufacturing and Service Operations Management (MSOM) Best Paper award, first prize in the 2012 MSOM Student Paper Competition (and two other finalist paper in other years) and the 2012 INFORMS “Doing Good with Good OR” first prize. In 2009, he received the IOE Department Faculty of the Year for the 2008-9 academic year.

Together, Drs. Kazemian and Van Oyen presented on, “Coordinating Clinic and Surgery Appointments to Meet Access Service Levels for Elective Surgery.” During their presentation, they presented a methodological framework to make efficient use of scarce resources including surgeons, operating rooms, and clinic appointment slots with a goal of coordinating clinic and surgery appointments so that patients with different acuity levels can see a surgeon in the clinic and schedule their surgery within a maximum wait time target that is clinically safe for them. They proposed six heuristic scheduling policies with two underlying ideas behind them: (1) proactively book a tentative surgery day along with the clinic appointment at the time an appointment request is received, and (2) intelligently space out clinic and surgery appointments such that if the patient does not need his/her surgery appointment there is sufficient time to offer it to another patient. As part of this work, a 2-stage stochastic discrete-event simulation approach was employed to evaluate the six scheduling policies. This work is important, they explained, because providing timely access to surgery is crucial for patients with high acuity diseases like cancer.

Join us next week for the fourth talk of the year titled “Prioritizing Hepatitis C Treatment in U.S. Prisons” presented by Turgay Ayer, PhD, Georgia Tech, School of Industrial and Systems Engineering.

symposium September 26, 2016:

“The CHEPS Symposium never ceases to amaze me. It really is a manifestation of exactly what CHEPS is all about: collaboration,” said Anna Munaco, Industrial and Operations Engineering Undergraduate.

On September 26th, 2016 CHEPS hosted its Fourth Annual Symposium on Healthcare Engineering & Patient Safety. Over 30 posters were on display representing a variety of research and projects from inside and outside of the university. Approximately 150 attendees came from throughout the university, representing Engineering, the School of Public Health, the Health System, the Medical School, the School of Nursing, and the Institute for Healthcare Policy and Innovation. Several, like returning alumni and local corporate representatives, also attended from outside the university.

“There are more alumni coming back to this event as the CHEPS alumni network grows,” said Bill Zhang, HEPS master’s student. “Meanwhile, I was able to communicate with other members of U of M community beyond CHEPS at the symposium. That’s why CHEPS symposiums have been such great events: bringing different brilliant minds together while focusing on advancement of projects related to healthcare.”

For the first time this year, alumni didn’t just attend the symposium and the traditional reunion dinner held the Friday before, several also took the time to hold a panel discussion for current CHEPS students. The panel focused on allowing participants to share their experiences in the healthcare field and answer questions about the industry.

Current students and alumni greatly enjoyed the many opportunities to interact with one another that the symposium and related events provided. Matt Rouhana, an alumnus of the HEPS master’s concentration now working in the Henry Ford Health System, said his favorite part of the symposium was the opportunity to learn “about the projects that the current students are working on and how some of my projects that I was on in the past have done, including both the Chemo project and the Asthma project.”

Unlike the alums who reflected on past projects and symposiums, Andrea McAuliffe, a first year HEPS master’s student, saw the symposium as a chance to immerse herself in CHEPS and look to the future. “As a new HEPS master’s student, it was really inspiring to see all the projects other students have worked on,” she said. “I especially liked learning what everyone’s background was, and how they brought a unique perspective to their work. I’m looking forward to attending and participating in future symposiums!”

Attendees not only had the chance to learn about a wide variety of research projects, they were also able to vote for their favorite poster. First place in the audience choice for best poster competition went to “Patient and Caregiver Engagement in a Health Information Technology Tool in the Context of Hematopoietic Cell Transplantation” by Alex Fauer, Anna Munaco, Roshun Sankaran, Maite Van Hentenryck, Rahael Gupta, Evan Bischoff, Amy Cohn, Lyndsey Runaas, and Sung Won Choi. For second place, attendees selected “A Systematic Analysis of Procedures, Cleanability & Manufacturer Cleaning Instructions of Surgical Instrument Reprocessing” by Bill Zhang, Megan Yanik, Maite Van Hentenryck, Wesley Chen, Roshun Sankaran, Hassan Abbas, William Pozehl, Joe DeRosier, and Jim Bagian.

Bill Zhang, who took second place in the poster competition said, “It was such a great event to connect all the donors, alumni, collaborators, advisers, and students by celebrating another productive year at CHEPS. I was honored to receive the second place in the poster competition, but the biggest reward was the encouraging words from others after I presented my poster to them.”

Anna Munaco agreed that sharing her research with other attendees was one of the highlights. “It was a pleasure to share my work with interested guests from industry, the School of Nursing, the hematopoietic service, the College of Engineering, and many other places. It is a great environment to exchange and learn about new research in the healthcare landscape. I am so glad and honored that I could attend and present a poster this year,” she said.

As the symposium and CHEPS grow, the depth and breadth of the research and collaboration represented each year has also grown. William Pozehl, CHEPS Research Area Specialist and a graduate of the HEPS master’s program, said, “The moment that struck me was, while listening to Amy give remarks, I found myself standing behind a row of the following people: Dave Munson, former Dean of the College of Engineering; James Woolliscroft, former Dean of the Medical School; John Ayanian, Director of the Institute for Healthcare Policy and Innovation; and Sanjay Saint, Chief of Medicine of the Ann Arbor VA Medical Center. That these and other important figures within the University of Michigan’s research community wanted to attend the symposium was incredibly gratifying. Seeing our students share their hard work with them was even more invigorating!”

[view photos from the symposium]

alum panel September 26, 2016:

On September 26th, in conjunction with the 2016 Symposium on Healthcare Engineering and Patient Safety, CHEPS drew upon the knowledge and experience of its alumni network by hosting a Healthcare Engineering Alumni Panel. The panel focused on allowing participants to share their experiences in the healthcare field and answer questions about the industry. This alumni panel consisted of six past Michigan, Industrial and Operations students of varying perspectives and positions. Panelists included: Sarah Bach, an Analytics Engineer at University of Chicago; Ryan Chen, a graduate student at Stanford University; Mark Grum, a consultant at GE Healthcare; Pamela Martinez, a Process Improvement Consultant/Analyst at University of Colorado Health; Vanessa Morales, a Management Engineer at Duke University Health System; and Nick Tempels, a Process improvement Consultant/Analyst at University of Colorado Health.

The panelists began the discussion by introducing themselves, explaining their current position and giving a quick history about how they got where they are today. Following this background, the floor was opened for audience members to ask questions. Questions ranged from very broad, for the whole panel to answer, to those targeted towards an individual path or experience. The conversation included discussing everything from educational path decisions to career preparedness.

It was a unique and rare opportunity to have questions answered from so many different perspectives, and audience members definitely took advantage of the occasion. The panel was able to share their point of view about making the decision to pursue higher education (how high to go/when to stop), which classes and skills have been the most helpful since leaving school, and their thoughts on transitioning from the educational environment to industry. It was incredibly beneficial for all in attendance (many of whom are looking at deciding their next steps) to get the chance to have first-hand accounts comparing and contrasting varying educational and industry pursuits. Audience members and fellow panelists alike were able to learn from each other and gain insight into the healthcare industry.

From all of us at CHEPS, and everyone who attended the event, we want to say a huge thank you to the insightful and helpful panelists. It is a testament to our strong community that so many alums are not only willing to share their experiences, but in some cases, travel across the country to do so. As panelist Nick Tempels said, “The panel session was probably my favorite part of the trip – great discussion!” With such a strong and successful alumni group, this panel was the perfect demonstration of what a great resource their amazing wealth of knowledge can be.

cochran September 19, 2016:

Following Dr. Sanjay Saint’s great first talk, Dr. Amy Cochran gave an intriguing talk on her cutting edge research as the 2nd featured speaker in the “Providing Better Healthcare through Systems Engineering” series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS). The lecture was filled with attendees who came from areas including the Department of Industrial and Operations Engineering, the University of Michigan Health System, the HEPS master’s program, and CHEPS.

Amy Cochran completed her Ph.D. in Applied Mathematics from Cornell University in 2013. Presently, she is a T.H. Hildebrandt Research Assistant Professor in the Mathematics Department at the University of Michigan. Her research interests are in mathematical biology, especially in computational psychiatry. She has focused on bipolar disorder and describing, mathematically, the volatility of mood that is characteristic of the disorder. Additional application areas of medicine include pediatrics, emergency medicine, and obstetrics.

Bipolar disorder is a chronic disease of mood instability. Longitudinal patterns of mood are central to any patient description, but are condensed into simple attributes and categories. Although these provide a common language for clinicians, they are not supported by empirical evidence. In this talk, Dr. Cochran presented patient-specific models of mood in bipolar disorder that incorporate existing longitudinal data. She described mood as a Bayesian nonparametric hierarchical model that includes latent classes and patient-specific mood dynamics given by discrete-time Markov chains. These models were fit to weekly mood data, revealing three patient classes that differ significantly in attempted suicide rates, disability, and symptom chronicity. Then Dr. Cochran discussed how combined statistical inferences from a population do not support widely held assumptions (e.g. mood is one-dimensional, rhythmic, and/or multistable). She presented a stochastic differential equation model that does not make any of these assumptions. This model accurately described the data and that it can be personalized to an individual. Taken together, this work moves forward data-driven modeling approaches that can guide future research into precise clinical care and disease causes.

Join us on October 3rd for the third talk of the year titled “Coordinating Clinic and Surgery Appointments to Meet Access Service Levels for Elective Surgery” presented by Pooyan Kazemian, PhD, and Mark Van Oyen, Professor, U-M, Department of Industrial & Operations Engineering.

saint September 12, 2016:

Sanjay Saint was the first featured speaker at the September 12th seminar of the “Providing Better Healthcare through Systems Engineering” series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS). Attendees came from areas including the Department of Industrial and Operations Engineering, the University of Michigan Health System, the HEPS master’s program, and CHEPS.

Dr. Sanjay Saint is the Chief of Medicine at the VA Ann Arbor Healthcare System and the George Dock Professor of Internal Medicine at the University of Michigan. His research focuses on preventing healthcare associated infection, implementation science, and medical decision-making. He is the lead author of a book recently published by Oxford University Press titled: “Preventing Hospital Infections: Real-World Problems, Realistic Solutions.” He holds a Medical Doctorate from UCLA and completed a medical residency and chief residency at the University of California at San Francisco (UCSF). He also obtained a master’s degree in Public Health from the University of Washington in Seattle.

Dr. Saint’s seminar titled, “The role of intersectional innovations in preventing hospital infection,” focused on five key points: (1) the importance of infection prevention and catheter-associated urinary tract infection (CAUTI) and hand hygiene, (2), an overview of how to prevent infection with a focus on recent data, and descriptions of both technical and socio-adaptive aspects to reducing healthcare-associated infection, (3), the definition of “intersectional innovations” and its distinction from “directional innovations,” (4) an overview of the intersectional innovations that could impact infection prevention efforts, and (5) future directions in infection prevention, including the possible role of mindfulness.

Dr. Saint believes that preventing hospital infections, in general, will require an integration and understanding of human factors engineering, sociology, sensory psychology, and a host of other disciplines. During his presentation, he engaged the audience with an exciting slideshow that included numerous illustrations, as well as many comical and relatable references. The seminar ended with a discussion between Dr. Saint and the audience.

Join us next week for the second talk of the year titled “Mathematical Classification of Bipolar Disorder from Longitudinal Mood Data” presented by Amy Cochran, PhD, U-M, Department of Mathematics.

Brandon Pitts August 16, 2016:

Brandon Pitts, a winter 2016 PhD graduate of Industrial and Operations Engineering (IOE), has joined The Center for Healthcare Engineering and Patient Safety (CHEPS) as a post-doctoral research fellow. He’ll be splitting his time between CHEPS and the Center for Ergonomics (C4E). In CHEPS he’ll be assisting with the Providing Healthcare through Systems Engineering seminar series, working on the surgical instruments project, working with medical collaborators, and mentoring CHEPS students.

In C4E, he’ll continue to work with Nadine Sarter who was his PhD advisor during his time at IOE. There he’ll be working on publishing papers from his dissertation titled “Age-related differences in multimodal information processing and their implications for adaptive display design” as well as putting together a research agenda for his upcoming faculty career at Purdue University. He’ll begin his faculty position in Purdue’s School of Industrial Engineering in January 2017.

Brandon is excited for his time at CHEPS. “I get to work on understanding healthcare operations and needs and, based on my knowledge of human factors, figuring out ways through research and basic engineering to address those needs. I also have a chance to serve as a connection between the work going on in the Center for Ergonomics and the Center for Healthcare Engineering and Patient Safety,” he says.

Board Games August 12, 2016:

After a hard day’s work, students gather at Charley’s to take advantage of their weekly 4 dollar burger special. Afterwards, with the 2016 Rio Olympics in full swing, HEPS masters student Elizabeth Olin was gracious enough to lend her her space at the Munger graduate residence to watch Michael Phelps make history. While watching the Olympics, students faced off in strategic battles of Settlers of Catan and Ticket to Ride. As the summer is winding down, the bond of CHEPS student could never be stronger.

Giancola July 18, 2016:

On Monday, July 18th, Mr. David Giancola (IOE BSE ‘63) visited the Center for Healthcare Engineering and Patient Safety (CHEPS) to share his career experiences in applying Industrial Engineering practices to healthcare. Mr. Giancola became one of the first industrial engineers to work in the healthcare setting after graduating from the University of Michigan. He shared many stories, one of which involved using probability theory to predict how many operating rooms would be necessary for efficient hospital operations. He spoke about the atmosphere of working with healthcare professionals and the importance of clear communication to achieve a common vision.

For Wesley Chen, it was an opportunity to hear more about a career path that he wants to follow himself. “I’m really interested in pursuing a career in healthcare consulting. I thought it was extremely interesting how he chose to explain the role of a systems engineer,” Wesley said.

First year IOE PhD student Karmel Shehadeh enjoyed how well Mr. Giancola related to her and the rest of the students in attendance as well as his sense of humor. She remarked that, “It was nice to hear someone just spend so much time on their personal experiences. To have someone of his caliber share their life experiences was really invigorating.”

The CHEPS program would once again like to thank Mr. and Mrs. Giancola for their gracious support of the program. We hope to see them again very soon.

cheps July 15, 2016:

This Thursday, CHEPS director James Bagian and program manager Joseph DeRosier gave an enlightening lecture about Root Cause Analysis. CHEPS students learned the importance and usefulness of Root Cause Analysis and how it can be applied to many different types of situations. James Bagian and Joseph DeRosier also taught the students an extension of Root Cause Analysis to implement a solution after finding the cause. After the lecture, students were able to apply what they had just learned in a case study. Needless to say everyone had a great time learning something new!

cheps July 8, 2016:

This Friday, July 8th, former student Eli Sherman and current student Ajaay Chandrasekaran presented us with a lunch and learn about machine learning. This was a great way for different students of different backgrounds to learn something new and innovative. As students enjoyed their lunches and snacks, they learned the significance of machine learning and how the study and construction of algorithms can make predictions in certain models. Eli implements machine learning in his research to find ways to predict when patients need serum potassium. Ajaay works on a project where machine learning is used to predict patient appointment behaviors in endoscopy.

cheps July 1, 2016:

Today, July 1, officially marks the beginning of a new academic and fiscal year. This is an exciting time of change, especially in medicine. Program directors and chief residents across the country are doubtlessly celebrating the end of a successful year and preparing for another as they welcome new trainees and say goodbye to old. Really though, these preparations began many months ago as residency leadership teams spent countless hours constructing the annual rotation schedules for their programs. For large programs, this can be highly time-consuming, but industrial engineering concepts can help alleviate and improve the process. This past semester, the Center for Healthcare Engineering and Patient Safety aided thirteen residency programs in the Department of Surgery, plus the Pediatric, Combined Medicine-Pediatric, and Internal Medicine residency programs to build their annual rotation schedules. In total, our work helped more than 400 residents and over 175 different services!

Building the annual rotation, or block, schedules for residents and fellows requires balancing the needs of the trainee with the needs of the services on which they work. Here at the University of Michigan, we have over 1,200 resident and fellow medical trainees spanning over 100 different specialties. Ensuring that each resident gets an appropriate amount of time on each service while also providing an appropriate resident complement for each service at all times can be challenging, especially in cases where multiple residency programs send trainees a particular service. As Janice Davis, Education Director for the Department of Surgery at the Univ. of Michigan, puts it, the biggest challenge in building a block schedule is “getting the various programs to work together so that there is balance in the number of learners assigned to service each month.” Fortunately, our efforts have brought the leadership together in better understanding their impact on other areas of the department.

Using linear programming models that can generate a department-wide schedule in a matter of seconds, our team works closely with Ms. Davis and other program leadership to draft and revise the schedule according to ever-evolving resident and service needs. Though we can significantly reduce the time required to generate a schedule, Ms. Davis must still identify some schedule modifications due to pregnancies, extended illnesses, and other unexpected events. Once we identify a potential remedy, Janice loves that “it takes seconds” for the system to determine whether her proposed solution can work.

Having assisted the Pediatric residency program in their block scheduling process the last two years to great success, we added Medicine-Pediatrics and Internal Medicine into the fold this year. As the Med-Peds residents spend time on both Pediatrics and Medicine services, integrating the decision-making process for all three groups was a natural fit. As new Internal Medicine chief resident Owen Albin says, “Having an automated way to effectively allocate rotations helped us minimize transitions of care that violate federal laws and are bad for resident health. It also helped us match rotations with residents during times in the year that are of optimal convenience.” The models proved especially beneficial in providing residents with their most preferred vacation periods, an important factor in resident satisfaction.

By adding the Medicine-Pediatrics and Internal Medicine programs to our scheduling portfolio, we nearly doubled the scope of our work. Naturally, that presented some challenges that both our engineers and clinicians are working to improve upon. Dr. Albin explains, “While automating the scheduling process has its advantages, it also leaves out an appreciation for some of the intricacies that come with allocating specific rotations to different individuals. The block scheduling creates an efficient and excellent foundation on which to build the schedule, but there still needs to be a significant role for personal input.” Our team is already hard at work identifying improvements in our processes and functionality to better serve our collaborators’ needs based on their feedback.

Congratulations to all those doctors who have just completed their training and good luck to all the new first-year residents joining us at the University of Michigan! Thanks especially to the program directors, chief residents, staff and students that have helped in these projects.

Bake off June 24, 2016:

The team of CHEPSters working with the BMT Roadmap app development attended Hematology & Oncology research rounds Monday morning. Dr. Lyndsey Runaas, hematology fellow and co-investigator for BMT Roadmap, presented the study’s current objectives and outcomes. Dr. Runaas took time during her presentation to acknowledge CHEPS to the hematology fellows in attendance, and how our involvement with their development team will contribute to better services to the enrolled patients and their families.

Another on going projects of CHEPS is the CHEMO project. The objective of the CHEMO project is to create a phlebotomy simulation to identify mediators to improve patient throughput. To do this, CHEPSters this week collected data from port draws at the Cancer Center’s phlebotomy unit to add to the simulation’s metrics.

CHEPSters don’t just work hard; we eat hard too! This Tuesday CHEPs organized a bake off. Students, faculty, and collaborators of CHEPs showed their skills as bakers to deliver us all kinds of delicious desserts. It was a great opportunity for our students, faculty and collaborators to meet each other, learn from each other, build relationships and networks, and most importantly stuff our bellies with yummy treats.

Today, Anna Munaco, Jackson Bennett, Elizabeth Olin, Pranjal Singh and Katherine Adams were able to take time from their busy CHEPS day to help Dr. Mariel Lavieri run an ER simulation for WISE Girls in Science and Engineering (GISE) camp to show how operations research can be applied to healthcare. The girls were able to run through the simulation of the ER department at a hospital, work together and identify elements of the process that were slowing it down. By the end of the activity, the girls were able to go from only discharging 7 patients in the ER to 24 patients! This was a great opportunity for younger kids to experience a little of what we do here at CHEPS.

lunch and learn June 17, 2016:

The chemotherapy team had an exciting week. Many of the members of the team had the opportunity to observe in the cancer center’s pharmacy where the drugs for infusion are made. Chemo team member, Samantha Roth, explained, “It was very useful to see the whole process in the pharmacy from the technician first getting the go-ahead for the drug to be made to the drug being given to the infusion center.” The chemotherapy team also began collecting port draw times at Phlebotomy.

This week after working many CHEPSters got together to enjoy Ann Arbor’s Restaurant Week and summer festival, Top of the Park. They went to Isalita to enjoy a four-course meal and then afterwards went to Top of the Park to watch Ferris Bueller’s Day Off. It was a relaxing way to spend their night and to get to know everyone better.

lunch and learn June 10, 2016:

It was another exciting and busy week at CHEPS!

This past Wednesday, CHEPS PhD Candidates, Brian Lemay and Young-Chae Hong, presented their research on scheduling. Many students that are working at CHEPS and others from different departments from around the university gathered at the CHEPS office to learn more about the exciting scheduling research that is taking place. Brian’s topic looks into conflicting scheduling requests and finding sets of requests that can be satisfied. Young-Chae’s topic looks into Pareto points for schedules to generate Pareto schedules that reduce the schedule space for chief residents to review. All of the students in attendance were incredibly engaged in the presentations and could see immediate value in the work that Brian and Young-Chae are doing.

After the presentations, everyone joined together in the Design Studio to enjoy lunch. Many people from different departments, including medicine, industrial and operations engineering, computer science, and nursing, were in attendance. It was a fun opportunity for everyone to meet new people and to learn about all of the different research projects taking place inside and outside of CHEPS. Overall, this lunch and learn was a great success.

A recent project involving CHEPS research assistants is a new collaboration with Dr. Sung Choi, pediatric Bone Marrow Transplant (BMT) physician at C.S. Mott Childrens Hospital, who is piloting a new health IT tool for pediatric and adult BMT patients. Anna Munaco, rising IOE senior, recently shadowed Dr. Gred Yankik, attending Pediatric BMT physician, to observe the inpatient unit’s process flow to better understand the patient’s experience post-transplant.

“I look forward to this project because I support patients being advocates for their own health, and creating a new tool for them to use as a resource to participate in their health outcomes” Munaco explained. “The goal of this new tool is to help patients navigate through the post-transplant progression safer and more efficiently.”

Nursing Innovation June 3, 2016:

Last week, new CHEPS research assistant Alex Fauer, undergraduate nursing & PhD pre-admit, attended the Hillman Foundation in Nursing Innovation’s annual conference at the University of North Carolina-Chapel Hill in Chapel Hill, NC. Alex gathered with other nursing PhD students, faculty, and researchers to collaborate on the current state of nursing science, and leadership through diversity, research, and transdiciplinary collaborations. Alex disseminated his award winning review Plasma biomarkers associated with inflammation and reproductive function to the attendees, calling to action the future role blood biomarkers will play in the occupational safety of workers who handle hazardous drugs.

Jeremy May 31, 2016:

“A Stochastic Programming Approach to Reduce Patient Wait Times and Overtime in an Outpatient Infusion Center,” a paper authored by Jeremy Castaing, Amy Cohn, Brian Denton, and Alon Weizer, has been published in IIE Transactions on Healthcare Systems Engineering.

Chemotherapy infusion treatments for cancer have significant and unpredictable variability in duration. This variability can have negative impact on operations – both patient wait time and staff overtime – if not managed well. Based on their observations at the University of Michigan Comprehensive Cancer Center (UMCCC) and collaborations with clinicians there, the authors present a two-stage stochastic integer program for designing patient appointment schedules under uncertainty in treatment times. Their objective is to minimize a trade-off between expected patient wait times and expected total time required to treat patients.

The publication of this article is the product of several years of research at CHEPS, in partnership with the UMCCC. This work, part of the chemo project, began in summer 2013. The optimization models developed by Jeremy, Amy, and Brian were used by the CHEPS Chemo team of summer 2015 to solve appointment scheduling problems on real data sets obtained from the UMCCC.

cheps students May 27, 2016:

We had another great week at CHEPS! Several of our team members attended this year’s annual Industrial and Systems Engineering Research Conference (ISERC) in Anaheim, CA early in the week. One full-time CHEPSter, Roshun Sankaran, presented “A Linear Programming Model for Scheduling Medical School Clinical Experiences,” which highlights two different scheduling projects the team has collaborated on with the University of Michigan Medical School. Sankaran stated, “I am really grateful that I got the chance to give a presentation to the attendees of the conference. Opportunities like this are one of the best parts about being at CHEPS.” Other students at CHEPS attended ISERC and also presented their work.

This past Tuesday, CHEPS students, Jackson Bennett, Anna Munaco, Samantha Roth and Eli Sherman went to a presentation given by Dr. Mona Hanna-Attisha on the Flint Water Crisis as it relates to the application of children’s health research. Dr. Mona Hanna-Attisha led a study, which confirmed that the proportion of infants and children with elevated blood lead levels had nearly doubled since Flint switched from the Detroit water system to using the Flint River for its water. The students found it fascinating to hear from someone leading the change in Flint. Computer Science student Samantha Roth said, “Much of what I knew about the Flint Water Crisis had come from the media. It was eye-opening to listen to Dr. Attisha share her first-hand experiences on the crisis. It was intriguing to learn that there were many actions that could have been taken to prevent the crisis.” In all, the CHEPS students learned a lot about the Flint Water Crisis from Dr. Attisha’s presentation and were glad to hear that she is continuing to lead efforts to support Flint children that were diagnosed with elevated blood lead levels.

iserc May 24, 2016:

Several members of the CHEPS team attended the Industrial and Systems Engineering Research Conference (ISERC) organized by the Institute of Industrial & Systems Engineers (IISE) in Anaheim, California at the Disneyland Resort Hotel. Moses Chan, Ajaay Chandrasekaran, William Pozehl, and Roshun Sankaran represented CHEPS at the conference which was held from May 21 -24, 2016.

The group presented on the following topics:

Annual Rotation Scheduling for Medical Residents Through Optimization, William Pozehl
Discrete Event Simulation of Outpatient Flow in a Phlebotomy Clinic, Ajaay Chandrasekaran
A Linear Programming Model for Scheduling Medical School Clinical Experience, Roshun Sankaran
Scheduling Dynamics of a Weight Management Program, Moses Chan

William Pozehl was impressed by the work of his fellow CHEPSters. He said, “The CHEPS students gave some brilliant talks. I was particularly impressed by Roshun’s talk in my session — as a non-engineer he did a fantastic job describing some in-depth modeling.”

While the students mostly focused on attending healthcare talks and delivering their own presentations, they also enjoyed the opportunity to learn about some research outside of healthcare. Roshun Sankaran said, “Most of the talks I saw were healthcare-related, though I did see a talk with Moses about modeling terrorist activity, and that was pretty interesting.” Ajaay Chandrasekaran added that he “enjoyed the variety of talks given by individuals from other institutions.”

One of the highlights for Moses Chan, was helping out his fellow conference attendees. “While the conference experience was enlightening, I also valued much the time discussing possible improvements with my fellow CHEPSters prior to their talks,” he said.

The conference not only allowed us to share our teams’ research work, more importantly it facilitated the conversation and exchange of ideas among fellow researchers in the field. With such opportunities we continue to serve our healthcare community, and many others, in a collaborative research environment.

Outside of the conference, the CHEPS crew enjoyed the beautiful weather and lots of time in Downtown Disney. Everyone was in agreement that the vegan Vietnamese restaurant they visited was the best culinary experience of the trip!

[View photos from ISERC.]

iserc practice talks May 20, 2016:

With our new students settling in and project teams ramping up for the summer, the CHEPS office was bustling this past week. On Tuesday, four members of the Surgical Instruments team visited the Neurosurgery operating rooms at UMHS. The team was observing the instrument flow before, during, and after surgery. For Megan Yanik, a soon-to-be second-year Medical Student, this observation session – while exciting – was par for the course. But for Nina Scheinberg, it was only the second opportunity to observe in the OR environment. “There’s a big difference between talking about the instrument flow in the ORs and actually seeing it,” she said. “This observation session is a testament to how engaged our UMHS partners are in this project, and I’m thankful that CHEPS and UMHS have a relationship that affords us these opportunities.”

In other news, Healthcare Engineering and Patient Safety (HEPS) Masters’ student Elizabeth Olin led the Chemo team’s weekly rounds at the University of Michigan Comprehensive Cancer Center this week. Olin and other research assistants are working to identify ways to improve patient flow in the the Cancer Center. For Alex Fauer, a senior in the University of Michigan’s undergraduate nursing program, observing interdisciplinary rounds is not unfamiliar. “I’ve been in meetings with doctors, nurses, etc., but this is the first time I felt like I’m contributing to the management of not just one patient, but potentially hundreds. I’m so grateful to be a part of CHEPS,” he said.

Additionally, a dozen CHEPS members gathered to watch and critique two students’ practice presentations for the Industrial and Systems Engineering Research Conference (ISERC) coming up in Anaheim this weekend. The practice talks were excellent, and we anticipate a great showing by CHEPS in California!

merrill bonder visit
merrill bonder visit
May 18, 2016:

On May 18th, the Center for Healthcare Engineering and Patient Safety (CHEPS) was honored and excited to host longtime friend and supporter, Mrs. Merrill Bonder, head of the Seth Bonder Foundation. Students, faculty, and friends alike shared a lunch in celebration of the collaboration and work made possible by the generous support from The Seth Bonder Foundation. Discussions ranged widely as each student was eager to share the amazing projects they are working on and how greatly they have benefited from the support of the Seth Bonder Foundation.

The Seth Bonder Foundation was founded in memory of the late Dr. Seth Bonder, a former IOE faculty member as well as the founder and former chairman/CEO of Vector Research, Inc. Much of his career was focused on improving the planning and operations of healthcare delivery enterprises. He was also an expert in national security and defense enterprises, with an international reputation for his work developing new procedures and directing analyses for planning and operations analysis of military forces.

Dr. Seth Bonder was particularly passionate about supporting and mentoring students. This legacy and memory are honored every day through the amazing work made possible by the funding, support and friendship Merrill Bonder and the Bonder Foundation have offered CHEPS.

jim bagian May 10, 2016:

CHEPS director, Jim Bagian, is quoted in a Politico Pro article titled “ONC Seeks Path Amid Contradictory Calls to Action.”

“The Institute of Medicine in 2011 called for creating a reporting and investigation system for health IT-related deaths and injuries. But such complex investigations require time and resources ONC lacks, says Jim Bagian, who sat on that IOM panel and leads the Center for Healthcare Engineering and Patient Safety at the University of Michigan.”

(A subscription to Politico Pro is required to read the full article.)

POMS May 9, 2016:

The Production and Operations Management Society (POMS) recently held their annual conference in Orlando, Florida from May 6-9, 2016. From CHEPS, Prof Amy Cohn, Brian Lemay, Billy Pozehl, Nina Sheinberg, Pranjal Singh, and Bill Zhang all attended the annual conference.

During the conference, Amy delivered a well-received talk on all of the great scheduling work that has been done with medical residents at the University of Michigan. Building off of Amy’s presentation, Brian discussed his research relating to the specific challenge of scheduling medical residents when they have conflicting requests for time-off. Pranjal also gave a great presentation on the work that is being done to improve patient access and adherence to a weight management program. Rounding out the CHEPS presentations was Bill, who gave an excellent talk on the work being done to improve the delivery of surgical instruments through process flow improvements.

While not delivering presentations, CHEPS members attended an assortment of presentations that covered a wide variety of topics including: a decision support system for appointment scheduling (Prof William Millhiser), how to be relevant in the age of analytics (Prof Mark Spearman), hospital-acquired conditions (Hamsa Bastani), long-term care for intensive care unit (ICU) patients (Prof Fernanda Bravo), and the economics of “flipping” operating rooms (i.e., having surgeons start on their next patient in a new room while their previous room is turned over) (Prof Nickolas Freeman). In-between presentations, CHEPS members networked with other professionals interested in healthcare related research and created many new connections while renewing old ones.

During the evenings, CHEPS members enjoyed exploring nearby Disney Springs and all of the great sights, sounds, and tastes it has to offer. CHEPS members also had the opportunity to attend the opening ceremonies to the Invictus Games—an athletic event started by Prince Harry as a way to inspire recovery, support rehabilitation, and generate a wider understanding and respect for wounded, injured, and sick servicemen and women. The opening ceremony included inspiring words by Michelle Obama, Prince Harry, George W Bush, and Morgan Freeman as well as a number of emotional stories from wounded warriors. Overall the conference was a great experience for everyone who attended!

The presentations given were:

Improving Patient Access and Adherence to an Endocrine Program, Pranjal Singh
Process Optimization for Improved Delivery of Surgical Instruments, Bill Zhang
Scheduling Medical Residents, Amy Cohn
Scheduling Medical Residents With Conflicting Requests for Time Off, Brian Lemay

[View POMS photos.]

rod capps May 6, 2016:

The 2016 Engineering Excellence in Staff Service Awards ceremony on Friday afternoon was a celebration of the outstanding service provided by College of Engineering staff. The event marked the presentation of the 10th annual College of Engineering Excellence in Staff Service Awards and Judith A. Pitney Staff Service Career Award. Started by Dean David C. Munson in his first year on the job, the awards ceremony seeks to honor the contributions of the hardest working and most dedicated staff members throughout the College.

One of this year’s award recipients was our own Rod Capps. Rod was selected to receive the award for his work at CHEPS and the Industrial and Operations Engineering Department. For the past several years Rod has served the department dutifully as an expert of web applications and databases. He aided the IOE Department over the course of the past year in the rollout of its new website. Rod has been an integral part of the Aviation Project, serving as a point of contact with the University’s IT Department on setting up and maintaining their database of over 80 million flight records. He also routinely lends his expertise on improving data retrieval techniques to CHEPS in order to improve the speed and robustness of data analysis. In his acceptance speech, Rod made sure to thank those that nominated him as well as his coworkers in IOE and CHEPS, and, of course, his wife of 20+ years who forms the second half of a husband-wife folk music group, Annie And Rod Capps.

Award recipients were nominated by several members of their home departments, including colleagues, supervisors, and faculty. A selection committee then whittled down the number of nominees to select eight award winners as well as the winner of the career award, which is open only to staff members who have been with the college for 10 or more years. The awards ceremony allowed the winners’ family, friends, and colleagues to celebrate their accomplishments, and it was followed by a lovely reception in the Chesebrough lobby complete with photo opportunities for those supporting the winners.

summer 2016 welcome May 2, 2016:

On Monday, May 2, the Center for Healthcare Engineering and Patient Safety (CHEPS) began the summer season with a welcome breakfast introducing both returning and new students, faculty and collaborators. The new affiliates got their first exposure to the incredible CHEPS network and officially took their place among them. With such an impressive group, it is sure to be a productive and exciting summer!

grum-strachan May 2, 2016:

On May 2, CHEPS students listened avidly as Dr. Cyril Grum and Nurse Cathy Strachan presented on how to behave as a student in a clinical environment. This informative session was an incredible opportunity to help prepare the highly diverse group for their clinical observations and/or interactions in the hospital setting. Given many of the students have never been exposed to the hospital environment, they were able to benefit greatly from this ‘clinical observation 101’ crash-course.

Dr. Grum is a University of Michigan Professor of Internal Medicine and Associate Chair for Undergraduate Medical Educations in the Department of Internal Medicine at the University of Michigan. He is well versed on this topic and commonly helps prepare medical students for their clinical work with similar seminars. Furthermore, Nurse Strachan has been a University of Michigan nurse and worked in the clinical environment for many years. Together they offered a comprehensive, robust introduction and explanation of the field.

Dr. Grum and Nurse Strachan provided insight into everything from what interaction & events to expect, to making the best impression, to succeeding in the clinical setting. They answered questions with care and patience. To make the experience interactive, Dr. Grum and Nurse Strachan challenged students to seriously consider their potential reactions in different scenarios. This prepared students for the unique and beneficial opportunities that clinical emersion can provide. The material they presented will be key in helping students navigate the potentially unfamiliar environments in a professional and successful way. We cannot thank them enough for their time and knowledge.

verter May 2, 2016:

On Monday, May 2, 2016, the Center for Healthcare Engineering and Patient Safety (CHEPS) kicked off summer with a Lunch and Learn session featuring Dr. Vedat Verter. Dr. Verter is a James McGill Professor of Operations Management at the Desautels Faculty of Management at McGill University, specializing in the application of business analytics for policy design and decision-making in the public sector. His areas of research are transport risk management, sustainable operations and healthcare operations management. In the area of healthcare, he focuses on preventive, primary, emergency, acute and chronic care processes, as well as their interaction. He is Director of McGill’s MD-MBA Program and Founding Director of the NSERC CREATE Program in Healthcare Operations and Information Management, a seven-University PhD/PDF training program across Canada.

In this talk, titled “Healthcare Operations Management in the Age of Business Analytics”, Dr. Verter presented an overview of two multi-disciplinary research projects, taking advantage of the full spectrum of business analytics, namely tools for decision making in tactical, strategic, and operational settings, for improving healthcare systems and care delivery processes. At the strategic level, he discussed the design, in collaboration with the Quebec Ministry of Health, of a breast cancer screening program in Montreal. This project made use of survey-based and secondary data to characterize women’s preferences for mammography services in order to estimate the likelihood of their participation in the screening program.

At the operational level, Dr. Verter provided an overview of his work (in progress) at the Montreal Jewish General Hospital surgical services which uses real time location system technology to gather data on patient care pathways as well as nurse behavioral patterns. This constant flow of data created by this system requires the use of big data analysis techniques for understanding the system dynamics with the goal of improving the accessibility of surgical services for patients.

The talk was well received by the audience and fostered an interactive discussion amongst attendees. Further discussion, from Dr. Verter’s methodology and technique, to introduction and involvement of technology lead to an intriguing and informational conversation and ultimately a very successful seminar!

moses trio April 28, 2016:

On Thursday, April 28, CHEPS’s own Moses Chan performed the violin in a piano trio along with Joe Jang on cello and Danny Luan on piano. The group began with Beethoven’s Piano Trio in B-flat, Op. 97, commonly known as the Archduke Trio. After a brief intermission, the group began again with Astor Piazzola’s hauntingly emotional Oblivion, a tango written for the movie Enrico IV. They then finished the recital with Debussy’s Piano Trio in G, L. 3, an expressive four-piece movement written when Debussy was only 18. CHEPS’s Eli Sherman also contributed his efforts as a page-turner.

More than a dozen CHEPS students and affiliates attended the concert which was held at the Kerrytown Concert House. All donations from the performance were graciously given to World Vision for disaster relief from the earthquake in Ecuador.

Thank you, Moses, for sharing your talent and music with us!

folk fest March 28, 2016:

On Monday, March 28th students from the Center for Healthcare Engineering and Patient Safety (CHEPS) had a mixer with the students from the Institute for Healthcare Improvement Open School (IHI-OS). Both of these groups strive to improve patient safety and the quality and efficiency of healthcare delivery through a multi-disciplinary, systems-based approach.

The event kicked off with an overview of what CHEPS and IHI-OS are all about. Billy Pozehl, Research Specialist at CHEPS, delivered a brief talk about the goals of CHEPS and some of the projects that are currently being worked on. Pauline Do, IHI-OS Chapter President, explained the role of IHI-OS and the primary aims of their projects.

The mixer continued with CHEPS and IHI-OS students chatting over pizza and refreshments. Individuals from both groups were able to discuss the projects that they were working on and how they are related to each other. CHEPS student Pranjal Singh shared, “IHI does a lot of the same things CHEPS does, but their approach is slightly different than ours. They look at things from a very design oriented approach. It’s really nice to see that we have a lot of things in common in terms of the problems we are trying to solve and that there is a lot we can learn from each other in future collaborations”.

Various CHEPS students had visual demos related to projects that were displayed during the event. Some of these included an appointment scheduling game ran by Nina Scheinberg, and a phlebotomy clinic simulation demonstrated by Ajaay Chandrasekaran.

At the beginning of this event many CHEPS students didn’t know what IHI-OS stood for, and many IHI-OS students didn’t know what CHEPS stood for. By the end of the event all of the students had a better understanding of what each other do and were excited about the possible collaborations between CHEPS and IHI-OS on coming projects.

SHS February 19, 2016:

The Society of Health Systems’ 2016 Healthcare System Process Improvement Conference in Houston was an amazing experience for all the CHEPS students who attended. The conference focused on the application of industrial engineering tools to transform the healthcare industry. Academic researchers, industry leaders, and technology vendors gathered from all over the country to share knowledge, network, and enjoy the mild spring weather.

“The SHS Conference was a great opportunity for me to learn about the impact industrial engineers can make in the healthcare industry outside the areas I have become familiar with through working at CHEPS,” said Jonathan Mogannam, an IOE undergraduate student.

The keynote speakers were both educational and inspirational. Dr. Denis A. Cortese, emeritus president and CEO of Mayo Clinic and current Director of the Health Care Delivery and Policy Program at Arizona State University, talked about achieving excellence and encouraged attendees to rethink quality and value for patients. Dr. James Rawson, Chair of the Department of Radiology and Imaging at Medical College of Georgia at Augusta University, stated the importance of IE from a physician’s perspective and challenged industrial engineers to save 100 million dollars in daily operations for the year to come.

“SHS was my first conference I have ever been to, and I thought it was really interesting to see so many other people sharing CHEPS’s interest in healthcare engineering,” said Paige Mollison, an IOE undergraduate student.

Poster and presentations sessions were instrumental as well. CHEPS own presenters, Nina Scheinberg, Billy Pozehl, Elizabeth Olin, Matt Rouhana, and Donald Richardson, presented their respective projects and received positive feedback from their audiences.

Matt Rouhana, a HEPS master’s student, was impressed by the presentations he saw. “I love the SHS conferences because of the high quality of the presentations at them,” he said. “This year’s was no exception, and I was able to attend a number of fantastic talks and network with some great people. And it was great to be able to enjoy some warm weather in Houston too!”

Donald Richardson, and IOE PhD student, enjoyed the smaller size of the conference saying, “Unlike larger conferences, SHS hosts a more close knit community of healthcare professionals and engineers. In this setting, networking came more natural even for me as a first time attendee. It was exciting to meet multiple speakers or audience members who showed interest in my own area who later were able join the audience for Matt Rouhana and my presentation.”

Nina Scheinberg, a recent IOE graduate, said, “HSPIC was both my first time attending a conference and my first time giving a presentation on Surgical Instruments, and both experiences were wholly valuable. I learned a lot about process improvement projects in hospitals around the country, and I had the chance to share my own team’s success with other Industrial Engineers interested in the same research. In addition to enjoying the conference, I also got to bask in Houston’s beautiful weather and feast on the local food. I’m so grateful that I had the opportunity to go on this awesome trip.”

Students from CHEPS were able to make many connections during the conference. Bill Zhang reconnected with his undergraduate classmates and internship supervisors. He also discussed discrete-event simulation with an expert form Carilion Clinic and an architect from a healthcare facility design firm.
“It is my first conference with CHEPS and it has been a great experience!” said Bill Zhang, a first year HEPS master student, “It was a precious opportunity to learn about the trend of the industry and other cutting edge research. It also provided such a nice platform for networking. With almost a third of all student poster presentations from our team, I am extremely proud of being part of CHEPS!”

CSE Undergraduate student Ajaay Chandrasekaran was also a first time conference attendee. He said, “SHS 2016 is the first conference that I have ever attended; it is an experience that I will never forget. The conference was a fascinating conglomeration of individuals, which included professionals from industry and academia as well as specialists from diverse realms, such as hospital management, process improvement, and machine learning. I valued the opportunity to present our team’s progress in the development of a phlebotomy clinic simulation for the Cancer Center. The conference was also a great opportunity to gain technical advice from other individuals, some having successfully developed simulation models to improve patient flow in their domains.”

Posters presented at the conference were:

Presentations at the conference were:

[View photos from the conference]

Mollison February 19, 2016:

Paige Mollison was the Undergraduate Student Award Winner at the Society of Health Systems’ 2016 Healthcare Systems Process Improvement Conference. The award recognized her poster titled “Scheduling Healthcare Providers Using Optimization.” The research presented on the poster was in collaboration with William Pozehl, Amy Cohn, Stephen Gorga, and Janice Davis. Awards for posters are judged on the level of impact of the project, the presentation of the content on the poster itself, and the ability to convey the story represented on the poster while speaking with the judges and other attendees.

Elizabeth and Young Chae February 1, 2016:

Elizabeth Perelstein, Ariella Rose, Young-Chae Hong, Amy Cohn, and Micah T. Long have an article titled “Automation Improves Schedule Quality and Increases Scheduling Efficiency for Residents” published in the February 2016 issue of the Journal of Graduate Medical Education.

Medical resident scheduling is difficult due to multiple rules, competing educational goals, and ever-evolving graduate medical education requirements. Despite this, schedules are typically created manually, consuming hours of work, producing schedules of varying quality, and yielding negative consequences for resident morale and learning. The article looks at how computerized decision support can improve the construction of residency schedules, saving time and improving schedule quality using the example of The Optimized Residency Scheduling Assistant which was implemented in the C.S. Mott Children’s Hospital Pediatric Emergency Department in the 2012–2013 academic year.

folk fest
folk fest
January 29, 2016:

Students Christine Barnett, Nina Scheinberg, and Bill Zhang along with Christine’s husband attended the 39th Annual Ann Arbor Folk Festival thanks to tickets gifted to CHEPS by Merrill Bonder and The Bonder Foundation. The group attended night one of the festival on January 29th. The musical lineup included City and Colour, Richard Thompson, Yo La Tengo, The Oh Hellos, Nora Jane Struthers & the Party Line, Penny & Sparrow, and Ben Daniels Band. David Mayfield was the MC.

All four had an excellent time and were grateful for the opportunity to see the concert. “The Folk Festival performances were incredible, and the entire event was seamlessly run. The fact that our seats were in the fifth row intensified the whole experience. It was hands down the best show I’ve been to in Ann Arbor,” said Nina.

Thank you to Merrill and The Bonder Foundation for the awesome Folk Festival experience!

brunner January 29, 2016:

On Friday, January 29th, 2016, the Center for Healthcare Engineering and Patient Safety (CHEPS) hosted a Lunch and Learn session featuring Dr. Jens Brunner. Dr. Brunner is a professor of Healthcare/Operations Health Information Management as a Faculty of Business and Economics at the University of Augsburg. He teaches courses in service operations management, modeling and optimization, integer programming, and healthcare management. His research has a special focus on processes in healthcare.

At the session, Professor Brunner discussed his recent work, which centers on flexible scheduling of physicians across short- to long-term planning horizons. He began by explaining that simply scheduling physicians to accommodate average demand would lead to issues, as the 90th percentile demand is much higher. He noted that low staffing levels lead to unplanned overtime and that high staffing levels lead to excessive personnel costs. This results in the need for a flexible shift schedule.

The model that Dr. Brunner and his colleagues created minimizes the number of physicians while adhering to approximately 30 constraints relating to satisfying demand and shift duration. If an extended shift is scheduled using the model, then the physician knows that they may have to work a longer shift. This ensures that demand is being met and at the same time increases the predictability of working hours. This model was evaluated with data from a case study at the German University Hospital. Their approach reduced unplanned overtimes by over 80% and the required workforce level was decreased by 20%.

The talk was well received by the audience and fostered an interactive discussion amongst attendees. It was brought up that this type of staffing model could be applied to nurse scheduling. This would provide certainty by allowing nurses to be aware in advance which day of the week they may need to stay longer. Professor Brunner concluded the session by noting that this model has been incorporated into a software tool with a user interface that is being marketed and used by physicians today.

We would like to heartily thank Professor Brunner and all of our guests for participating in this enriching Lunch and Learn session.

transfer team January 19, 2016:

Gabriel Zayas-Caban (Postdoctoral Research Assistant in CHEPS), and Mariel Lavieri (CHEPS affiliate and IOE faculty member), Folafoluwa Odetola (Assistant Professor, Department of Pediatrics and Communicable Diseases) and Luke Bruski (IOE Master’s Alum) authored an article titled “An Innovative Framework to Improve Efficiency of Interhospital Transfer of Children in Respiratory Failure” which was published in the Annals of the American Thoracic Society on January 19, 2016.

High mortality and resource use burden are associated with hospitalization of critically ill children transferred from Level II Pediatric Intensive Care Units (PICUs) to Level I PICUs for escalated care. This study utilized innovative methods to create thresholds of transfer that might reduce delay in transfer. The full article is available at the link above.

WIDTH January 15, 2016:

On Friday, January 15th several students from the Center of Healthcare Engineering and Patient Safety (CHEPS) participated in a panel at the School of Public Health (SPH). The panel was hosted by WIDTH, which is an interdisciplinary forum within the SPH for doctoral students to discuss their dissertation topics, research ideas, and results with other students and faculty.

The panel began with Billy Pozehl providing a brief overview of CHEPS and explaining its primary goal of improving the delivery, quality, and safety of healthcare through systems engineering approaches. Billy explained that CHEPS focuses on the collaboration of students from different backgrounds, which creates multidisciplinary teams. He also noted that implementation and innovation are major focuses of this research work. Billy stressed the important role that education plays with students coming from health and engineering backgrounds and the opportunities they have to learn from one another. Finally, he explained the importance of dissemination and awareness of CHEPS, which this event is a prime example of.

Each of the students gave a brief overview of the research they have been working on and shared their unique perspective of their experience working at CHEPS. Matt Rouhana discussed a project that he is working on at the Cancer Center and how it aims to improve experience of outpatients receiving chemotherapy by reducing wait times. Hassan Abbas spoke about his project at C.S. Mott Children’s hospital, which evaluates patient flow. He explained that, when he began at CHEPS, he was given an overview of some of the optimization concepts and has continued to expand his knowledge of engineering principles.

Next, Brian Lemay discussed his work regarding scheduling residents and the challenges it includes. He mentioned the difficulty of determining the value of schedules and the limitations of using computers instead of people to construct schedules. Brittany Lopez spoke about her experience working at the VA Hospital in the endoscopy unit, which looked at the workflow of scope reprocessing. She explained how valuable this project work was, as it gave her a chance to see first hand how systems engineering techniques could be utilized in the healthcare setting. Finally, Gabriel Zayas-Caban discussed some of his post-doctoral research work in emergency medical services, the newborn screening process, and how he is now looking at the policy side of his work in healthcare.

This panel was a great platform for the students to share what they’ve been working on and to bring awareness to CHEPS. There is a lot of opportunity for collaboration with the School and Public Health students and CHEPS is looking forward to these future endeavors.

ICE team December 22, 2015:

Recently, three CHEPS students completed a project in collaboration with the University of Michigan Medical School to schedule first year medical students to the medical school’s new Initial Clinical Exposure (ICE) program. Jonathan Mogannam, a senior undergraduate student studying Industrial and Operations Engineering, Roshun Sankaran, a senior pre-med undergraduate student studying Neuroscience, and Henry Ballout, a junior undergraduate student studying Organizational Studies worked alongside Angie Sullivan and Dr. Joseph House, administrators from the ICE program, to design a linear programming model using Open Solver in Microsoft Excel, which assigned first year medical students to the clinics they would visit based on student preferences and individual restrictions.

The ICE program, part of the new medical school curriculum unveiled for the 2015-2016 school year, is designed to expose first year students to the clinical environment earlier than ever before, and allows them to shadow different healthcare professions in order to understand more thoroughly the different roles essential to the effective delivery of healthcare. From a scheduling standpoint, this involved assigning 167 first year medical students to 18 different clinics and specific healthcare professionals they will shadow over the course of the six week program. Some of the constraints governing the clinic assignments were a student’s ability to drive to offsite clinics, the varying clinic capacities, individual student preferences, and many others.

The team implemented the modeled problem using Open Solver in Microsoft Excel, ultimately producing clinic assignments schedule that optimized student preferences and other metrics deemed essential by program administrators Angie Sullivan and Dr. Joseph House. This is the second semester that CHEPS students have scheduled medical students to their ICE clinics, and hope to continue this collaboration in the future.

denton December 21, 2015

Analytics continues to bring dramatic change to the healthcare industry in the United States and other countries, offering advances and challenges for the year ahead. In the article “Analytics and Healthcare: Ten Trends for 2016” featured on the HealthData Management website, CHEPS affiliate Brian Denton offers up 10 trends to chart in 2016.

Mark-Van-Sumeran December 14, 2015:

Dr. James Bagian was the eleventh and final featured speaker at the December 14th seminar of the “Providing Better Healthcare through Systems Engineering” series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS). Attendees came from the Department of Industrial and Operations Engineering, the University of Michigan Health System, the HEPS master’s program, and CHEPS.

Dr. Bagian is the Director of CHEPS and is a Professor in the Department of Anesthesiology in the Medical School and in the Department of Industrial and Operations Engineering in the College of Engineering at the University of Michigan. Previously, he served as the first Director of the VA National Center for Patient Safety (NCPS) and the first Chief Patient Safety Officer for the Department of Veterans Affairs from 1999 to 2010 where he developed numerous patient safety related tools and programs that have been adopted nationally and internationally. Presently, he is applying systems engineering approaches to the analysis of medical adverse events and the development and implementation of systems-based corrective actions that will enhance patient safety primarily through preventive means.

In his seminar, titled “Going Beyond RCA to Effect Real Improvement and Impact Safety Culture” Dr. Bagian explained how root cause analysis is a widely used technique in healthcare that has had inconsistent success. He attributed this issue to the lack of a second A in the term, action, making the new term root cause analysis and action. Dr. Bagian discussed the different elements of RCA2. The first was risk-based prioritization. He explained that only 1-2% of reports get acted upon, so “You want to pick the ones that are going to have the biggest impact”. Dr. Bagian explained that you want to pick the items with the highest risk, which has two dimensions, probability and severity. Probability is classified as frequent, occasional, uncommon, or remote and severity is classified as catastrophic, major, moderate, or mild.

Another element of RCA2 discussed was team membership. Dr. Bagian explained how small teams are the most effective and that a patient representative should be involved in the process if possible. Additional elements discussed included timing, flow diagramming, interviewing, and causation determination. Dr. Bagian emphasized that action is the most important step and the aim of this methodology is to prevent recurrence and reduce risk. He explained that accountability is key, meaning everyone should “Know what will be measured and how it will be measured” proceeding implementation. Finally, he explained the importance for leadership to be involved in these initiatives and when done right, this standardized approach “will change the whole [healthcare] system.”

Mark-Van-Sumeran December 11, 2015:

On Friday, December 11th, 2015, the Center for Healthcare Engineering and Patient Safety hosted a Lunch and Learn session featuring Mark Van Sumeran, a board member and advisor to health care suppliers in Richmond, Virginia. Mark has been involved in healthcare management for 35 years. He spent eleven years as a senior officer for a Fortune 300 company; twenty years in healthcare consulting, including ten at the Partner/VP level; and four years at a large academic medical center.

At the session, Mark shared his experience in and knowledge of providing strategic advisory assistance to healthcare companies. He shared his statistical projections for where the rapidly transforming healthcare industry is headed, and explained financial trends based on fluctuations in age demographics of the population in the United States.

The talk was highly pertinent to its audience of researchers in the healthcare industry, and Mark’s projections provided a glimpse of the issues that hospitals and healthcare companies might face in the years to come.

Among the guests was Walt Hancock, Professor Emeritus in IOE and former IOE chair, who was one of Mark’s professors when he attended the University of Michigan. Mark expressed his appreciation that Professor Hancock was able to attend the session and contribute to the discussion, even remarking that Professor Hancock was his inspiration for pursuing a career in healthcare.

A copy of Mark’s Lunch and Learn presentation is available here as well as a longer version which he presented at the Medical Device Supply Council’s Fall Meeting. We would like to heartily thank Mark and all of our guests for participating in this Lunch and Learn session.

tucker December 7, 2015:

Mustafa Sir was the tenth featured speaker at the December 7th seminar of the “Providing Better Healthcare through Systems Engineering” series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS). Attendees came from the Department of Industrial and Operations Engineering (IOE), the University of Michigan Health System, the HEPS master’s program, and CHEPS.

Mustafa Sir is an Assistant Professor of Health Care Systems Engineering at the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery. Dr. Sir graduated with a Ph.D. in Industrial and Operations Engineering from the University of Michigan in 2007. He also holds a B.S.E. and an M.S.E. degree in IOE and a M.S.E. degree in Electrical Engineering – Systems, all from the University of Michigan.

In his seminar, titled “A Data-Driven Optimization Approach for Designing Shift Templates in Emergency Departments”, Dr. Sir discussed how he used historical patient volumes and systems engineering techniques to create optimal shift templates in the ED at the Mayo Clinic. The model minimizes the number of patients exceeding the staff bed capacity given the bed capacity in each pod and total full time equivalent (FTE) hours in a week. It also takes into account constraints regulating how pediatric patients are covered. This model generates results having lower length of stay and wait times for patients and aims to reduce peaks and valleys in patient demand.

Dr. Sir stated, “I’ve learned that finding the optimal solution is just the beginning”. He explained that after the results are generated, they often need to be discussed with the clinical staff and modified to meet new requirements. Dr. Sir plans to conduct a post-implementation analysis, however simulation verification is currently being worked on. The results show improvement in patient wait times until they get a bed and unit they see a physician. Future work includes expanding this model to assist in shift scheduling for nurses. Dr. Sir’s talk fostered an interactive discussion between him and attendees and ended by explaining a few other innovative problems he is working on.

Join us next week for the eleventh and final talk of the year titled “Going Beyond RCA to Effect Real Improvement and Impact Safety Culture” presented by James Bagian, MD, PE, U-M, CHEPS.

tucker
daskin
November 30, 2015:

Mark Daskin and Emily Tucker were the ninth featured speakers at the November 30th seminar of the “Providing Better Healthcare through Systems Engineering” series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS). Attendees came from the Department of Industrial and Operations Engineering, the University of Michigan Health System (UMHS), the HEPS master’s program, and CHEPS.

Mark Daskin is the Department Chair of, and Clyde W. Johnson Collegiate Professor in, the Industrial and Operations Engineering Department at the University of Michigan. Daskin received his PhD from the Civil Engineering Department at M.I.T. in 1978. Professor Daskin’s research focuses on the application and development of operations research techniques for the analysis of the health care problems, as well as transportation, supply chain, and manufacturing problems.

Emily Tucker is a PhD student in the Industrial and Operations Engineering Department at the University of Michigan. Prior to graduate school, she received her BS in Industrial Engineering from NC State and worked as a Research Health Economist at RTI International. Emily’s research focuses on the applications of operations research to health care and public health policy.

In their seminar, titled “Using Optimization to Assist in Surgical Nurse Scheduling”, Professor Daskin and Emily discussed how they are using integer programming to help schedule 200 nurses across three pods at UMHS. The model includes hard constraints, such as hospital requirements and soft constraints, including nurse preferences for days and shifts. Currently, nurse managers manually do this scheduling every four weeks, which takes roughly one month of time. Although this work is still ongoing, the model only takes four minutes to run and the schedules can be used as starting points for creating final schedules.

Next steps in this research work include changing hard constraints to soft constraints to improve and increase the number of solutions. Additionally, Eva Cahnman, a senior in Industrial and Operations Engineering collaborating on this project, is creating a user interface to display the schedule for the nurses managers to utilize. Following the talk, an attendee asked what some foreseeable challenges would be in implementation. Emily responded that the main challenges are making sure the model accurately reflects what is going on, and making sure that “what we consider a good schedule is what the nurse managers consider a good schedule.”

Join us next week for the tenth talk of the year titled “A Data-driven Optimization Approach for Designing Shift Templates in Emergency Departments” presented by Mustafa Y. Sir, PhD, Mayo Clinic.

wiens November 23, 2015:

Jenna Wiens was the eighth featured speaker at the November 23rd seminar of the “Providing Better Healthcare through Systems Engineering” series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS). Attendees came from the Department of Industrial and Operations Engineering, the University of Michigan Health System, the HEPS master’s program, and CHEPS.

Jenna Wiens is an Assistant Professor in Computer Science and Engineering (CSE) at the University of Michigan. She currently heads the Machine Learning for Healthcare research group within the AI lab. Professor Wiens’ research interests lie at the intersection of machine learning, data mining, and medicine. The overarching goal of her research agenda is to develop the computational methods needed to help organize, process, and transform data into actionable knowledge.

Professor Wiens’s seminar, titled “Machine Learning for Data-Driven Healthcare”, focused on how patient data can be used to build models that will help healthcare providers avoid bad patient outcomes and better predict infections. One of the main goals of her research is to leverage the data from electronic medical records to learn accurate models for better predicting Clostridium difficile (C. diff), which is a healthcare-associated infection. Professor Wiens spoke about some of the challenges of Big Data in healthcare such as high dimensionality, paucity of cases, and institutional and population differences for which she stated, “One size fits all is not the right solution”.

Professor Wiens discussed building risk stratification models and more specifically, the transferability of these models across hospitals. She compared a global model, which uses data from multiple hospitals, with a hospital specific model, which focuses on data from just one hospital. The challenges with these two models are that the global model doesn’t account for institutional differences and the hospital specific model has limited amounts of data. Professor Wiens is working on an innovative solution called the Source and Target model, which leverages all data but focuses on the hospital specific features as well. Professor Wiens’s current research directions include exposure susceptibility in collaboration with the VA and a systems biology approach in collaboration with UMHS.

Join us next week for the ninth talk of the year titled “Using Optimization to Assist in Surgical Nurse Scheduling” presented by Mark Daskin, PhD, U-M, IOE Chair and Kayse Maass, PhD candidate, IOE.

weizer November 16, 2015:

Bethany Daily and Cecilia Zenteno were the seventh featured speakers in the “Providing Better Healthcare through Systems Engineering” series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS). Attendees came to their November 16th talk from the Department of Industrial and Operations Engineering, the University of Michigan Health System, the HEPS master’s program, and CHEPS.

Bethany Daily is the Senior Administrative Director, Perioperative Services at Massachusetts General Hospital (MGH). As a member of the Executive Perioperative Services team, her responsibilities include the strategic direction and implementation of information systems. Bethany received her Bachelor of Arts at the University of Michigan-Ann Arbor and her Master of Healthcare Administration at University of North Carolina-Chapel Hill.

Cecilia Zenteno is an Operations Research Manager at MGH and a Research Affiliate at MIT. Her responsibilities span mathematical modeling, data analysis and executing initiatives in collaboration with all levels of healthcare providers and administrators. Cecilia received her Ph.D. in Operations Research from Columbia University and worked as a post-doctoral fellow within the MGH-MIT Collaboration for two years before joining MGH full time in 2014.

Bethany and Cecilia’s seminar, titled “OR in the OR (and beyond) at Massachusetts General Hospital”, focused on how Operations Research techniques are used to re-design and improve care processes at MGH. They discussed various projects in different phases that they are currently working on. One project utilizes integer programming in order to determine how to allocate patients in different beds to meet capacity constraints. Another project they discussed uses an optimization model to standardize the patient appointment path and balance patient load throughout the week.

Bethany and Cecilia explained that the main goals of their work and of MGH primary care as a whole include patient experience, population health, professional satisfaction, and efficiency. They also provided attendees with insight on lessons they’ve learned, such as working on the top priority problems first and reaching out to leadership to support engagement and implementation. Lastly, Bethany and Cecilia explained how “helping people appreciate how these [systems engineering] methods can apply to healthcare” is an important part of their roles.

Join us next week for the eighth talk of the year titled “Machine Learning for Data-Driven Healthcare” presented by Jenna Wiens, PhD U-M, CSE, MLD3.

weizer November 9, 2015:

Alon Weizer was the sixth featured speaker at the November 9th seminar of the “Providing Better Healthcare through Systems Engineering” series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS). Attendees came from the Department of Industrial and Operations Engineering, the University of Michigan Health System, the HEPS master’s program, and CHEPS.

Dr. Weizer is currently Medical Director of the University of Michigan Comprehensive Cancer Center and Associate Professor of Urology. He completed his undergraduate studies at Duke University, medical school at Baylor College of Medicine, and surgery and urology training at Duke University Medical Center. Clinically, Dr. Weizer focuses on Urologic Oncology with particular interests in bladder, kidney, and testis cancer. He is also the lead physician of the Bladder Cancer Clinical Innovation Program focusing on process improvement for patients receiving bladder cancer care at the University of Michigan Health System.

Dr. Weizer’s seminar, titled “Team Based Improvement for Patients undergoing Cyctectomy for Bladder Cancer at U-M”, focused on his projects aimed at improving bladder cancer patients’ experience. He explained that bladder cancer impacts over 70,000 people a year and is one of the most expensive cancers to treat because of the high level of care required post surgery. He explained that his job is like a “medical plumber” as he is responsible for removing the entire bladder, not just the cancerous tumor during surgery. Dr. Weizer shared a video clip of him performing this approximately 5-hour surgery with attendees. He noted that “the bladder does not really like to be removed”, making it a fairly strenuous surgery.

Dr. Weizer’s project work began in 2011, using lean principals to drive process improvement. The general structure of these projects is first, to engage everyone who will be involved. He stated, “Without people who are going to think about and want to change a process, you aren’t going to get there”. Then he would employ systems engineering tools such as value stream maps, simulation, and mathematical models to drive his projects. One problem he has addressed is that bladder patients must attend 4-8 pre-operative appointments in up to 3 different locations. To solve this problem, his team developed a quantitative model to optimize appointment scheduling, which took into account variation in appointment and travel times. This project, along with many others, has been extremely influential in improving patient experience.

Join us next week for the seventh talk of the year titled “OR in the OR (and Beyond) at Massachusetts General Hospital (MGH)” presented by Bethany Daily, MHA, MGH and Cecilia Zenteno, PhD, MGH.

October Lunch and Learn October 29, 2015:

In a Lunch and Learn session hosted at Center for Healthcare Engineering and Patient Safety on October 29, 2015, professionals from Improvement Path Systems (IPS), Rochester MI, discussed their experience in improving healthcare services. Three speakers were featured in this session, including Jim Kamp, Chief Operating Officer, Chelsea Thull, Healthcare Consultant, and Matt DiTullio, Healthcare Analyst.

Mr. Kamp initiated the discussion with the tragic story of Josie King, an 18-month child who died from a hospital acquired infection due to medical errors back in 2001, emphasizing the importance of timely feedback and adequate communication in patient care. In IPS’ work to help prevent central line-associated blood stream infections (CLABSI), they developed an automated electronic system to closely monitor patients with potential risk of acquiring an infection. The system retrieves EHR data and generates a dashboard of summary and longitudinal electronic history of specific patients, which provides a close-to-real-time, standardized report of patient statuses. The report allows healthcare professionals to provide appropriate feedback and call for timely actions. IPS plans to extend their services into other types of infections, such as catheter-associated urinary tract infections (CAUTI) and surgical site infections (SSI).

One of the challenges faced by IPS, also commonly faced in the healthcare system, is the implementation of change. Mr. Kamp and Ms. Thull pointed out that to successfully implement changes, the key is to understand the culture of the environment thoroughly before designing solutions. Mr. Kamp also spoke to the uniqueness of each organization, which calls for a unique, tailored solution.

At the end of the discussion, the speakers described the skill sets they value at IPS. With a baseline of technical skills, such as data analysis and programming, they emphasize the importance of effective communication skill to present complex data-heavy results to healthcare providers. The passion to ‘translate technical skills to impacting [patient healthcare]’, one of the core values discussed by Mr. Kamp, has brought Mr. DiTullio back to IPS after two years in the advertising industry. Mr. DiTullio, an IOE alum, expressed the urge to move back into the healthcare services, where he can utilize his unique background and experience to ultimately help improve people’s lives.

For more information about Improvement Path Systems, visit http://www.improvementpathsystems.com/. Thank you to our speakers and guests for participating in this insightful Lunch and Learn session!

murphy seminar October 26, 2015:

Susan Murphy was the fifth featured speaker seminar in the “Providing Better Healthcare through Systems Engineering” series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS). Attendees came to her October 26th talk from the Department of Industrial and Operations Engineering, the University of Michigan Health System, the HEPS master’s program, and CHEPS.

Dr. Murphy is an H.E. Robbins Distinguished University Professor of Statistics and Professor of Psychiatry. She is a member of the US National Academy of Medicine and a 2013 MacArthur Fellow. Dr. Murphy’s research focuses on improving sequential and individualized decision making in health. She currently works as part of interdisciplinary teams to develop clinical trial designs and learning algorithms in mobile health.

Dr. Murphy’s seminar, titled “Learning Treatment Policies in Mobile Health”, emphasized that the goal of her work is to help people reach their health goals. The two research projects she discussed were HeartSteps Activity Coach, which uses smartphones and wearable sensors to provide activity suggestions and Smoking Cessation, which is a wristband that measures activity, stress, cigarette smoking, sleep quality and more. Dr. Murphy’s talk described a sequence of steps that facilitate effective learning of treatment policies, which is observations, actions, and responses. Decisions include how often to send a health tip and what they should be. For instance, a tip about walking should not be sent on a very cold day or while the user is already on a walk.

The talk was followed by a question and answer session with attendees addressing questions such as, “How do you measure stress?” Dr. Murphy explained that there is perceived stress and physiological stress and that stress could be measured by various physiological metrics such as the peak-to-peak interval of your heart rate and the expansion of your lungs. Dr. Murphy is currently seeking participants to sign up for her HeartSteps trial, which can be done by following this link: http://dept.stat.lsa.umich.edu/~samurphy/.
There will be no talk next week. Join us in two weeks for the sixth talk of the year titled “Team Based Improvement for Patients Undergoing Cystectomy for Bladder Cancer at UMHS” presented by Alon Z. Weizer, MD, MS, UMHS, Urology.

gonzalez lunch October 15, 2015:

On Friday October 15th CHEPS was delighted to host Christine Gonzalez for a lunch & learn catered by Pizza House in Ann Arbor. Ms. Gonzalez is a 2014 alumna of the Industrial & Operations Engineering department and she now works as an analyst for Huron Consulting Group in their Healthcare Division.

In this talk, Ms. Gonzalez discussed how her time in IOE and working at CHEPS prepared her for a career in healthcare consulting. Christine answered questions, dispelled some of the rumors, and revealed the facts about the consulting lifestyle. She shared examples of current and past job project experiences, providing insight into what it is like to work for a consulting firm. We thank Ms. Gonzalez for joining us for lunch and sharing with us her insights and experiences.

dimitrov seminar October 12, 2015:

Nedialko Dimitrov was the fourth featured speaker at the October 12th seminar of the “Providing Better Healthcare through Systems Engineering” series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS). Attendees came from the Department of Industrial and Operations Engineering, the University of Michigan Health System, the HEPS master’s program, and CHEPS.

Dr. Dimitrov is an Assistant Professor in the Graduate Program in Operations Research & Industrial Engineering at the University of Texas at Austin. He received a PhD in Theoretical Computer Science from the University of Texas at Austin and B.S. degrees in Mathematics and Computer Science from the University of Michigan, Ann Arbor. His research focus is on optimization, with applications in infectious disease control and national security.

Dr. Dimitrov’s seminar, titled “Weathering the Chikungunya Storm: Arbovirus Risk in Texas”, discussed Chikungunya, a mosquito-borne viral disease, and how systems engineering tools can be utilized for risk management and forecasting. This disease is primarily contracted in Central and South America, however cases also appear in Texas. His talk focused on solving two main questions: 1. Where do the mosquitoes live in Texas? 2. What are the risk zones in Texas? Dr. Dimitrov’s approach to answer these questions uses a combination of data-driven models and optimization, which consider variables such as temperature, precipitation levels, type of environment, and topographic data.

Dr. Dimitrov explained that future work related to this project includes quantifying uncertainty and coming up with methods to collect higher volumes of data. He also discussed the collaboration between his team of Operations Research folks and the Department of Health Services. He stressed the importance of having subject matter experts from Health Services validate the models his team creates. Dr. Dimitrov concluded the talk by stating, “Common sense tells you the earth is flat,” meaning that although common sense is useful, you can not fully rely on it when creating extensive mathematical models.

There will be no talk next week due to Fall Break. Join us in two weeks for the fifth talk of the year titled “Learning Treatment Policies in Mobile Health” presented by Susan Murphy, PhD U-M, Statistics, Psychiatry, ISR.

rosales seminar October 5, 2015:

Claudia R. Rosales was the third featured speaker in the “Providing Better Healthcare through Systems Engineering” series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS). Attendees came from the Department of Industrial and Operations Engineering, the University of Michigan Health System, the HEPS master’s program, and CHEPS.

Dr. Rosales is an assistant professor of supply chain management in the Eli Broad College of Business at Michigan State University. She has a BS in chemical and industrial engineering, an MS in quantitative analysis, and a PhD in operations management. Her current healthcare research includes optimization of medical supplies inventory at the point-of-use, analyzing the impact of new technologies in the healthcare supply chain, and forecasting of hospital spending, among others.

Dr. Rosales’s seminar, titled “Hospital Inventory Management – New Trends in Healthcare,” discussed the challenges of supplies management and two different approaches used to track inventory that address some of these challenges. The first option is using Automated Dispensing Machines, or ADMs, which are computerized cabinets that help track cost by patient and allow for full inventory visibility. The second option discussed was the Two-Bin System, where items are stored in a primary and a secondary bin. This option eliminated the need for manual counting and utilized an RFID tag system that would notify the system when a bin needed to be replenished.

Dr. Rosales explained various systems engineering techniques that were incorporated into her research such as simulation, stochastic modeling, and optimization. A discussion following the talk included a conversation about the tradeoffs of the two different systems. Attendees discussed other ideas for supply management including the use of bar codes to track inventory. Dr. Rosales acknowledged that this is a very complex problem and that “sometimes the optimal solution may not be the most practical solution.”

Dr. Rosales shared and discussed her article, “Point-of-Use Hybrid Inventory Policy for Hospital,” with attendees at the seminar.

Join us next week for the fourth talk of the year titled “Weathering the Chikungunya Storm: Arbovirus in Texas” presented by Nedialko B. Dimitrov, PhD, University of Texas-Austin.

2015 symposium
2015 symposium
2015 symposium
September 28, 2015:

On September 28th, 2015 CHEPS hosted its Third Annual Symposium on Healthcare Engineering & Patient Safety. Approximately 150 attendees came from a variety of University of Michigan units including Engineering, the School of Public Health, the Health System, the Medical School, the School of Nursing, and the Institute for Healthcare Policy and Innovation. Several, including returning alumni, also attended from outside the university.

“The CHEPS Symposium gets bigger and better every year! I really enjoyed presenting and getting feedback from alumni and previous collaborators that were part of the project I’m currently working on,” said HEPS master’s student Pamela Martinez Villarreal. Those in attendance had the opportunity to view over 35 posters which highlighted research projects and various healthcare engineering related units throughout the university.

Attendees could also participate in five games and simulations which helped them gain a better understanding of specific healthcare problems and solutions. Ajaay Chandrasekaran, a CSE undergraduate student, led attendees through a phlebotomy table top simulation. “The Phlebotomy Tabletop Game encouraged symposium attendees to consider policy changes that could increase patient throughput and reduce patient waiting times at a phlebotomy clinic. It attempts to emulate issues encountered by staff at the UM Comprehensive Cancer Center phlebotomy clinic which result from high patient inflow,” he explained.

There were ample opportunities for attendees to share ideas. IOE PhD student Kayse Maas said, “The CHEPS Symposium is unique in that it draws a cross-disciplinary audience of students, academicians, healthcare providers, and industry professionals. It is great to have so many people from varied backgrounds discuss how we can work together to enhance healthcare in today’s world.” In addition to speaking with attendees throughout the event, those manning posters, games, and simulations each also gave a mini-presentation. These presentations were filmed and will be available on our website soon.

The winner of the symposium’s audience choice best poster competition was “Innovations in Surgical Instrument Reprocessing Methods for Improved Patient Safety and Financial Stewardship at UMHS” presented by Rama Mwenesi and detailing research by Rama Mwenesi, Nina Scheinberg, Amy Cohn, James P. Bagian, Joseph DeRosier, Mark Grum, and Shawn Murphy. Rama says a visitor to his poster commented that, “the fact that your research solutions have been implemented really sets your project apart and shows great promise.” The prize for best poster was a conference travel grant.

Other prizes presented were a raffle prize for simulation participation which went to David Hutton and best tweet which went to Brian Lemay and Hassan Abbas for the tweet below.

More tweets from the event can be viewed at the #chepssymposium hashtag.

Below are additional thoughts from students who attended and presented at the event.

“The annual CHEPS symposium was the first event that I’ve attended with CHEPS as a presenter, and I really enjoyed being able to see everyone’s hard work as well as get the opportunity to talk with others about how I’ve spent my time with CHEPS.”
-Paige Mollison, IOE undergraduate student

“Presenting at the symposium was a great experience. All of the attendees were attentive and asked great questions. It really gave me a new appreciation for my work!”
– Matthew Rouhana, HEPS master’s student

“Participating in CHEPS symposium was a very enriching experience. The friendly atmosphere helped me to communicate my work efficiently to the attendees from different professional levels. The opportunity to see the work of other participants which tackled issues in health and occupational safety from different angles was the greatest.”
– Karmel Shehadeh, IOE PhD student

[View videos from the symposium]
[View pictures from the symposium]
[View pictures from the reunion dinner]

alums at 2015 symposium September 28, 2015:

Vanessa Morales, who graduated from the HEPS master’s concentration in 2014, wrote about her recent return to Ann Arbor for the Symposium on Healthcare Engineering and Patient Safety weekend. Her take on the weekend is below. Thanks, Vanessa!

Four of us HEPS master’s alums flew back for symposium weekend: Spyros Potiris who is at Dana-Farber, Sarah Bach at Mayo Clinic, Joe East at Maine Medical Center, and myself at Duke Health. There was no hesitation deciding if we would come for that weekend. Sarah said it best: “To me, that’s like asking whether you’re going home for Thanksgiving.”

Our time spent at CHEPS working on our graduate degrees was phenomenal. While it was academically challenging, we got to participate in exciting healthcare projects and made lifelong friends in the process. So an opportunity to come back to Ann Arbor, to see our CHEPS family, and to go to a game at the Big House, was something we would never pass up.

The reunion dinner at Conor O’Neills was the perfect start to the weekend. Our old friends greeted us with much enthusiasm. It was wonderful to be surrounded by a sea of familiar faces as well as new talent. The conversations were contagious, smart, warm, and welcoming. The alumni, current students, and a sprinkle of faculty joined and made it a memorable evening. I took a step back and observed the diversity of the group and the conversations and felt so lucky to be part of the group, to be back home.

From a professional standpoint, CHEPS was an incredible experience that is serving us well as we start our careers. According to Sarah, “having this network of likeminded individuals who are doing similar work in hospitals across the country is an invaluable resource.” Spyros, Joe, Sarah and I all share our experiences in industry and compare and contrast our roles in our respective organizations. Many healthcare organizations face similar problems so we enjoy learning the techniques used by our colleagues at their institutions as many could be applicable to our work1.

The Symposium on Healthcare Engineering & Patient Safety is the perfect venue for us to get a fresh perspective on the projects and initiatives going on in other leading healthcare organizations and at CHEPS. I’m always humbled by the brilliant minds at CHEPS and all the hard work they put into their research. Coming back after a year, it’s most interesting to see how established projects have developed and grown! The Symposium is also the best venue for us as alumni to share with the group what is relevant in the industry and how we can best support the current students as they seek jobs after graduation.

While we get deeply engrossed with conversations about our jobs and the hospital world, it isn’t just about that for us. We respect and value each other professionally, but most importantly, personally2. At the end of the day, we are friends, we trust each other and care about each other no matter how much time has passed. This gem of a quote from Sarah captures the CHEPS dynamic best:

“During my time at University of Michigan I was a part of many groups and student organizations and can honestly say that the bonds I formed with my CHEPS friends are some of the strongest. I think the fact that we call ourselves family is a huge testament to the community and environment Amy has built at CHEPS. All of the CHEPS students I’ve worked with are extremely hard working, gifted, and intelligent people who are truly passionate about the work they are doing.”

The weekend was remarkably fun. We rounded up the whole CHEPS family for an array of social activities and had an incredible time. Our bond with CHEPS is truly special and differentiates us from any other program at the University. Thank you to Amy and everyone else for making it such a memorable event for us. CHEPS means family and it forever will.

-Vanessa Morales MSE

Thank you 1: Sarah Bach and 2: Joe East for your contributions.

[View videos from the symposium]
[View pictures from the symposium]
[View pictures from the reunion dinner]

sales lunch September 25, 2015:

Members of the CHEPS community gathered at Conor O’Neill’s on Friday, September 25, to ring in the new semester. The group included CHEPS undergraduate and graduate students, faculty members, returning CHEPS alumni, and other CHEPS associates. Merrill Bonder, Executive Director of The Seth Bonder Foundation; CHEPS Director Jim Bagian; CHEPS Associate Director Amy Cohn; Professor Mariel Lavieri; and Professor Larry Seiford were all in attendance.

The reunion was part of a series of events centered around the 3rd Annual Symposium on Healthcare Engineering & Patient Safety which took place the following Monday, September 28th. It was an excellent opportunity for our newest CHEPSters to meet current researchers and associated faculty as well as graduates of the HEPS program. Guests enjoyed delicious food and terrific conversation throughout the night.

The entire CHEPS community would like to extend a huge thank you to both Gene Kim and Merrill Bonder for their generous contributions to the occasion!

[View photos from the dinner]

sales lunch September 21, 2015:

On September 21st, Anne Sales was the second featured speaker in the “Providing Better Healthcare through Systems Engineering” series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS). Attendees came from the Department of Industrial and Operations Engineering, the University of Michigan Health System, the HEPS master’s program, and CHEPS.

Dr. Sales is a Professor in the Department of Learning Health Sciences, School of Medicine, University of Michigan, and Research Scientist at the Center for Clinical Management Research at the VA Ann Arbor Healthcare System. Her training is in sociology, health economics, econometrics, and general health services research. Her current work involves understanding the way feedback reports affect provider behavior and the role of social networks in uptake of knowledge transition interventions.

Dr. Sales’s seminar, titled “Lessons from Implementation Science—Applications to Safety and Quality in Health Care,” began with defining implementation science, which she recognized has many definitions as it is an emerging research field. Dr. Sales defined the main role of implementation researchers as intervening to implement new practices and employ behavior change techniques. She stated that, “Today, the work that has to be done is a combination of the actions of many people.” Dr. Sales acknowledged that there are over one hundred frameworks in both implementation and dissemination methods, one having been discovered by her colleagues at the VAAAHS.

A discussion following the talk included conversation of how systems engineering techniques can be incorporated into implementation science, such as process mapping and simulation. It was noted by one of the attendees that, “There is an opportunity to merge some important streams of research.” Dr. Sales agreed that implementation science should be multidisciplinary and that the field is currently full of a group of eclectic and intelligent people.

Join us next week at the 3rd Annual Symposium on Healthcare Engineering and Patient Safety from 5:00-7:30 at NCRC Dining Hall, Building 18, 2800 Plymouth Road.

lavieri lunch September 14, 2015:

Mariel Lavieri was the featured speaker at the September 14th seminar of the “Providing Better Healthcare through Systems Engineering” series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS). Attendees came from the Department of Industrial and Operations Engineering, the University of Michigan Health System, the HEPS master’s program, and CHEPS.

Dr. Lavieri is an Assistant Professor in the Department of Industrial and Operations Engineering at the University of Michigan. She has bachelor’s degrees in Industrial and Systems Engineering and Statistics and a minor in String Bass Performance from the University of Florida. She holds a Masters and PhD in Management Science from the University of British Columbia. In her work, she applies operations research to healthcare topics. Her research develops models to guide screening, monitoring, and treatment decisions of chronic disease patients, as well as models for health workforce planning.

Dr. Lavieri’s seminar, titled “An Innovative Framework to Improve Efficiency of Interhospital Transfer of Children in Respiratory Failure,” focused on how the decision of whether a patient should be transferred from a from one ICU to another could be determined using a systematic framework. She discussed the formation of the project, which focused around two questions: 1. What is the problem? 2. What is the impact? The talk continued with input from one of Dr. Lavieri’s collaborators, Fola Odetola, M.D., regarding the complexity of pinpointing the objective of this model from his perspective. Gabriel Zayas-Caban, Postdoctoral Research Assistant at CHEPS, and Luke Bruski, MSE in Industrial and Operations Engineering, also made profound contributions to this research project.

Dr. Lavieri fostered an interactive discussion with the attendees regarding specific examples of the tradeoffs of transferring a patient. Responses included specialized physicians and equipment being potential benefits of a transfer, and risk of transportation and cost as some of the potential issues. Her seminar also drove great conversation between health care professionals and students encompassing the project scope, limitations, and possible future applications.

Join us next week for the second talk of the year titled “Lessons from Implemental Science—Applications to Safety and Quality in Health Care” presented by Anne Sales, PhD, RN, U-M, School of Nursing.

researchpalooza
researchpalooza
August 20, 2015:

CHEPS students participated in Researchpalooza on Thursday, August 20th 2015. The students shared information about the Center for Healthcare Engineering & Patient Safety and demonstrated some of the interactive tools they worked on this summer including a pediatric emergency department scheduling game, a patient flow app, and a phlebotomy workforce planning simulation.

They enjoyed both interacting with visitors to their table and seeing what other organizations were displaying at their tables. It was an excellent opportunity to explore the breadth of research happening at the university and make new connections.

Researchpalooza is hosted by the UMMS Office of Research in conjunction with the annual Health System Ice Cream Social. Over 80 offices and labs participated in the event which saw over 3,000 attendees this year.

truven lunch August 17, 2015:

On August 17, 2015, the Center of Healthcare Engineering and Patient Safety hosted a Lunch and Learn session where professionals from Truven Health Analytics discussed their services and operations.

The primary speaker was Larry Yuhasz, a Senior Director of Business Development in the Provider Business Operations unit. With more than 25 years of combined experience with Truven Health, WebMD, and Thomson Reuters Healthcare, he was able to provide a comprehensive overview of healthcare information and data analytics. Some of Mr. Yuhasz’s publications can be found here.

The second guest at the event was Jeffrey Olin, a Director of Product Development with extensive computer science experience. Mr. Olin was able to provide a great outline of Truven Health’s data collection and analytics methods.

Mr. Yuhasz began the discussion by explaining how healthcare engineering and optimization will be critical in solving the “tsunami problems of the future.” As health systems grow through mergers and acquisitions in the future, Mr. Yuhasz predicts they’ll become substantially larger and fewer in number. As a result, having organized and aggregated data from each entity will become more important yet more difficult to collect.

By collecting data, cleansing it, and then providing recommendations to their clients, Truven Health is able to provide superior healthcare information services to its clients. Specifically, Mr. Olin gave a great overview of their operational process which includes the following cyclical steps: 1) organize/analyze data, 2) create/improve solutions, 3) deliver results, and 4) measure change. Through this process, Truven Health’s vision is “to improve the quality and lower the cost of healthcare through the better use of data and analytics.”

In summary, we gained valuable insight on how engineering and big data concepts can be applied to the healthcare industry. At the same time, Mr. Yuhasz also reminded us of the humanity of this industry: “This differs from building an engine block in Detroit. It’s a living system which breaths, eats, socializes, [etc…].”

Both also shared information about career opportunities at Truven. Thank you to both of our guests!

informs hc group
informs hc group
informs hc poster
July 31, 2015:

A large contingent from The Center for Healthcare Engineering and Patient Safety (CHEPS) attended the 2015 INFORMS Healthcare Conference in Nashville, Tennessee from July 29th to July 31st. On the trip were Hassan Abbas, Andrea Bouwhuis, Moses Chan, Amy Cohn, Mark Grum, Brian Lemay, Pamela Martinez Villarreal, Rama Mwenesi, Billy Pozehl, Donald Richardson, Matt Rouhana, and Brooke Szymanski. Several of the students presented talks or posters at the event, many in a session titled “Student Research Projects in Healthcare Operations” chaired by CHEPS Associate Director Amy Cohn.

Many students took advantage of field trips offered the day prior to the conference to the Vanderbilt Children’s Hospital, the Vanderbilt Surgical Case Cart Prep Center, and Aegis Science Corp. Once the conference began on Wednesday, they were eager to start presenting and attending sessions.

“We conduct year-long research projects and, to be able to have the opportunity come and present and showcase what we’ve done so far and actually show the progression in terms of our work, that was a pretty exciting opportunity to have that platform. And not just to present, but also to gain feedback in terms of where we should be looking to go based on the insights from members of the audience,” said Rama Mwenesi.

There were ample opportunities to collaborate. “It was interesting seeing the contrasting views of the healthcare professional and the engineer. I mean we see this all the time when we’re working at CHEPS and just going to the hospital and getting the different perspectives but to see that at a much larger scale at the conference where you’re not just having a physician at the hospital you’re collaborating with but a hospital maybe across the country…. It’s just a large scale collaboration of all these doctors and engineers coming together at the conference,” said Donald Richardson.

Hassan Abbas realized many of the attendees at the conference were surprised and impressed by the level of collaboration already happening at The University of Michigan because of CHEPS. He said of the poster session, “We had a lot of people come up and talk to us… they’re really surprised to hear that I’m a nursing student and Brooke’s a nursing graduate and Andrea is a med student. And they’re surprised to hear how closely we’re working with everybody at CHEPS.”

The CHEPS group was pleased to be able to share their experience while learning from others. “It’s been incredible to see the different projects that everyone is working on and all the different facets of how people are coming at very similar problems,” observed Andrea Bouwhuis.

Busy conference days didn’t stop anyone from checking out the Nashville nightlife once presentations were done for the day. Outings included a dinner with CHEPS collaborators Professors Harriet Nembhard and Julie Ivy as well as trips to enjoy live music at both Tin Roof and The Bluebird. Mark Grum said of the city, “The atmosphere and the people around here are extremely exciting. Broadway Street is filled with a bunch of up and coming artists and you walk down the street and you can hear a bunch of different musicians playing and it’s a very lively city and it’s really exciting to be here.”

The trip may have even garnered a certain music genre a few more fans. “I’m starting to like country music now,” said Pamela Martinez Villarreal. “I’m not a country music fan but I think Nashville might have converted me,” agreed Hassan Abbas.

Links to the talks and posters presented by CHEPS students at the conference are below.

Presentations

Poster

  • Hassan Abbas & Brooke Szymanski: “Patient Flow in a Pediatric Emergency Department”

[View photos from the conference]

abbott and sales lunch and learn June 26, 2015:

On Friday, June 26, 2015, The Center for Healthcare Engineering and Patient Safety featured University of Michigan School of Nursing Professor Anne E. Sales and Associate Professor Patricia Abbott for a Lunch and Learn discussion regarding their unique perspectives on healthcare engineering and patient safety.

Professor Sales has worked in health services research for the U.S. Department of Veterans Affairs for nearly 20 years. The VA staffs the largest number of health systems engineers and nurse practitioners in what is the largest integrated healthcare system in the United States. Her work focuses primarily on implementation research and bringing evidence-based practice into clinical settings, and in particular, how providers take up new evidence and whether they implement new discoveries in their services.

Professor Sales shed some light on the future of nursing homes in her discussion of a new initiative with the Center for Healthcare Ethics that aims to improve the documentation of patient preferences. Automated feedback makes it is possible to measure the degree to which documentation is being implemented and the significance that it has on patient care by examining how these mechanisms produce behavior change. One future aim is to use informatics as tools to automate and tailor messages to individuals so that feedback is obtained in a more effective manner.

Associate Professor Abbott is addressing questions related to human systems engineering and in exploring new approaches to big data analytics. Specifically, she is interested in making data more meaningful by designing it according to situational awareness and in ways that are easy to synthesize. Using visualization techniques and computer science, her current work involves the customization and presentation of data in ways that would be most likely to influence behavior.

As part of a new initiative, the VA offers a virtual reality system that allows students and health professionals to examine data and simulate emergency simulations without any potential risk to real patients. Virtual reality can be widely used to examine the system wide effect of changing multiple variables without actually harming a real system. These types of simulations are highly applicable in the healthcare field, especially in patient safety, but can also be applied to many other large and similarly complex systems.

We thank our guests for a fascinating and insightful perspective into systems engineering!

Bagian and DeRosier June 16, 2015:

Center for Healthcare Engineering and Patient Safety (CHEPS) Director Dr. James P. Bagian and CHEPS Program Manager Joe DeRosier served on the panel which produced a new report titled “RCA2: Improving Root Cause Analyses and Actions to Prevent Harm.” The National Patient Safety Foundation (NPSF) panel released the report on June 16, 2015; it contains guidelines developed to help healthcare organizations improve the way they identify and investigate adverse events, and close calls and then implement actions to mitigate or eliminate the identified risks. Dr. Bagian co-chaired the panel and DeRosier served as a principal writer of the report.

Root cause analysis (RCA) is a process widely used by health professionals to learn how and why errors occurred. “Human error is not a true root cause,” says Dr. Bagian. For example, in an instance where a patient is given the wrong medication, the true root cause may be two bottles which look similar and are easily confused. Writing the incident off to human error would likely lead to repeat errors and patient harm. “Telling people to be careful isn’t an effective solution. Actions need to be taken that sustainably mitigate or eliminate the risk of patient harm,” explains Dr. Bagian.

The panel renamed the RCA process RCA2 with the second A meaning action. In the above example, an action might be changing the packaging for one medication or adding barcodes to the bottles so the medications would not be so easily confused.

“Unless real actions are taken to improve things, the RCA effort is essentially a waste of everyone’s time,” says Dr. Bagian. “A big goal of this project is to help RCA teams learn to identify and implement sustainable, systems-based actions to improve the safety of care.”

RCA is commonly conducted after harm occurs. The NPSF guidelines emphasize the need to prioritize hazards based on the risk they pose, even if harm has not occurred. Close calls can provide a valuable opportunity to learn and implement corrective action before a patient is harmed. Prioritizing hazards according to risk is consistent with the practice of other high-reliability industries, such as aviation and nuclear power.

NPSF has been a central voice for patient safety since 1997. “RCA2: Improving Root Cause Analyses and Actions to Prevent Harm” has been endorsed by a number of related organizations and is being widely distributed to hospitals, health systems, and other settings.

Co-chairs of the panel that created the report, James Bagian, MD, PE, and Doug Bonacum, CSP, CPPS, will discuss the report in a webcast on Wednesday, July 15, 2015, at 1:00 pm Eastern Time. The webcast, provided by NPSF, is complimentary thanks to the support of The Doctors Company Foundation.

Dr. Bagian is quoted in a Modern Healthcare article about the new report.

Jin June 11, 2015:

Haomiao Jin delivered a talk titled “Using Technology and Data Analytics to Improve Depression Care Among Patients With Diabetes” to a full house in the CHEPS conference room on June 11, 2015. Attendees came from CHEPS and areas including the College of Engineering, the University of Michigan Health System, and the School of Social Work.

Approximately 30% of patients with diabetes are suffering from depression; however about 45% of those with depression are undiagnosed and thus untreated. Haomiao, a PhD candidate in Industrial & Systems Engineering at the University of Southern California (USC), addressed how the presence of depression among patients with diabetes often leads to worse health outcomes, increased healthcare utilizations and elevated suicide risk. Although prior evidence and the 2008 Mental Health Parity Act have supported providing mental care for patients with chronic illnesses such as diabetes, significant barriers exist to impede the integration of mental care in the primary care settings, especially in safety-net systems.

The Diabetes-Depression Care-management Adoption Trial (DCAT) tested an innovative solution of automated telephonic depression screening and monitoring technology integrated with patient registry and prompting systems to facilitate the adoption of evidence-based depression care for patients with diabetes. The comparative effectiveness trial included 1406 patients from 8 safety-net clinics in 3 quasi-experimental study groups: the usual care arm, the collaborative care arm, and the technology-facilitated care arm.

Haomiao described a propensity score method that enabled the comparison among the three study groups. Using the wealth of data collected in DCAT, he described the development of a generalized multilevel regression prediction model to predict depression episodes and severity. Expanding to include another safety-net diabetes and depression trial, the prediction model was applied to analyze several depression screening policies. The series of analyses established a prediction model-based screening approach that has the potential to improve efficiency in managing patient population with depression and better prioritize the use of provider resources and time to deliver effective care for high-risk patients. The studies presented in the talk received the Honorable Mention Awards for two consecutive years (2014 & 2015) in the Annual Student Research Paper Contest of the Centers for Disease Control and Prevention’s Preventing Chronic Disease journal.

More information about Haomiao Jin is available in his biosketch and at his Research Gate page.

young-chae lunch June 9, 2015:

IOE PhD student, Young-Chae Hong, was the fifth featured speaker in the PhD Lunch and Learn series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS). This series provides PhD students the opportunity to present their healthcare work-in-progress to fellow PhD students and interested faculty and clinicians for feedback and discussion.

Young-Chae’s June 9th presentation, titled “Multi-Criteria Optimization Problems,” walked attendees through the process of an optimization problem as it applied to real-world medical scheduling issues. Attendees at the Lunch and Learn got a taste of the research and challenges that Young-Chae has been working on, including adequately weighing physician’s abstract preferences in terms of real numbers in order to supply them with a desirable schedule for all physicians. These preferences may be according to sleep schedules, undesirable shifts, or balancing safe patient care with learning experiences. Explanation of Pareto-optimal solutions for this problem sparked many questions and conversations with participants while learning about methods of solving the scheduling problem in a way that satisfied the most people and constraints.

If you are interested in receiving information about upcoming events or would like to present your current research, contact Gene Kim (genehkim@umich.edu). We are looking forward to more great sessions and discussions!

szymanski June 4, 2015:

CHEPS student, Brooke Szymanski has passed her NCLEX. Congratulations, Brooke! 

Brooke graduated from the University of Michigan School of Nursing with a BSN in Winter 2015. Now that she’s passed the NCLEX, she’s been issued her RN license by the state of Michigan and is ready to begin practice as a nurse. 

Brooke is currently interviewing for jobs and hopes to one day work in pediatrics. Eventually, she’d also like to return to school and obtain a master’s in nursing in order to work as a nurse practitioner. 
 
Brooke says that there’s a side of healthcare she would not have been exposed to if not for her work with CHEPS. She explained, “Nursing is focused on the direct patient care and I had never previously considered all of the other disciplines that contribute to a hospital or medical practice running smoothly. By working at CHEPS, I also got to observe in areas of the hospital that I would not have had the opportunity to otherwise, such as the Mott ED and Dr. Reddy’s clinic.”

ISERC June 2, 2015:

Moses Chan, Young-Chae Hong, Brian Lemay, and Rama Mwenesi of CHEPS along with Industrial and Operations Engineering student Kayse Maass traveled to Nashville, Tennessee from May 30th through June 2nd to present their work at the Institute of Industrial Engineers (IIE) Annual Conference and Expo. They presented on the following topics:

During the remainder of the conference, students networked with students, professors, and professionals from industry while attending presentations covering a wide-variety of topics. They were also treated to inspiring presentations by the conference’s keynote speakers, including Professor Mark Daskin, Department Chair of the University of Michigan’s Department of Industrial and Operations Engineering.

During the evenings, the students had a chance to explore Music City, home of the Grand Ole Opry and Country Music Hall of Fame, and take in some of the unique sights, sounds, and tastes that the city has to offer. Overall, it was a very successful and enjoyable learning experience.

[View photos from the conference]

bonder lunch May 28, 2015:

On Thursday, May 28th Merrill Bonder, Executive Director of The Seth Bonder Foundation, visited The Center for Healthcare Engineering and Patient Safety (CHEPS) and shared a lunch with the CHEPS students, many of whom receive funding from The Bonder Foundation. Additional attendees at the luncheon included Bonder Fellowship recipients from the Industrial and Operations Engineering Department, Associate Dean for Academic Affairs Alec Gallimore, CHEPS Director James Bagian, CHEPS Associate Director Amy Cohn, and IOE faculty including Department Chair Mark Daskin and Professor Larry Seiford.

Merrill says The Bonder Foundation could not be more pleased with the direction of CHEPS. She elaborated that the purpose of the foundation is to support Seth Bonder’s legacy and what he believed in “This program fits that so perfectly. Seth had a working relationship with Amy [Cohn] and he was impressed with her work then. That only carries forward,” Merrill said.

Merrill sees CHEPS students frequently during visits to Ann Arbor as well as at a variety of conferences. At the luncheon, the students presented her with a photo album filled with pictures from their meet-ups. Merrill explained that the connection with students is a large part of what makes her work as head of The Bonder Foundation so rewarding saying, “The bonus for me is that I’ve met so many well-deserving and very bright students and I get to become a small part of their lives too…. It’s a blessing for me. I love what I do and that I’m carrying on what Seth wanted to do…. It’s just as rewarding for me as someone who receives the grant.”

Here’s what some of the students and alumni in attendance had to say about the luncheon:

“Merrill Bonder has supported CHEPS to make great strides in improving healthcare. But, during the luncheon, I was reminded about how she is genuinely interested in our work and believes that what we are doing makes a difference.” – Mark Grum, HEPS Master’s Student

“I thought that the luncheon with Merrill Bonder was a wonderful event to reconnect with Mrs. Bonder and be able to keep her updated on our research. Her support of CHEPS and all the work that we do is greatly appreciated and I think it is important for her to be able to meet us students so we can express our gratitude in person.” – Nathan Janes, IOE Master’s Student

“It’s always nice to see Mrs. Bonder! The luncheon was a great opportunity to express to her our gratitude for all the continued support The Bonder Foundation has given us.” – Pamela Martinez Villarreal, HEPS Master’s

“It’s always so wonderful to have Merrill visit. We had great conversation and great food amongst great company. With every story that Merrill shares, I feel like I get a better sense of the man Seth was and feel so grateful that his dreams are able to live on in part through the work that we do at CHEPS.” – Billy Pozehl, CHEPS Research Assistant and 2014 HEPS Master’s Graduate

“Without the gracious support of Merrill and The Bonder Foundation, I would not be able to be in the HEPS Master’s program here at Michigan. I’m so glad I got to speak with Merrill at the luncheon, hear stories about Seth and his work, and see how much great work we’ve been able to do here at CHEPS with her support.” – Matthew Rouhana, HEPS Master’s Student

[View photos from the lunch]

s15 welcome May 8, 2015:

The CHEPS summer 2015 team gathered to eat ice cream, celebrate summer, meet new team members, and discuss upcoming projects on Friday, May 8th. We’re excited for a fun and productive summer. Welcome, everyone!

dc trip May 8, 2015:

CHEPS students Rama Mwenesi and Pamela Martinez Villarreal along with Amy Cohn, CHEPS Associate Director, attended the Health Policy Residential Program in Washington, DC from May 4th until May 8th, 2015. The program was organized by the University of Michigan Ross School of Business to examine the involvement of the U.S. government in healthcare, key healthcare policy issues, and the institutional and political context in which these policies are crafted.

“Some of the topics we covered were the partisan divide in congress, lobbying, advocacy, consulting, and healthcare reform. Overall, it was a very insightful experience and it gave us a much broader perspective of healthcare,” said Pamela.

Rama said the programming aided him in gaining “a much deeper understanding and appreciation for the work and role of government in healthcare policy reform and implementation.”

[View photos from 2015 Health Policy Residential Program]

s15 welcome May 4, 2015:

Vanessa Morales, a 2014 HEPS Master’s graduate, represented CHEPS at the Investigating Student Learning (ISL) Poster Fair on May 4, 2015. The event, held by the Center for Research on Learning and Teaching (CRLT), gives attendees the chance to learn about projects recently funded by the ISL Grant which supports instructors as they develop projects to assess what students are learning in their courses and how.

Vanessa presented a poster titled, “Assessing the Impact of Cross-Disciplinary, Project-Focused, Action-Based Immersive Learning Experiences in Healthcare and Engineering.” The project was awarded a 2014 ISL Grant. Vanessa collaborated on the project with Amy Cohn, CHEPS Associate Director, and Michelle Macy, a CHEPS affiliate and Assistant Professor of Pediatric Emergency Medicine.

Vanessa, who is now a Management Engineer in the Duke University Health System, said of her experience at the fair, “The event was a wonderful chance to share the collaborative and multidisciplinary environment of CHEPS to other areas at U of M. Similar disciplines, such as Education and Pharmacy were exploring the same themes of this immersion and collaborative work and it was great to hear their stories and share successes in projects. Our project with CRLT sparked attention from numerous attendees and I’m happy to have been the bridge between them and CHEPS.”

lemay lunch April 30, 2015:

First-year IOE PhD student, Brian Lemay, was the fourth featured speaker in the PhD Lunch and Learn series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS). This series provides PhD students the opportunity to present their healthcare work-in-progress to fellow PhD students and interested faculty and clinicians for feedback and discussion. Attendees came from the UMHS Pediatric Emergency Department, HEPS master’s program, Department of Industrial and Operations Engineering, and CHEPS.

Brian’s presentation, titled “Addressing Challenges in Scheduling Healthcare Providers,” discussed the various complexities of scheduling within the healthcare field. He spoke about challenges pertaining to multi-criteria objectives and context specific rules. He emphasized one of the main challenges to be infeasibility, meaning that there is no possible schedule that satisfies all of the given requirements. He spoke about techniques to improve modeling including creating composite variables, to have one variable represent multiple decisions, and sequences, to reduce the complexity of the decision variables. He also discussed an iterative solving approach which would put bound on each metric to identify areas of infeasibility.

Brian enjoyed the chance to present and collaborate. “It was a great opportunity for me to improve my speaking abilities and gather feedback from both students and faculty on my research. There were numerous insightful questions and I think it was a great learning experience for everyone,” he said.

Brian noted that his future research plans include focusing on infeasibility analysis. He will be working on creating algorithms to identify sources of infeasibility and determine potential fixes to overcome them. His presentation led to great discussion with the Pediatric Emergency Department physicians about their scheduling challenges, and how it is related to the work Brian is doing.

Brian and others from CHEPS have set up a time to observe the current scheduling procedure for Pediatric Emergency as a result of the conversation at the Lunch and Learn. “The doctors are experts on all of the scheduling rules and personal situations that need to be accounted for and we hope to provide some expertise on how to leverage technology to help make better schedules that satisfy their needs and desires,” he explained.

A big thank you to Marina Epelman for assisting in hosting this Lunch and Learn! If you are interested in receiving information about upcoming events or would like to present your current research, contact Gene Kim (genehkim@umich.edu). We are looking forward to more great sessions and discussions!

lopez VA April 28, 2015:

Undergraduate IOE student and research assistant in the Center for Healthcare Engineering and Patient Safety (CHEPS), Brittany Lopez, presented her analysis of endoscope reprocessing at the Veterans Affairs Ann Arbor Healthcare System (VAAAHS), on Tuesday, April 28, 2015. This presentation was a culmination of hard work and dedicated focus this semester to the flow of equipment and staff in the current Endoscopy Suite in order to inform the design on an upcoming renovation project slated for the area.

Brittany’s findings and recommendations will be instrumental to the VAAAHS as they work to develop a design for the Endoscopy Suite that enables standardization of workflow, minimizes non-value added movement of staff, reduces bottlenecks in the current equipment staff, and patient flows, and distributes work evenly throughout the day. Great job, Brittany!

bagian April 28, 2015:

Vanessa Morales graduated with a HEPS Master’s in 2014 and is now a management engineer in the Duke University Health System. In the video below, she discusses her time at CHEPS and how what she learned as a student here continues to impact her today.

bagian April 28, 2015:

Center for Healthcare Engineering and Patient Safety Director, James Bagian, has been named one of the “50 Experts Leading the Field of Patient Safety” by Becker’s Hospital Review. The list consist of advocates, professors, researchers, administrators, and healthcare providers who have won awards, published articles, spoken out, and led initiatives to reduce harm and ensure safety in healthcare.

In addition to his duties as Director of CHEPS, Bagian is a Professor in the Medical School and the College of Engineering at the University of Michigan. Previously, he served as the first Director of the VA National Center for Patient Safety (NCPS) and the first Chief Patient Safety Officer for the Department of Veterans Affairs from 1999 to 2010 where he developed numerous patient safety related tools and programs that have been adopted nationally and internationally.

James Bagian’s entry on the list as well as the full list of experts can be viewed at the Becker’s Hospital Review website.

PAG
PAG
April 23, 2015:

Members of the CHEPS community recently presented to University of Michigan President Mark S. Schlissel and his advisory group. The President’s Advisory Group Meeting, titled “Healthcare Policy & Implications for UMHS in the Era of Healthcare Reform,” was held in Rackham Assembly Hall on Thursday April 23, 2015.

CHEPS students, Pamela Martinez Villarreal and Hassan Abbas, were members of a student panel at the meeting titled “Learning Opportunities in Health Policy and Health Systems Engineering for U-M Students.” CHEPS Associate Director Amy Cohn chaired the session, along with Professor Matt Davis. After the professors spoke briefly about CHEPS and other organizations enabling students to work across disciplines to solve healthcare problems, the students (who also included Brenda Duverce from the School of Public Policy and Rahael Gupta and Steven Weinberg from the School of Medicine) spoke for about 15 minutes.

“I was very honored and excited to share with President Schlissel and his advisory board all the great things we are doing at CHEPS. The round table gave us a chance to talk about our personal experiences and give an idea of what it means to work at the intersection of engineering and healthcare, and the importance of the multidisciplinary work we are doing,” said Pamela Martinez Villarreal, a HEPS Master’s student.

Hassan Abbas, School of Nursing student and CHEPS collaborator, also appreciated the opportunity. He said, “Presenting to the President’s Advisory Board was truly an honorable experience. Being able to speak on a panel with other students and being a part of the luncheon gave me a great opportunity to highlight some of the amazing things I have been able to experience here in the past two years. I was not only able to speak about my career path in nursing, but I was able to speak on behalf of the projects I am a part of here in CHEPS and the collaboration efforts we have with all of our partners, which really gave the President and his Advisory Board a brief pinch of what’s going on at this outstanding university.”

Pamela and Hassan were also able to present President Schlissel with a CHEPS fleece which they reported he was very grateful to receive!

PEDS group April 10, 2015:

The Pediatric Residency Scheduling project team completed a year’s worth of work Friday, April 10th finalizing both the block schedule for the 2015-16 academic year for Pediatrics and the June shift schedule for the Pediatric Emergency Room!

Building the block schedule is typically one of the last and most difficult tasks assigned to the Chief Residents. Needing to coordinate service coverage with customized educational requirements for 100 residents (Peds, Peds Neuro, and Med-Peds) while also meeting numerous vacation and other high-priority requests like coordinating electives for unique international experiences and tracking towards specific fellowships is nearly impossible to do by hand without inevitably upsetting a bunch of the residents. This year, the Chiefs asked that we help solve that problem.

After spending the past several months defining, refining, and tuning a model formulation of the problem, the team successfully used the model to first build the annual rotations for the senior residents, and now have done the same for the incoming interns as of the April 10th team meeting! We especially thank all the students who worked so tirelessly and our fantastic Chief Residents, Ed O’Brien, James Reinhart, and Shaili Rajput, for their wonderful collaboration. Congratulations on finishing out the year and best of luck in your next adventures!

During the same meeting, we also built the June schedule for the residents in the Emergency Room at C.S. Mott Children’s Hospital. Having built the monthly shift schedules for the past few years now, we have come to appreciate the impact that a good schedule can have on the residents and patients. This year has seen some tremendous ER schedules, and we hope that our efforts have led to better resident education and higher-quality patient care.

Once more thank you to Ed O’Brien for a terrific year and we look forward to continuing collaborations as you enter the Anesthesiology residency program here! In addition, we’re excited to work with incoming Chief Resident Steve Gorga for the 2015-16 academic year!

rama
nate
April 10, 2015:

Friday, April 10 was an exciting day for the students at CHEPS. In addition to being the end of many months of working on building a block schedule for the Pediatric Residency program, Friday was also the culmination of many months of training for two of CHEPS own student-athletes, Rama Mwenesi and Nate Janes.

The University of Michigan Boxing Team hosted the 2015 United States Intercollegiate Boxing Association (USIBA) National Championships Thursday, April 9 – Saturday, April 11 on campus. Rama Mwenesi, one of our HEPS Master’s students leading the Surgical Instruments project, is co-captain of the Men’s Team. He represented the University in the national title bout for the 165 lb. (middle-weight) class in the Open Division, the highest “experience-level” division allowed by the USIBA in amateur boxing. In a bout against a former sparring partner from the local rival club at Eastern Michigan University, Rama fought hard but was just barely edged out in a split-decision for the championship. Nevertheless, we are proud of Rama’s achievements in the ring and thankful that he came away unscathed!

Meanwhile, Nate Janes, a senior IOE student working on the Aviation, Transplant, and Surgical Block Scheduling projects, represented CHEPS as a member of the 2014-15 University of Michigan Cheer Team competing in Daytona, FL. On Thursday and Friday, Nate was part of a 22-person squad at the NCA & NDA Collegiate Cheer and Dance Championship. Entering the finals in 3rd place after Thursday’s Prelim round, the team put on an outstanding performance Friday afternoon on their way to a come-from-behind victory. They won by 0.08 points for their third consecutive national championship! Congrats to Nate and the entire team on defending the title!

friese April 7, 2015:

CHEPS affiliate, Christopher R. Friese Ph.D., RN, AOCN®, FAAN, has been recognized with the Oncology Nursing Society (ONS) 2015 Rose Mary Carroll-Johnson Distinguished Award for Consistent Contribution to the Nursing Literature. Friese was selected for this award due to “the impact that he has made on the oncology nursing profession through his high quality research publications, his dissemination of findings for policymakers and practitioners, and his efforts to support the professional development of colleagues.”

Friese is an assistant professor of nursing at The University of Michigan and a member of the Comprehensive Cancer Center. He will be presented with the award at the opening ceremony of the ONS 40th Annual Congress in Orlando, Florida on April 23, 2015.

twinkierun
twinkierun
April 1, 2015:

CHEPS community members participated in the Ann Arbor Twinkie Run on April 1, 2015. The group included George Tam (who took first in his age group), Elizabeth Olin, Donald Richardson, Pamela Martinez Villarreal, Amy Cohn, Peter Cohn, and Jonathan Cohn.

The 5k Twinkie Run is a fundraising event for Ann Arbor Active Against ALS, a nonprofit whose mission is to raise funds for research toward effective treatments and ultimately a cure for ALS, while raising awareness of the disease, encouraging physical activity, and building a compassionate community. The race includes optional Twinkie tasting throughout the race and a homemade Twinkie contest.

CHEPS also raised money for ALS research at the start of the Fall 2014 semester by participating in the ALS Ice Bucket Challenge.

twinkierun twinkierun

nursing day
nursing day
March 30, 2015:

Members of the CHEPS community attended Dean’s Research Day at the University of Michigan School of Nursing on March 30th, 2015. The annual event highlights nursing research and strives to inspire new ideas and collaborations. Several presentations and nearly 30 posters were featured.

CHEPS students displayed their poster titled, “Patient Flow in C.S. Mott Children’s Hospital.” In attendance from CHEPS were Hassan Abbas, Mark Grum, Stephanie See, Brooke Szymanski, and Gabriel Zayas-Caban.

“Attending the School of Nursing Dean’s Research Day was a great opportunity to learn about other groups projects, while also being able to display the work we do at CHEPS. Having the work that CHEPS does, at a mostly clinical session, was a hit. I was able to talk to past/future professors and current classmates about the collaboration between engineering and nursing at CHEPS and how significant this type of research is within the healthcare community. We received interest from many students and faculty who were genuinely intrigued in the projects we are working on at CHEPS, which made the whole experience incredible. I definitely am looking forward to the next Dean’s Research Day!”
– CHEPS student and nursing undergraduate, Hassan Abbas.

“The Nursing Research Day was really exciting with a lot of great projects and people interested about the work that others are doing. It was great to see my engineering work have a similar impact in the nursing field. Lots of nurses came and told us that what we were working on was really important and explained the clinical importance that could come from our work.”
– HEPS master’s student, Mark Grum.

PSU 2015
PSU 2015
March 28, 2015:

The 2015 Workshop of the Center for Integrated Healthcare Delivery Systems (CIHDS), a unit of the Clinical and Translational Science Institute led by Professor Harriet Nembhard from the Industrial Engineering Department at Penn State University, took place at Penn State University on March 28th, 2015.

A diverse group, including faculty, students, and practitioners, gathered to discuss efforts in establishing healthcare engineering programs at their respective institutions in order to tackle current challenges facing healthcare providers and administrators. The conference highlighted past and present efforts as well as opportunities.

As Professor Julie S. Ivy, from the Industrial and Systems Engineering (ISE) Department at North Carolina State University noted, “Our clinical partners agree that industrial engineers are the perfect people for health care…” but sometimes lack clinical exposure/background, which is “…what motivated us to create our Health Systems Certificate Program at North Carolina State.”

Professor Amy Cohn kicked off the workshop with an overview of the Center for Healthcare Engineering and Patient Safety (CHEPS) and discussed challenges in healthcare systems engineering and ways to meet those challenges. Professors Ivy and Nembhard also provided overviews of similar programs at their institutions. Both discussed health systems research in general, highlighting directions for future research.

The student presentations where one of the highlights of the workshop. They showcased breadth in both application and solution approaches to the many complex challenges in healthcare. Students presented research on healthcare operations (e.g. scheduling OR and Clinic Time for Surgeons at the University of Colorado hospital) using combinatorial optimization techniques, medical decision-making using Markov processes and simulation (e.g. cancer management), and evaluating multidisciplinary collaborations in healthcare using social network analysis to name a few.

“The thing I love most about these workshops is getting to see and hear about problems that I have never considered before especially the super cool way of how optimization methods are applied,” said CHEPS doctoral student Jeremy Castaing. Other highlights included opportunities to meet new people and network, exchanging experiences and perspectives as well as research ideas.

CHEPS masters student Rama Mwenesi summarized his experience as a “phenomenal one.” As he put it, “Many times these opportunities to learn about current work in academia are reserved for PhD candidates only and so having this chance as a master’s student has really been amazing. Following this seminar my question now is how can we leverage the experiences to maintain the momentum and keep up the conversation amongst faculty, administrators and above all students.” In that spirit, the workshop concluded with an eye toward exploring opportunities for developing collaborations between the institutions.

The following topics were presented by members of the CHEPS community:

  • Stochastic Optimization for Scheduling Infusion Patients at the UM Cancer Center, presented by Jeremy Castaing (PhD student, Industrial and Operations Engineering).
  • Challenges in Healthcare Systems Engineering and Ways to Meet These Challenges, presented by Amy Cohn (Associate Professor, Industrial and Opertations Engineering; Associate Director, CHEPS)
  • Simulation of Phlebotomy Lab to Improve Full-Day Experiences of Patients at the UM Cancer Center, presented by Pamela Martinez (Masters student, HEPS)
  • Improving the Delivery of Surgical Instruments at the UM Health System, presented by Rama Mwenesi (Masters student, HEPS)
  • A Decision Support Tool to Schedule OR and Clinic Time for Surgeons at the University of Colorado Hospital, presented by Luke Stumpos (Undergraduate student, Industrial and Operations Engineering)
  • Using Simulation to Assess the Impact of a Medical Observation Unit at the Pediatric Emergency Department, presented by Gabriel Zayas-Caban (Post-doctoral scholar, CHEPS)

[View photos from 2015 CIHDS Conference]

Richardson March 27, 2015:

CHEPS affiliate and IOE PhD student Donald Richardson received an honorable mention in the 2015 Ford Foundation Predoctoral Fellowship competition. Ford Foundation Predoctoral fellowships are awarded in a national competition administered by the National Research Council (NRC) on behalf of the Ford Foundation. The awards are made to individuals who have demonstrated superior academic achievement, are committed to a career in teaching and research at the college or university level, show promise of future achievement as scholars and teachers, and are well prepared to use diversity as a resource for enriching the education of all students.

cohn March 26, 2015:

Professor Amy Cohn, CHEPS Associate Director, was presented with the Alpha Pi Mu Industrial Engineering Honor Society’s Professor of the Year Award at the IOE Graduate Student Banquet on Thursday, March 26th. Every March, IOE students cast their vote for this award which recognizes instructors who have made a great impact on their education and lives. Congratulations, Professor Cohn!

hfhs visit
hfhs visit
hfhs visit
March 25, 2015:

The Center for Healthcare Engineering and Patient Safety hosted a dinner and discussion with Lucy Young, Andrea McAuliffe, and Jack Jordan of the Henry Ford Health System (HFHS). The event featured a presentation of the industrial engineering work being done at HFHS, an open discussion, and the exchange of ideas about industrial engineering and operations research in healthcare. Physicians, hospital administrators, academics, and students were all in attendance, including Dr. Jeff Desmond, Interim Chief Medical Officer of UMHHC, and Dr. Jack Billi, Associate Vice President for Medical Affairs at UM.

Lucy Young, a graduate of the University of Michigan in Industrial and Operations Engineering, gave a brief overview of industrial engineers and performance improvement at HFHS. Henry Ford has over 35 years of performance improvement history. Today they tackle a variety of problems in the area, from process redesign and data analysis to implementation support and working with clinical care teams. Andrea McAuliffe, another IOE grad, presented on bundled payments for total joint replacements, an analysis project conducted by HFHS. She detailed how they used a time-driven activity-based costing methodology (TDABC) to measure true costs and quality of joint replacements, so as to improve the value of the service. Finally, Jack Jordan, Director of Clinical Analytics at HFHS, talked about a real-time patient harm monitoring system. The goal of this “HARM” model is to identify patient harm, understand what went wrong, and react appropriately within a 48 hour time frame. By highlighting more patient harm with the advanced EMR systems available today, we can take more effective steps to provide better care for patients.

All of the presentations prompted excellent discussion, with attendees asking thoughtful questions and lending different opinions throughout the evening. Some areas of discussion included difficulties in estimating and understanding costs of medical care, the potential of advanced EMR in today’s healthcare environments, and defining quality in healthcare (The following article from the Wall Street Journal considers the question of quality in healthcare from multiple perspectives: http://www.wsj.com/articles/what-quality-measures-should-be-used-to-evaluate-health-care-providers-1427079654). Attendees stayed past the official conclusion of the event, sharing in more great food and discussion.

Below are the slides and video from the discussion.

If you are interested in receiving information about upcoming events or would like to organize a dinner and discussion at CHEPS, please contact Gene Kim (genehkim@med.umich.edu). We are always looking for great presentations and discussions!

Wu Lunch and Learn March 23, 2015:

Third-year IOE PhD student, Victor Wu, was the third featured speaker in the PhD Lunch and Learn series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS). This series provides PhD students the opportunity to present their healthcare work-in-progress to fellow students and interested faculty and clinicians for feedback and discussion. Attendees came from areas including the HEPS master’s program, the Department of Industrial Operations Engineering, and CHEPS.

Victor’s presentation, titled “Optimizing Global Liver Function in Liver Stereotactic Body Radiation Therapy Treatment Planning,” highlighted his work to optimize global liver function (GLF) in liver cancer patients receiving stereotactic body radiation therapy (SBRT) treatment. The goal of SBRT is to deliver high doses of radiation to cancerous tumors while delivering low doses to vital organs to preserve organ function. A patient’s liver function prior to treatment can influence the risk of liver toxicity and side effects post-treatment. Optimizing the GLF in patients can influence the amount of radiation delivered to portions of the liver, the treatment plan, and possible side effects.

The presentation led to an interesting discussion about future work including understanding the clinical impact, the additional percentage of liver preservation that is considered significant, and including additional components to the model.

A big thank you to Marina Epelman for hosting this lunch-and-learn! If you are interested in receiving information about upcoming events or would like to present your current research, contact Gene Kim (genehkim@med.umich.edu). We are looking forward to more great sessions and discussions

shs video still March 19, 2015:

Professor Judy Jin, a CHEPS affiliate, has been elected a Fellow of Institute of Industrial Engineers (IIE).This award recognizes outstanding leaders of the profession who have made significant, nationally recognized contributions to industrial engineering. A fellow is the highest classification of IIE membership. Professor Jin’s award will be presented during the IIE Annual Conference & Expo 2015, to be held May 30 – June 2 in Nashville. Congratulations, Professor Jin!

lounge chairs
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poster session
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March 12, 2015:

The 2015 Healthcare Systems Process Improvement (HSPI) Conference sponsored by the Society for Health Systems (SHS) took place in Orlando, Florida from February 18th to February 20th, 2015. Attendees gathered from around the country to discover and share past, present, and future research that will transform healthcare operations and systems.

“Communication was highlighted as key to a successful project across the conference presentations. This conference provided a great platform connecting practitioners and researchers toward the same goal, improving healthcare,” said Moses Chan, December 2014 IOE master’s graduate and current research assistant in CHEPS. Presentations and posters presented by CHEPS at the conference were well attended and had fantastic discussion and feedback.

Presentations

Using Simulation to Show the Impact of Variability on Training Transplant Surgeons, presented by Roshun Sankaran
The development of a graphical simulation-based tool has been useful in recognizing limitations in the current medical training environment, beginning to develop new alternatives, and providing an intuitive way to help providers better understand stochastic processes and their impact on training.

“Attending the conference was a really great and informative experience, as I had never done anything like that before. I’m incredibly grateful to have had the opportunity to present, and learned a lot from the experience. The feedback that I received from other CHEPS students and Amy in the days leading up to the conference were invaluable, and I think it speaks to the collaborative and supportive nature of CHEPS.
At the conference itself, I was surprised at the breadth of different topics that were presented both through presentations and posters. I definitely got the impression that healthcare engineering is a growing field that can impact almost every aspect of the healthcare system all the way from the national policy level, which was talked about at the luncheon, down to scheduling at individual clinics.
Spending time with the other students that went was also a lot of fun, and I hope that maybe next year I can stay a little bit longer! I really enjoyed the experience overall, and look forward to attending future conferences and hopefully being able to present as well.” – Roshun Sankaran, undergraduate pre-med student

Customization vs. Convenience When Developing Healthcare Scheduling Tools, presented by Amy Cohn
Industrial engineering and operations research based decision support tools can be very valuable in reducing workload and enhancing quality of provider scheduling. A scheduling tool must capture the unique requirements of the clinical environment and the nuances of its culture to be successful. With experience in developing several different scheduling tools, there are modeling and algorithmic issues as well as collaborative and educational opportunities.

Posters

Improving Patient Experiences in an Outpatient Chemotherapy Infusion Center, presented by Pamela Martinez-Villarreal and Matthew Rouhana
An ongoing (multi-year) in-depth collaboration between engineering faculty, physician, and nursing faculty and staff, engineering students, medical students, and nursing students. The experience of developing the collaboration, scoping areas of study, and engagement with patient advocates to get multiple perspectives on the problem has played a major role in this project.

“I had a great time attending so many thought-provoking presentations at the conference. Seeing the work that others are doing to advance the field and improve healthcare was impressive and inspiring. I also got the chance to speak with someone from Australia who was working on a very similar project as me. It was encouraging to exchange ideas with her and know that people are working on these types of problems all over the world.” – Matthew Rouhana, HEPS master’s student

Patient Flow in Pediatric Asthma, presented by Mark Grum and Hassan Abbas
Using process flow mapping, data analysis, and predictive modeling to better understand the trajectory of pediatric asthma patients, to predict their length of stay, and to identify methods for delivery of care.

“The SHS conference was a great experience not only to talk to healthcare professionals about the projects I was working on, but talk to them about projects they are doing and potential tools or methods that have found successful. The willingness to collaboration shocked me but helped me learn more than I thought I would. Many people were very impressed with CHEPS as a whole, whether it was from the talks or the posters and it was awesome to have a great reputation in the healthcare engineering community.” – Mark Grum, HEPS master’s student

“The SHS Conference allowed me to see first-hand what others are doing to integrate engineering and healthcare, which was really an eye opening experience. I was able to network with engineers and nurses at the conference and hear about their projects while also presenting the projects I have been a part of at CHEPS.” – Hassan Abbas, undergraduate nursing student

Patient Scheduling and Capacity Assessment for an Endocrinology Clinic, presented by Moses Chan and George Tam
In this research, we have taken the novel approach of collecting, over several months, a daily snapshot of the year-long clinic scheduling horizon and developing a relational database to analyze this data. The aim is to understand how patient appointments are scheduled and how appointments are cancelled, rescheduled, and ultimately used or “wasted.”

“SHS was my first experience at a healthcare conference. The various sessions held at the conference really allowed me to see how the many skill sets and tools I’ve learned in my industrial engineering classes are applied to various innovative and multidisciplinary projects that all have one overarching goal: to provide better care for the patient while reducing process errors.” – George Tam, IOE master’s student

Panel Discussion

Academic – Industry Partnering – Finding Synergy, presented by David Cowen with Amy Cohn
A panel discussion including professors and industry partners about the partnership between academic institutions and industries to create unique relationships that improve recruiting staff and brings innovative approaches to projects.

SHS YouTube Video Contest

CHEPS students were also presented with an honorable mention award for their entry into the Society for Health Systems YouTube video contest at the conference. “I enjoyed the SHS Conference very much as it was a great space to share, learn, network, and bond more as a team. During the poster sessions, I was happy to see that people were interested in our projects and open to share their thoughts and experiences. Furthermore, it was great to have won an award for the SHS video contest and the poster session competition!” said Pamela Martinez Villarreal, the HEPS master’s student who filmed and edited the CHEPS video entry.

We are looking forward to the HSPI 2016!

[View photos from the 2015 HSPI Conference]

long lunch and learn March 10, 2015:

Fifth-year IOE PhD student, Troy Long, was the second featured speaker in the PhD Lunch and Learn series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS). This series provides PhD students the opportunity to present their healthcare work-in-progress to fellow students and interested faculty and clinicians for feedback and discussion. Attendees came from the HEPS master’s program, the Department of Industrial Operations Engineering, and CHEPS.

Troy’s presentation, titled “Efficient Constructive Heuristics for 4pi Treatment Planning,” highlighted his work to develop patient-specific radiation treatments. Radiation beams are delivered externally to cancerous tumors in the patient’s body. The goal of radiation treatment is to destroy cancerous tissue while minimizing the exposure of harmful radiation to surrounding healthy tissue. Treatment plans must take into account the radiation beam’s dosage and angle to deliver the optimal amount of radiation to the patient. This work can be clinically translated to help determine optimal beam location and create ideal treatment plans.

His presentation led to great discussion about future work including integrating Beam Orientation Optimization (BOO) clinically.

If you are interested in receiving information about upcoming events or would like to present your current research, contact Gene Kim (genehkim@med.umich.edu). We are looking forward to more great sessions and discussions!

5k
5k
March 8, 2015:

Several members of the CHEPS community participated in the annual Conor O’Neils St. Patrick’s Day 5k on Sunday, March 8th 2015. The participants included Brittany Lopez, Anne Ayanian, Valerie Chase, Amy Cohn (Irish by blood), Ed O’Brien (Irish by surname), and George Tam (Irish by wardrobe). Despite the chilly temps and hilly course, all runners finished successfully and went on to celebrate with vast quantities of bacon afterwards.

5k group 5k group 5k group

caban February 26, 2015:

Gabriel Zayas-Caban, a postdoctoral research assistant in the Center for Healthcare Engineering and Patient Safety, has been awarded a Presidential Postdoctoral Fellowship. Beginning in 2011, the University of Michigan joined in a partnership with the University of California to offer postdoctoral fellowship opportunities at the University of Michigan. The program offers postdoctoral research fellowships in science, technology, engineering, or mathematics (STEM), economics, and political science fields, coupled with faculty mentoring, professional development and academic networking opportunities.

The specifics of Gabriel’s research and award are below.

Undergraduate institution: University of South Florida
Ph.D. institution: Cornell University
Dissertation title: Dynamic Allocation of Healthcare Resources
Dissertation advisor: Mark E. Lewis
Statement about research interests: The goal of my research is to develop data-driven frameworks, using queueing theory, Markov decision processes, simulation, and other Operations Reserch techniques, that can identify effective and practical policies for resource allocation in healthcare settings. In particular, it centers on (1) working closely with physicians and practitioners to develop accurate models and (2) addressing analytical challenges to enable these frameworks to handle more realistic scenarios, determine when practical dynamic policies are optimal, and use these results to design more robust strategies. For example, when catastrophic events overwhelm the supply of EMS vehicles, it is necessary for cities in the affected region to request aid (in the form of added capacity) from neighboring municipalities to bring the affected region back to its day-to-day levels of operation. The first part of my dissertation used queueing theory, Markov decision processes, and mathematical programming to develop a systematic framework for allocating ambulances for such scenarios. The second part of my dissertation addressed the question of how to prioritize the work by the medical provider to balance initial delays for care with the need to discharge patients in a timely fashion. We developed a multi-server two-stage tandem queueing model for the aforementioned triage and treatment process. We then used a continuous-time Markov decision process (CTMDP) formulation and sample path arguments to determine the optimal dynamic schedule for the single-server model. Using data from a hospital, we compared the performance of several potential service policies in a discrete simulation study. This work was motivated by the Triage-Treat-and-Release program at the Lutheran Medical Center, a full-service, 462-bed academic teaching hospital in Brooklyn, New York
UM PPFP primary mentor: Amy Cohn, Industrial and Operations Engineering

lunch and learn February 23, 2015:

Third-year IOE PhD student, Jeremy Castaing, was the first featured speaker in the PhD Lunch and Learn series presented by the Center for Healthcare Engineering and Patient Safety (CHEPS). This series will provide PhD students the opportunity to present their healthcare work-in-progress to fellow PhD students and interested faculty and clinicians for feedback and discussion. Attendees came from the HEPS master’s program, the Department of Industrial Operations Engineering, and CHEPS.

Jeremy’s presentation, titled “Mathematical Optimization to Reduce Patient Wait Times in an Outpatient Infusion Center,” highlighted the complexities of scheduling patients to decrease patient wait time and staff overtime. Treatment lengths vary, which can have negative impact on operations. Taking this uncertainty into account can help improve patient scheduling. Due to prolonged computational times, a heuristic algorithm was developed to find approximate solutions to schedule patient appointments under uncertainty of treatment times.

His presentation led to great discussion about future work including extensions of the optimization model as well as interesting metrics to evaluate the quality of an appointment schedule.

If you are interested in receiving information about upcoming events or would like to present your current research, contact Stephanie See (sesee@umich.edu). We are looking forward to more great sessions and discussions!

lunch and learn February 12, 2015:

CHEPS will be organizing and hosting a Lunch and Learn series to provide PhD students the opportunity to present their healthcare work-in-progress to fellow PhD students as well as interested faculty and clinicians for feedback and the chance to interact socially and enjoy a meal together. Jeremy Castaing will be presenting his research at the first Lunch and Learn on Monday, February 23 from 12 to 1 pm on North Campus (Location to be determined and will be sent to those who RSVP.) If you plan to attend, please RSVP to Stephanie See (sesee@umich.edu) by Monday, February 16 to ensure enough food for everyone. Additionally, please let Steph know if you would like to be added to the PhD Lunch and Learn mailing list for information about upcoming events. We are looking forward to great discussion and company!

shs video still February 5, 2015:

CHEPS students entered the Society for Health Systems (SHS) YouTube video contest and received an honorable mention. The purpose of the contest was to create a video presentation which would excite high school students to become an IE in the healthcare industry or convince a current IE to pursue a career in healthcare.

The CHEPS video which was filmed and edited by Pamela Martinez Villarreal and features Sarah Bach, Vanessa Morales, Rama Mwenesi, and Billy Pozehl came in second of all the entries in the competition. The team’s video will be recognized during a lunch and learn session at the Healthcare Systems Process Improvement Conference on Feb 18 – 20.

You can view the video below.

daskin February 3, 2015:

CHEPS affiliate Professor Mark Daskin, Industrial and Operations Engineering Department Chair and Clyde W. Johnson Collegiate Professor, has been invited to become a member of The Honor Society of Phi Kappa Phi. Phi Kappa Phi is the nation’s oldest, most selective, and most prestigious all-discipline honor society. Their mission is “to recognize and promote academic excellence in all fields of higher education and to engage the community of scholars in service to others.” Professor Daskin was nominated by Dean David Munson for his outstanding accomplishments on behalf of the College of Engineering.

caban January 27, 2015:

Gabriel Zayas-Caban, a postdoctoral research assistant in the Center for Healthcare Engineering and Patient Safety, is part of a project team working to speed up test screening results for newborns. The group has received a grant from the Robert Wood Johnson Foundation to study how to minimize the time between when blood is drawn and when results get to parents and healthcare providers. You can read more about their research in this blog post by Dr. Beth Tarini, Assistant Professor in the Department of Pediatrics and the Child Health Evaluation and Research (CHEAR) Unit at The University of Michigan.

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January 17, 2015:

Mrs. Merrill Bonder from the Bonder Foundation stopped by CHEPS for a visit over the weekend of January 17, 2015. Mrs. Bonder’s grandson, Matt Howard, came along on the trip and CHEPS students took him on a tour of The University of Michigan campus. Could Matt be a future CHEPster in the making?

CHEPS student George Tam said, “Matt, Liz, Brittany, Nate, and I went to Zingerman’s Deli for lunch then took Matt around both North and Central Campus. Following amazing sandwiches, we all stumbled upon the Hack-A-Thon and got a chance to not only tour the buildings of North Campus, but play video games with the ‘hackers.'”

“On Central Campus, we all got to visit the Law Quad, the spinning cube, the Business School, and the Central Campus diag. However, the biggest highlight for Matt was seeing ‘packable’ snow, which resulted in a group impromptu snowball fight in the middle of the North Campus diag. We all felt like teenagers again.”

The group also attended the men’s basketball game against Northwestern where they proudly represented CHEPS and U of M and were delighted to spot CHEPS affiliate Rishi Reddy who was at the game with his wife Gwen but disturbed to find him wearing Northwestern colors.

Multi-talented CHEPS student Nathan Janes also cheered at the game which Univeristy of Michigan won 56 to 54. Feel free to remind Dr. Reddy of the win if you should spot him in his Northwestern gear!

cohn January 13, 2015:

Professor Amy Cohn, CHEPS Associate Director, has been selected as a recipient of the 2014-2015 College of Engineering Service Excellence Award. This recognition is in honor of the numerous undergraduate, master’s, and PhD students that she has supervised; her community service in the Ann Arbor public schools; her service to the Industrial & Operations Engineering Department including five terms on the Department Committee; her service to the College and the University including her work on the leadership committee of IHPI; and her leadership on national and international levels in healthcare and aviation. Congratulations, Professor Cohn!

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