||November 21, 2019:
CHEPS Associate Director Amy Cohn recently traveled to Florida Polytechnic University to advise faculty there as they work to develop their own center similar to CHEPS. Professor Julie Ivy, a Fitts Faculty Fellow in Health Systems Engineering at North Carolina State University and a long-time friend of CHEPS, joined Professor Cohn on the trip. They were invited by Professor Grisselle Centeno, a new faculty member at Florida Polytechnic who serves as the Director for the health systems engineering center there. Professor Centeno is also a friend of CHEPS and has presented her work in our seminar series.
Professor Cohn appreciated the opportunity to share lessons learned from her work at CHEPS. “Part of the mission of CHEPS is not only to do our own work and train our own students but share our work to help others broaden the reach,” she said. Professors Cohn and Ivy spent two days discussing their work in healthcare to the university president, provost, advisory board members, and faculty while helping Professor Centeno work toward her vision of the health systems engineering program at Florida Polytechnic. In addition to enjoying the chance to share their knowledge and collaborate with friends, they enjoyed the beautiful campus and warm Florida weather while not feeding the alligators.
|November 15, 2019:
Lauren Hirth worked with CHEPS for three years as an undergraduate Biomedical Engineering student. After graduating in the spring of 2019, she started work at the National Institutes of Health. She recently checked in with an update about her work:
“I am currently working as a postbaccalaureate research fellow at the National Institutes of Health Clinical Center. Specifically, I work in the Functional and Applied Biomechanics Lab in the Rehabilitation Medicine Department. My main project is a longitudinal study with infants that are at risk of a cerebral palsy diagnosis. I am using both EEG and near-infrared light technologies to monitor brain activity during different motor tasks. I am really looking forward to learning more about the onset and development of motor tasks in this population and hope to help bridge the gap between engineering applications and clinical diagnoses and treatments. I have also worked to standardize and streamline a new pipeline script that can be used by others in the lab to process EEG data. Just as I learned through my projects at CHEPS, there are always ways to improve the functioning of healthcare systems and processes!”
Thanks to Lauren for the update! We love seeing our CHEPS alums continue to do exciting and innovative work.
On the left, Lauren is pictured in the lab where she works.
|November 14, 2019:
CHEPS had the pleasure of a visit from recent alum Sheridan Tobin recently when she returned to Ann Arbor for a football game. Sheridan, who graduated with her B.S. in Public Health in May 2019 worked at CHEPS during her final year of studies. She’s now working as a support counselor at a community-based mental health non-profit that serves young people in foster care and the juvenile probation system. She said that, while her job now is definitely different than what she did with CHEPS, she took what she learned at Michigan with her. “In working in the hospital systems, a lot of it is figuring out the logistics of how working in direct-care works. I think having some experience observing at hospitals and just being in the thick of it in a clinical setting, it looks different in community-based, but I think having some of that background was helpful,” she explained. “Also, when I came into CHEPS, I didn’t know anything about what CHEPS was doing. I was non-engineer learning all of that. And, in my current job, I don’t have a mental health background like my colleagues do. I’m kind of learning again in a different way how to take my background into something new and with people coming from different places so it’s interdisciplinary in kind of a similar sense.” Thank you for visiting, Sheridan! We love seeing our alums!
|November 11, 2019:
On November 11th, Dr. Lavanya Marla presented her work on “Data-Driven Greedy Policies and Performance Bounds for Ambulance Location and Deployment” as part of our Providing Better Healthcare Through Systems Engineering Seminar Series. Dr. Marla is an Assistant Professor in Industrial and Enterprise Systems Engineering at the University of Illinois- Urbana Champaign. Dr. Marla previously worked as a Systems Scientist with Heinz College at Carnegie Mellon University. Her research currently focuses on using data-driven optimization, statistics, and machine learning to construct robust, decision-making models specifically related to transportation logistics.
Dr. Marla’s lecture outlined her work related to modeling and optimization of ambulance location and deployment. Her research started with observations of the ambulance system in India where only 750 ambulances are available per 75 million people. This highly resource-constrained system sparks questions about how access to a limited number of ambulances can be improved and optimized when adding additional ambulances to the system may not be possible. Dr. Marla and her colleagues worked model the current ambulance system using data from 10,000 emergency calls and by incorporating congestion and human behavior patterns. Use of the Greedy Algorithm allowed for simulation of system changes at various ambulance sites to see how the number of calls answered in 15 minutes or less, number of calls answered in 30 minutes or less, and the number of unserved calls could be affected or improved. By carefully determining model constraints, Dr. Marla and her colleagues were able to show that through static ambulance repositioning, they could improve the number of calls served in 15 minutes or less by 6.1% and by dynamic repositioning, improvements of 39% were possible. Through careful data analysis and proper constraint definition, complex real-world systems can be significantly improved and lives can ultimately be saved.
We thank Dr. Marla for braving the terrible snowstorm to participate our seminar series and present her fascinating, complex, and impactful work.
||November 8, 2019:
On Friday, November 8th, many CHEPS students presented at the Engineering Research Symposium (ERS). ERS is a university-wide event that showcases undergraduate and Ph.D. student research. CHEPS students had the opportunity to submit an abstract and poster for research projects that they are involved in at CHEPS! Here are the posters that were presented at the symposium:
This event gave students a chance to show off their work and network with other engineering students and faculty. Here are some quotes from CHEPS students about their experience during the symposium:
“I think ERS was a fun experience. I loved that it was in the Dude so we could run into classmates and friends. I also think it was good practice for the CHEPS Symposium. It made me think about how to quickly explain the important parts of the project to someone that has no idea what the project is about. Usually we talk to collaborators or peers about our work, so it was good to get practice talking to other people prior to the symposium.” – Kate Burns
“This symposium was a great experience for me to not only show off the great work we have been doing at CHEPS but to also learn about other impressive research being conducted throughout the university. Although my poster had minimal turnout, the people that did stop by seemed extremely interested and had interesting perspectives and ideas that our team had not previously considered.” – Matt Levenson
“I really enjoyed being able to talk to other presenters about my project as it gave me valuable experience in being able to verbalize all that we have done since the summer. I also enjoyed being able to see other projects. Everyone’s projects were all very interesting!” – Luke Liu
“I would say the ERS was a great opportunity to share our work with the other members of the Michigan Engineering community. I was happy to see so many people engaged and interested in the work we do on the TRAUMA team.” – Hannah Strat
|November 4, 2019:
On November 4th, Michael Krautmann presented his work on “Improving Access to Medicines in Low- and Middle- Income Countries” as part of our Providing Better Healthcare Through Systems Engineering Seminar Series. Michael is an alumnus of the U of M Industrial and Operations Engineering Department and worked as a Peace Corps volunteer in Zambia for three years after graduating. Michael joined the William Davidson Institute Healthcare Initiative at the University of Michigan in 2015 and his research and consulting currently centers around strategy and decision-making to improve public health efficiency, services, and supply chain.
Michael’s presentation highlighted his experience on the ground-level in Zambia where he worked to understand and identify supply chain inefficiencies in health care clinics. Lack of access to basic medications in many parts of the world is thought to be a direct result of bad roadways, lack of electricity, and other physical barriers when, in reality, many companies outside of healthcare have already successfully bridged those gaps to make their products available in the most remote areas of the world. Instead, Michael pointed to a lack of infrastructure and organization as the major barrier to proper healthcare access. In order to effectively convey the complexity of the supply chain system in countries like Zambia, Michael and his colleagues use detailed process maps, supply chain software tools, and relevant performance metrics such as clinic reporting rates and accuracy. Throughout his lecture, Michael stressed the importance of effectively presenting the problem when trying to motivate change and spark action, especially in the incredibly complex healthcare industry.
We thank Michael for taking the time to participate in our seminar series and sharing his valuable life experience and advice about navigating difficult healthcare problems and truly making an impact.
Join us on Monday, November 11th when Lavanya Marla, Ph.D. will discuss “Data-driven Greedy Policies and Information-Relaxation Bounds for Ambulance Location and Deployment.”
|October 29, 2019:
CHEPS alumnus Jason Card came back to the University of Michigan to give a Lunch & Learn discussing his experience working with the Johns Hopkins Applied Physics Laboratory (APL). The APL was started during World War II to develop a better way for the US Navy to combat fighter planes. From that point, they have started to tackle different challenges, such as developing technology to allow a paraplegic to use prosthetics, a tool to manage epidemic outbreaks, and a tool to reduce healthcare-associated infections. When it comes to healthcare research they hope to revolutionize health through science and engineering.
Jason’s main focus of work is on value-based care and the musculoskeletal (MSK) applied value atlas. For value-based care, the project goal is to create a patient-centered healthcare process. The idea behind this is to get coordinate multiple specialists in one facility and get them to talk about complex patients together. By doing this, it reduces the number of appointments needed and allows the doctors to effectively communicate with one another. In regards to the MSK applied value atlas, they want to be able to create an atlas of historical data on injuries in the military. With this data, they will be able to accurately predict which occupations and areas are susceptible to specific injuries. In addition to an alumnus working on it, our own CHEPSter Jordan Goodman interned at the APL this summer and helped Jason with this project!
Jason also filled attendees in on the positions APL will be looking to hire interns and graduates in soon and took the time to talk one-on-one with several CHEPS students. Thank you, Jason, for traveling back to UofM to discuss ways to apply the knowledge we learn in CHEPs.
|October 28, 2019:
On October 28th, Katie Esper presented her work on “Applying Systems Engineering to Ensure Military Readiness and Health” as part of our Providing Better Healthcare Through Systems Engineering Seminar Series. Katie Esper joined the Johns Hopkins University Applied Physics Laboratory in 2010 as a health systems engineer and is currently the Program Manager of Force Health and Readiness. Her work centers around a mission to ensure a medically ready force, ready medical force, and delivery of safe and effective healthcare across all military and humanitarian missions. Katie is also an alumna of the University of Michigan Industrial and Operations Engineering Department.
During her presentation, Katie highlighted the dual mission of the U.S. Military Health System which consists of the readiness and benefit missions. The readiness mission focuses on ensuring that there is a medically ready military force as well as a ready medical force to be deployed in wartime and on humanitarian missions around the world. The benefit mission refers to providing healthcare benefits to the 9.5 million military health beneficiaries in the U.S. Both of these missions present unique engineering challenges related to the determination of readiness measures, root cause analysis, and prevention of injuries sustained during training, and prediction of materials, staff, and other resources needed at military hospital sites. The medical force deployed on these missions must be adequately prepared for the scenarios that they are likely to encounter. In peacetime, it is critical to ensure that medical staff have opportunities to practice their skills in complex trauma cases through hospital experience or simulation. By employing systems engineering approaches, Katie and her colleagues tackle these challenging problems in order to ensure the safety, health, and welfare of our military personnel and those who support the front lines.
We thank Katie Esper for participating in our seminar series and highlighting the important and often overlooked challenges present in our military health system today.
||October 26, 2019:
On Saturday, October 26, 2019, the Michigan Marching Band performed a halftime show titled “We Choose to Go” in honor of the National Aeronautics and Space Administration (NASA). The halftime performance at the University of Michigan vs. Notre Dame football game was a celebration of the long-standing collaboration between the University and NASA as well as the 50th anniversary of Apollo 11’s moon landing. The band performed several space-related songs and created formations such as a rocket and the NASA logo on the field. CHEPS Director Jim Bagian, a former NASA astronaut, joined the band on the field during their performance along with many other special guests.
— Written by Liz Fisher, CHEPS Staff
|October 25, 2019:
On Friday, October 25th, University of Michigan alum and Friend-of-CHEPS Dan Herman returned to campus to get to know some of our current CHEPSters as well as give a talk about his experiences in industry and consulting. After graduating from the University of Michigan in 1982 with a degree in Industrial and Operations Engineering, Dan began his career in the Healthcare IT industry and later founded Aspen Advisors. Now he works as a self-employed consultant and enjoys hiking throughout Colorado’s mountains in his spare time.
Dan and a group of CHEPS students had a casual lunch together. And CHEPSters were able to exchange questions and get to know Dan on a personal level. With over 35 years of experience in the field of healthcare analytics, Dan provided lots of tips to help us succeed in our future endeavors. He stressed the importance of building relationships early on and expanding upon personal networks in order to ensure opportunities in the future. He also emphasized the value of building a reputation for being dependable, hardworking, and productive, as well as having meaningful mentors and asking questions whenever possible.
A huge thanks to Dan Herman for taking the time out of his schedule to visit us! We look forward to seeing him again in the future!
|October 25, 2019:
CHEPSters attended the IOE Lunch and Learn seminar “Leveraging Pharmacy and Medication Data to Improve Human Health” by Dr. Corey Lester of the U-M College of Pharmacy on Friday, October 25th. Dr. Lester spoke about his research on improving patient safety through efforts to reduce medication dispensing errors in community pharmacies. He described some background on the operations of community pharmacies and presented his Medication Event Framework showing how dispensing errors happen; he then spoke about his upcoming research on solutions to these issues. We look forward to hearing more about Dr. Lester’s awesome work in the future!
||October 23, 2019:
CHEPS students, alumni, and faculty attended the 2019 INFORMS Annual Meeting in Seattle, Washington from October 20th-23rd. The INFORMS Annual Meeting brings together academic researchers and industry thought leaders working in the fields of operations research, management sciences, and data analytics. The CHEPS presentations included:
INFORMS was a great opportunity for current CHEPS students to visit with alumni who are continuing their great work of moving healthcare forward using engineering tools. Current students particularly enjoyed seeing Drs. Karmel Shehadah and Donald Richardson, two CHEPS alumni who each defended their dissertation earlier this year. Students also attended several sessions from colleagues doing great work at other institutions, including Northeastern University, North Carolina State University, and Mayo Clinic.
Students who attended said their favorite thing about attending this year was:
“I met Peter Jackson, the advisor of my Master’s degree’s very first case study project, at the AAS dinner. Peter had given us a lot of great advice and help for the project and also for the whole Master’s journey. Not long after the project, he retired and went to SUTD in Singapore, so it feels really amazing to be able to meet and greet him again.”-Junhong Guo, IOE Ph.D. Student
“Watching Dr. Jenna Wiens [Assistant Professor, Computer Science and Engineering] present for the first time at INFORMS on learning from clinical time series…she was eloquent and very inspiring to me. She was part of the session in which I presented, which was empowering because she is a powerhouse. Others in the session included Dr. Marina Epelman [Professor, Industrial and Operations Engineering] and Carolina Riascos [Ph.D. student, University of Toronto]. I felt honored to be part of such a strong session of women making a difference in healthcare” – Amanda Moreno Hernandez, IOE Masters student
“Getting to share a newer project on access to specialty care for rural patients. This is a newer project and it was my first time sharing it outside of CHEPS. There was great feedback and many new ideas that I’m excited to explore. I am thankful to Dr. Kayse Maass (Assistant Professor, Northeastern University) for inviting me to speak in the session. My second favorite part of visiting Seattle was the Cinnamon Works cookies!” – Adam VanDeusen, IOE Ph.D. student
Additional highlights of the conference included a “Michigan Night” reception at the Starbucks Reserve Roastery, exploring Pike Place Market, and of course, catching up with Mrs. Merrill Bonder.
— Written by Adam VanDeusen, IOE Ph.D. Student
|October 20, 2019:
On Sunday, Oct 20th, CHEPS Associate Director Amy Cohn and current Ph.D. student Junhong Guo attended the business meeting held by Aviation Applications Section (AAS) during the annual INFORMS meeting in Seattle, WA. During the award ceremony at the end of the meeting, Junhong was awarded Honorable Mention for the AAS 2019 Best Student Presentation Competition, where he presented his work on “A Delayed Column Generation Approach for Solving a Cargo Crew Scheduling Problem”. This research has been generously supported by many other CHEPSters and staff during the past one and a half years, and wouldn’t be such a success without their great help!
Following the meeting, Junhong joined with several other AAS members, had dinner at Hard Rock Cafe Seattle, and furthermore exchanged thoughts and ideas not only on aviation but also on healthcare applications.
||October 18, 2019:
Friend-of-CHEPS Mark Van Sumeren took time out of his busy schedule (including welcoming a granddaughter to the family this week!) to speak with CHEPSTERs this past Friday. Drawing on his vast experience in the industry, Mr. Van Sumeren shared seven key tips on launching a successful career in healthcare. Mark described his career as “anything but a straight line” and shared his journey from UM to the Detroit Medical Center to Ernst & Young to Owens & Minor before starting his own consulting firm, Health Industry Advisor LLC.
In brief, Mr. Van Sumeren’s seven tips were:
1. Healthcare is a great career industry, due to the passionate workforce and need for talent with IOE skills.
2. You must reinvent yourself continually by growing your skillset to match the needs of the industry.
3. Lifelong learning is key! You must surround yourself with people from whom you can learn and who want to learn from you.
4. Culture matters! If the culture of the organization you find yourself in is toxic, run!
5. Passion is everything! “Go where it takes you, leave when it’s gone.” If you’re not passionate about the work you’re doing and don’t have that same “drive” it’s time to find a new problem to solve and place to do it.
6. Take on the problem that no one else will, by finding a tough problem and attacking it. If you choose the problems you want to solve, you won’t get stuck with the uninteresting ones.
7. Those who get ahead: Work well with others, deliver consistently, and make others successful. Above all else, Mr. Van Sumeren emphasized that those who have a “Hall of Fame” career find ways to make the people around them successful. He relayed the anecdote that at Ernst & Young, the measure of success for Partners was not how many projects they sold, but how many other partners they made.
Mr. Van Sumeren fielded several questions from students including sharing that to motivate training coworkers on a task, you have to get over the “It’s faster to do it myself” attitude. By focusing on the time you’ll save not having to do the task next time and the benefits of having a new set of eyes on the problem, you set yourself and your coworkers up for success. He also shared some of the nuances of working in different corporate structures including non-profit, partnerships, publicly traded, and private equity. Mr. Van Sumeren also reminded students that perceived risk in a career move should be viewed as exciting rather than daunting since it represents an opportunity for growth.
Thanks to Mr. Van Sumeren for sharing so many valuable insights and taking the time to carefully consider students’ needs as they enter their next phase of life. We look forward to having you visit CHEPS again in the future.
|October 18, 2019:
CHEPS alum Chloe Smither recently completed her MSc in Operational Research at The University of Edinburgh. Her master’s thesis was titled “Integer Programming Formulations for Edge Deletion Problems.” Chloe got her B.S.E. in Industrial and Operations from the University of Michigan and worked with CHEPS for nearly two years of her undergraduate career. Now that she’s completed her master’s Chloe is working out of London as a Data Analyst at British Airways. We hope she’ll make it back to the States and Michigan to visit us at CHEPS occasionally!
|October 13, 2019:
CHEPS took over the 2019 Chicago Marathon. Current CHEPSter, Adam VanDeusen, and CHEPS alumna, Sarah Bach, ran 26.2 miles around the windy city on October 13. Adam and Sarah kept each other motivated remotely throughout months of training, leading to each of them earning their best marathon times on race day. They look forward to cracking more personal records at future marathons!
|October 7, 2019:
On October 7th, Dr. Emily Mower Provost presented her work on “Human-Centered Computing: Using Speech to Understand Behavior” as part of our Providing Better Healthcare Through Systems Engineering Seminar Series. Dr. Mower Provost is an Associate Professor in Computer Science and Engineering at the University of Michigan. Her research is focused on analysis and modeling of complex human behavior and expression of emotion for potential applications in improving diagnosis and treatment techniques for mood disorders. Using algorithm approaches, Dr. Mower Provost and her colleagues aim to characterize and predict human behavior, emotions, and moods.
Although speech analysis has applications in several fields, Dr. Mower Provost highlighted the use of speech assessment and algorithms for monitoring bipolar disorder. Human speech patterns are incredibly complex and are influenced by many external factors such as the environment in which people are speaking, the personality of the speaker, emotions, and lexical content of the conversation. Pharmaceutical treatments do currently exist for bipolar disorder, however, patient compliance can be problematic. Frequent check-ups and potential rehospitalization can be incredibly costly and often follow potentially catastrophic manic and depressive episodes. Within the Chai Lab, Dr. Mower Provost focuses on audio-visual emotion modeling and assistive technology development to track mood patterns of bipolar patients, monitor patient conditions, and predict possible manic or depressive episodes before they occur. Personal and clinical assessment calls of bipolar patients and healthy controls were monitored by the research team (with participant consent) over a 6-12 month period and speech patterns were annotated for rhythm and acoustics. After several years of work to control data variability, the team was able to successfully demonstrate a correlation between mood and emotion and valence (positivity) and activation (energy) which has immense potential to be applied in clinical mood disorders as well as other diseases.
A video of the presentation is available for viewing.
We thank Dr. Mower Provost for her presenting her outstanding work and we are excited to see where this data can be applied in the future.
There will be no seminars on Monday 10/14 and 10/21. Please join us again on Monday, October 28th when Katie Esper, MPH, MHCDS of Johns Hopkins APL presents “Applying Systems Engineering to Ensure Military Readiness and Health.”
|September 30, 2019:
On September 30th, Dr. James Bagian presented his work on “Embedding Patient Safety into the Fabric of an Organization: Critical Elements to Make it Happen” as part of our Providing Better Healthcare Through Systems Engineering Seminar Series. Dr. Bagian is the Director of the Center for Healthcare Engineering and Patient Safety and a Professor of Anesthesiology in the Medical School and College of Engineering at the University of Michigan. 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 Veteran’s Affairs from 1999 to 2010 where he launched numerous patient safety programs and tools that have been adopted worldwide. Dr. Bagian also served as a NASA astronaut on two Space Shuttle missions and was an investigator of both the Challenger and Columbia space shuttle disasters. His work currently centers around implementation of systems engineering approaches to the investigation and analysis of adverse medical events to offer solutions, prevent repeat occurrences, and enhance patient safety.
Throughout his lecture, Dr. Bagian drew parallels between adverse events and statistics in the aviation and healthcare industries. The differences in the reporting of adverse events and employment of corrective actions between the two industries was striking. A 2010 study carried out by the Center for Medicare and Medicaid Services (CMS) found that approximately 1.5% of patients treated in hospitals die per year as a result of adverse medical events. Another 27% of patients were victims of adverse events resulting in temporary or permanent injury. Dr. Bagian highlighted the impact that culture within the healthcare industry has on the occurrence of these events. The “compliance culture” in which care providers uncritically and robotically follow rules and regulations rather than actively considering the appropriateness of the policy or procedure for the individual being treated and when necessary questioning before acting can be very dangerous. Shifting to a “safety culture” is essential to avoid shaming of individuals who make mistakes and to encourage proper reporting of close-call or near-miss events that can be studied to employ effective solutions that prevent harm in the future. In healthcare, there is an expectation that people will never make any mistakes which is simply impossible. Through his work with the VA and at Michigan Medicine, Dr. Bagian has shown how systems engineering approaches related to patient safety can change the culture within the hospital and attitudes that focus on identifying the underlying root causes and contributing factors so that meaningful and sustainable countermeasures and improvements can be implemented. Offering new tools and programs to support accident reporting, including close calls, and swift systems-based corrective actions can ultimately ensure patient safety and save lives.
We thank Dr. Bagian for his engaging presentation and for bringing his unique perspective and background to the extremely important topic of patient safety.
Join us for our next seminar on October 7th at 4:30 pm in 1123 LBME when Emily Mower Provost, PhD discusses “Human-Centered Computing: Using Speech to Understand Behavior.”
|September 23, 2019:
On September 23rd, Dr. Kevin Taaffe presented his work on “The Impact of Communication, Coordination, and OR Design on Surgical Patient Flow and Safety” as part of our Providing Better Healthcare Through Systems Engineering Seminar Series. Dr. Taaffe is the Harriet and Jerry Dempsey Professor of Industrial Engineering at Clemson University and worked in the transportation logistics industry for American Airlines and Sabre earlier in his career. His research centers around the use of simulation models to optimize patient and provider workflows in the clinical environment. During his lecture, Dr. Taaffe focused on the use of simulations to pilot a mobile application designed to map patient flows through the perioperative stages of surgery and to optimize operating room design.
The perioperative stage of surgery includes pre-operation, during operation, and post-operation care. As you can imagine, there are several tasks involved in moving patients through this process and communication and coordination between various job functions are essential. The complexity of this process can make communication between lab technicians, nurses, physicians, surgeons quite challenging. As a result, Dr. Taaffe and his team sought to streamline the process of updating and accessing patient statuses through the Periop Mobile Learning System (PeriopMLS). PeriopMLS is a mobile application for Android phones which organized patient status updates through a convenient checklist and color-coded system. Nurses and clinicians could use this application to see completed and upcoming tasks for each of their patients. Dr. Taaffe and his team made use of ARENA simulation modeling to pilot this application without disrupting the clinical environment through a live test. The use of simulation modeling to test the application provided the team with valuable feedback and the opportunity to train users. User feedback and application prototypes were passed onto Epic to potentially integrate and improve features of the current electronic medical record system.
Dr. Taaffe’s second project involved collaboration between his engineering team and architects to determine key design considerations affecting work-flow in the operating rooms. Clutter caused by equipment and people in the OR can pose safety risks to patients and providers. After studying video recordings of 35 procedures and noting contact events (when individuals were with 0.6m of each other) and traffic patterns, Dr. Taaffe and his team developed a simulation model to determine how several factors including room size, number of doors, number of staff members, table orientation, location of nursing workstations, and procedure type influence the total number of contact events between staff members. One interesting finding was the statistically significant impact of table orientation on contact events. The impact of design factors can be further assessed to determine optimal room design and potential impact of design choices.
We thank Dr. Taaffe for participating in our seminar series and demonstrating the importance of stakeholder and user feedback to improve our healthcare system and workflows.
Join us for our next seminar on September 30th at 4:30 pm in 1123 LBME when CHEPS Director Jim Bagian, MD, PE discusses “Embedding Patient Safety into the Fabric of an Organization: Critical Elements to Make it Happen.”
|September 16, 2019:
On September 16th, Dr. Shuai Huang presented his work on “Smartphones Medicalized, with Data Analytics for Complex Disease Management” as part of our Providing Better Healthcare Through Systems Engineering Seminar Series. Dr. Huang is an Associate Professor in the Department of Industrial and Operations Engineering and an adjunct faculty member in the Department of Biomedical Informatics and Medical Education (BIME) and the Integrated Brain Imaging Center (IBIC) at the University of Washington. His research focuses on the development of new methods for modeling, diagnosing, and monitoring complex network diseases such as Alzheimer’s disease, Type I diabetes, and clinical depression. He also works to develop statistical and data mining tools for a variety of large datasets including genomic, neuroimaging, and demographic data to facilitate new scientific discoveries.
In his presentation, Dr. Huang highlighted the potential of using smartphone data to track disease trajectories and monitor patient conditions. Currently, 81% of adults in the U.S. own smartphones which can track, collect, and store enormous amounts of data ranging from GPS to audio/video recording to proximity sensing. By harnessing the data tracked by our phones, we can gather valuable behavioral data which can be used to track diseases such as Alzheimer’s and depression. Dr. Huang gave examples of video and audio data that can be used to diagnose and monitor patients through their speaking patterns and facial expressions recorded on smartphones. Biomarkers such as changes in the distance between facial features and the ratio of laughter to words when we talk can be indicative of depression. Development of new methods for sorting the data recorded by smartphone technology offers exciting new ways of informing physicians with real-time patient data recorded outside the clinic. Painting a more complete picture of the patient’s responses to treatment can allow for the design of more precise treatment plans and connect patients with accurate and valuable health information.
We thank Dr. Huang for his willingness to participate in our seminar series and present his fascinating work.
Join us for our next seminar on September 23rd at 4:30 pm in 1123 LBME when Kevin Taaffe, Ph.D. discusses “The Impact of Communication, Coordination and OR Design on Surgical Patient Flow and Safety.”
|September 9, 2019:
George Tam, a CHEPS alum who earned his B.E. in Industrial and Operations Engineering in 2014 and M.Eng. in the same field in 2015, returned to campus this week as to recruit for Delta Airlines where he’s employed as Senior Analyst in Transatlantic Revenue Management. While in Michigan, he also stopped by his old stomping ground at CHEPS. In addition to giving a Lunch & Learn for an audience of about half CHEPSters and half IOE undergraduates, he spent the day at CHEPS, having informal conversations with students. “Whenever I meet with students, it’s a two-way street,” said George. “I tell them about Delta or give career advice, but I learn from them as well.” And, we got the benefit of not one but two CHEPS and IOE alums! Sanjeev Muralidharan who also works as a Network Planner at Delta, spent much of the day at CHEPS as well and chimed in with many helpful insights during George’s Lunch and Learn and the Q&A session after.
Dean Golan, an IOE undergraduate, said, “Having the chance to speak with George one-on-one about his experiences at Delta provided me with an in-depth understanding of network planning and revenue management career opportunities. I am also now incredibly interested in pursuing a career in the airline industry, so I am very grateful for this opportunity!”
In his Lunch and Learn presentation, George discussed how all of the aspects of IOE that are involved in his work at Delta Airlines. “In scheduling, I’ve used so many IOE 310 and 510 skills,” he mentioned. He also pointed out that aviation and the work students are doing at CHEPS isn’t as different as some might imagine. “The beauty with healthcare and aviation is there are transferable skills and concepts,” he said.
Another tie between CHEPS and the airline industry George observed was the importance of cross-collaboration. As an example, he cited an app Delta developed to allow all employees involved with a flight, from catering to the flight crew to gate agents, to talk with one another. He compared to his time at CHEPS where, as an engineer, he was able to collaborate with healthcare practitioners and gain valuable insights on how to solve problems in the healthcare industry.
Another area where George had some excellent insights to share was preparing for career fairs and corporate information sessions. He’s been recruiting for Delta for several years and emphasized the importance of the 4 Ps to students, “print (resume and what you’ve achieved), pitch (what makes you unique), personality (Would someone want to work with you?), passion (Would you like working here?).” He also helped students with some factors to consider when deciding whether to pursue grad school or a full-time job after their undergraduate studies. In all decisions, he urged the students to “Think about your aspirations. Where do you want to be later in life, not just next year?”
George wrapped up his presentation by encouraging attendees to consider several factors when deciding on their first full-time job: work/life balance, opportunities for mentorship, building bridges, maintaining bridges, and productively addressing setbacks.
||September 9, 2019:
This week, Dr. Amy Kilbourne presented her work on “Driving Innovation, Implementation, and Sustainability in a Learning Health System” as part of our Providing Better Healthcare through Systems Engineering Seminar Series. Dr. Kilbourne is the Director of the VA Quality Enhancement Research Initiative (QUERI) and a Professor of Psychiatry at the University of Michigan Medical School. QUERI aims to improve the health of veterans in 40 cities nationwide by accelerating the implementation of researched treatments and therapies in real-world practice.
Currently, the lead time for implementing new, researched treatments on the frontline is approximately 17 years. As you can imagine, this timeline stalls innovation and prevents the improvement of patient outcomes which can be incredibly frustrating for researchers, clinicians, and patients alike. In her presentation, Dr. Kilbourne attributed treatment implementation failures to the lack of organized implementation strategies, education, and methods of training for frontline clinicians. So-called “late adopter” healthcare sites frequently delay implementation of new treatments due to low bandwidth, newly established competing innovations, or competing priorities.
To address the hesitations of late-adopting sites, QUERI works to combat their concerns by providing education through internal and external facilitators and replicating effective programs (REP). Additional facilitators and support are offered to sites that prove more difficult to engage through enhanced REP programs. In addition, Dr. Kilbourne discussed the innovative use of Sequential Multiple Assignment Randomized Trials (SMART) to inform the development of adaptive intervention strategies and better accommodate the changing needs of sites and individuals. Through the organized implementation plans offered by these initiatives, improved patient outcomes have been recorded and other potential applications including mental health treatment access in schools are being explored.
We are so grateful for Dr. Kilbourne’s engaging lecture and her incredible work to improve mental health outcomes of our beloved veterans.
Join us next week on September 16th when Shuai Huang, PhD presents “Smartphones Medicalized, with Data Analytics for Complex Diseases Management.”
||August 29, 2019:
CHEPS Associate Director Amy Cohn had the privilege of speaking to students in the University of Michigan Medical Scientist Training Program (MSTP) at their annual weekend retreat at the Ralph A. MacMullan Conference Center on Higgins Lake this August. The MSTP Program “prepares physician-scientists for careers in academic medicine” by enabling them to pursue their M.D. and Ph.D. simultaneously. While many of the students are pursuing Ph.D. in a field that is traditionally paired with medicine such as biology, there are a growing number of students from less common fields including some from the Industrial and Operations Engineering Department. In fact, CHEPS collaborator and IOE Ph.D. student Erkin Otles introduced Professor Cohn before her talk and hosted her during the event.
“I enjoyed getting to spend some time informally with the students and appreciated doing so near the beauty of Higgins Lake,” said Professor Cohn. “I was particularly impressed by the poster sessions and really enjoyed talking to the undergraduates who were participating in the retreat. I hope to see some of them at CHEPS in the future.”
Her presentation was titled “An Engineer’s Perspective on How to Improve Healthcare Delivery.” While she was prepared with fifty slides, Professor Cohn was only able to get through about ten of them due to having so many questions during her presentation and engaging in a lively discussion with the attendees. “It was exciting to see how many students, even in more traditional fields, were interested in ways that engineering could contribute to healthcare,” she said. “I’m grateful for the opportunity to present at the retreat and to connect with these students. I hope the relationship between CHEPS and MSTP will continue to grow.”
||August 21, 2019:
On Wednesday, August 21st, CHEPS had the privilege of hosting Dr. Anurag Malani for a Lunch and Learn. Dr. Anurag Malani is an alumnus of the University of Michigan’s IOE Department and is currently the Medical Director for the Infection Prevention and Antimicrobial Stewardship Programs at St. Joseph Mercy Health System.
Dr. Malani spoke to the CHEPS students about his path from engineering to medicine and cited his IOE studies as being immensely valuable in his career as a medical doctor. According to Dr. Malani, the IOE curriculum provides skills that are important to practicing physicians including the ability to understand data, take a systematic view of processes, and problem solve. Students also learned Dr. Malani’s advice on how engineers can best communicate with physicians.
We also had the pleasure of hearing from a second Dr. Malani! Dr. Preeti Malani, the Chief Health Officer and a Professor of Medicine in the Division of Infectious Diseases at the University of Michigan and Dr. Anurag Malani’s sister, attended the Lunch and Learn and shared her insights with students as well. She also spoke about her experience working with Maize & Blue Cupboard whose mission is “to ensure members of the University of Michigan community, whether on a tight budget or physically restrained from getting to a grocery store, receive equitable access to healthy, nutritious, and nourishing food and the ability to prepare it for themselves or others.” We appreciated learning about this valuable resource on campus!
Thank you Dr. Anurag Malani and Dr. Preeti Malani for sharing your experiences with the CHEPS students!
||August 19, 2019:
CHEPS collaborator Dr. Alex Peahl rode in the 2019 Pan-Mass Challenge at the beginning of August to raise money for the Dana-Farber Cancer Institute. The annual bike-a-thon is a two-day and 168-mile ride that crosses Massachusetts and raises funds for cancer research and treatment.
2019 was Dr. Peahl’s third year riding in the challenge. She road alongside her husband and father-in-law in honor of their good friend Dudley as well as the people in her life affected by cancer, her patients, and the team of doctors, nurses, and residents she works with at Michigan Medicine.
She said on her fundraising page, “The riders’ passion, the volunteers’ encouragement, and the community support as we rode past cheering families was truly inspirational.” More information is available on the Pan-Mass Challenge website as well as Dr. Peahl’s fundraising page. Donations can be made for this year’s challenge until October 1, 2019.
— Written by Liz Fisher, CHEPS Staff
||August 2, 2019:
On Aug 1st and 2nd, CHEPS students woke up bright and early to volunteer at Discover Engineering. CHEPSters collaborated with high school students on an emergency room simulation game and several Ergolympics activities, which were games designed to demonstrate ergonomic principles. By the end of the 20-hour ER staffing simulation, Team Fish pulled ahead with a net hospital profit of $10,925. The high school students loved the Ergolympics stations, especially cornhole and Stroop. For cornhole, students lifted weights between rounds to understand the effects of fatigue on posture and performance. Meanwhile, during Stroop, students tried to match a list of colored words to colored squares on a board as quickly as possible. In the debrief session, students were taught the aims of the games and also gained a foundational understanding of what industrial engineering is all about. By the end of Discover Engineering, all the high school students learned one very important lesson: “Engineers make things. Industrial engineers make things better.”
||August 2, 2019:
CHEPS collaborator Emily Boltey successfully defended her Nursing PhD dissertation, titled “Measuring the process of interprofessional collaboration in the care of critically ill adults,” on Friday, August 2nd. In her research, Emily conducted a time-motion study on interprofessional collaboration in the ICU. Many errors in the ICU originate from systematic problems, not individuals. Emily realized that one way to address this was to improve teamwork and the first step to doing so was to be able to measure collaborative actions between coworkers. Emily collaborated with CHEPS to create an app that allowed her to record collaborative actions quickly and efficiently while performing observations. CHEPS Associate Director Amy Cohn was a member of Emily’s committee along with Chair Professor Deena K. Costa, Dr. Jack Iwashyna, and Dr. Julia Seng. To learn more about Emily’s work and her collaboration with CHEPS, see CHEPS Pulse: Quantifying Collaboration in the ICU. Congratulations, Dr. Boltey!
||July 31, 2019:
On Wednesday, July 31st, Simran Malik shared her research at the Undergraduate Research Opportunity Program (UROP) Summer Symposium in the Michigan League. Simran, a Computer Science undergraduate working at CHEPS this summer, presented a poster titled “Computer Simulation Modeling of a Competency-Based Surgical Training Paradigm.” The symposium was bustling from start to finish and many attendees stopped at Simran’s poster to discuss her research and ask questions. And, of course, several CHEPSters came by to show their support! Simran has been an excellent addition to the CHEPS team this summer and we’re all proud of her and her work!
||July 30, 2019:
On July 14 and 30, groups of CHEPS students visited Michigan Medicine’s Clinical Simulation Centers. These centers serve as innovative environments and learning laboratories, with realistic manikins and advanced computer programs used to simulate realistic scenarios, and are used as training by physicians, nurses, and other healthcare professionals. During the tour, CHEPS students had a chance to see rooms with manikins serving different purposes, such as training on inserting jugular vein needles, operating rooms for a patient on oxygen supply, a delivery room, and a pediatric surgery room.
||July 30, 2019:
On July 30th, CHEPSters flocked the BSRB Seminar room to support our very own Amanda Moreno-Hernandez while she presented at the Michigan Institute for Clinical and Health Research (MICHR) poster session. The poster session showcased many different projects involving healthcare and clinical research. Holding her own as the only engineer in the entire room, Amanda spoke to the importance of simulation in aortic dissection patient flow in the ICU in order to optimize costs and number of patients treated. She was asked a multitude of questions involving the simulation model and input metrics, answering each one with immense knowledge and enthusiasm. Other projects included topics such as effects of consent in HIV research testing and how schizophrenia medications lead to other health-related issues. We are so proud of Amanda and cannot wait to see how this project develops from here!
||July 29, 2019:
A group of CHPES students, as well as CHEPS Associate Director Amy Cohn, attended the 2019 INFORMS Healthcare Conference in Cambridge Massachusetts from July 27th to the 29th. Following this year’s conference theme “Transforming Health with Data, Mind and Hand” our CHEPSters Jakob Kiel-Locey, Michelle Chen, Amanda D. Moreno-Hernandez, our recent Ph.D. alums Karmel Shehadeh and Donald Richardson, and Professor Amy Cohn participated as speakers of multiple technical sections. The conference kicked-off with a full house technical session titled Improving Patient Access and Flow in Outpatients Clinical Settings. Karmel, Jakob, Michelle, and Donald presented their work and projects in this session. Their presentations were:
“I was thrilled to present our work on simulating an outpatient endoscopy clinic to an audience with such a wealth of healthcare experience. Watching my fellow CHEPSters and IOE students present their work and gracefully answer tough questions from the audience was so fun and a great reminder of how awesome CHEPSters are,” said Jakob.
Our very own Amy Cohn also gave a talk titled “Implementing Provider Scheduling Decision Support Tools in Clinical Practice.” Many of our friends from the Industrial & Operation Engineering Department also attended the conference and presented their work. Daniel Otero and Luke DeRoos, both first-year IOE Ph.D. students, presented talks titled “Cholesterol Follow-Up Policy in the context of Preventive Treatment of Cardiovascular Disease” and “Modeling the Effect of Presumed Consent on Organ Transplant Waiting List Candidates” respectively. Other sessions were built around topics such as application of optimization in disease dynamic and treatment policy, prediction and prevention of diseases with the use of different models, resource allocation, policymaking, and many more. During the last day of the conference CHEPSter Amanda presented work done on “Simulating the Flow of Patients with Aortic Dissection through a Cardiac Intensive Care Unit.”
Without a doubt, the conference was a great experience and opportunity to connect with other professionals who are “Transforming Health with Data, Mind, and Hand.” As Michelle said, “It was great to broaden my view of IE in healthcare and meet brilliant people.” We all also enjoyed learning about the landmarks of Boston and Cambridge from our Associate Director. In addition, our baseball fans Jakob and Amanda got to see the Red Sox playing the Yankees at Fenway Park.
— Written by Amanda Moreno-Hernandez, IOE Masters Student
||July 25, 2019:
On Thursday, July 25th, CHEPSters went to Ann Arbor’s weekly Sonic Lunch Concert Series. The band Guster, a famous Boston-based alternative rock band, played at the event. Upon arriving at the venue, the students decked themselves with Sonic Lunch temporary tattoos, stickers, and pins. As the opening act played, they filled the air with bubbles, illuminating the crowd and atmosphere with excitement. They also worked together to decorate the ground, using colorful chalk to draw the CHEPS logo. When the band finally arrived, CHEPSters gathered together and cheered. From “Bad Bad World” to “Satellite”, Guster took the crowd through a lively musical adventure, certainly one for the books.
|July 18, 2019:
On Thursday, July 18, all of the newly admitted summer CHEPS students attended an IHPI Skill-Building Seminar with Dr. Grum, a professor of Internal Medicine, and Cathy Strachan, a Registered Nurse, to learn about professionalism, personal safety, and security when dealing with patient care in University of Michigan Hospitals.
Dr. Grum began his seminar by speaking about the principles of professionalism in hospital wards and highlighted what is expected of CHEPS students whenever they visit the hospital. The seminar was highly interactive, with Dr. Grum and Mrs. Strachan asking for the CHEPS students’ perspectives and opinions on various matters throughout the talk. In addition to professionalism in hospital culture, the students also learned about the importance of patient confidentiality and how to effectively de-identify patient information. This was an extremely valuable seminar and will directly benefit CHEPS students as they interact with hospital wards in their current and future projects!
|July 12, 2019:
On Friday, July 12th, CHEPS students welcomed IOE PhD candidate Luke DeRoos for a Lunch and Learn. Luke shared his research related to the possible influence of presumed consent in organ transplantation.
Luke began with data illustrating a long-existing challenge in organ transplantation which is the extremely high organ demands across the United States. “Over a hundred thousand people are waiting for organs” and “22% have died while waiting for organs,” he explained. Presumed consent policy, if implemented, could be a very effective way to mitigate the high demands. How will presumed consent affect the organ waitlists? That’s where Luke’s research started.
Luke intended to understand the number of waiting patients, waitlist removal, and years of life gained after transplantation under the influence of higher organ supply due to presumed consent. He built up the predicted model and generated data under ideal allocation and random allocation of organs. The result will fall between that range when in practice. The results showed that the higher impact the policy is expected to produce, the fewer people who will die or become too ill on the waitlist before getting a transplant, and the more years of life the patients will gain after transplantation. As a result, Luke drew the conclusion that presumed consent would bring large gains in years of life. But the organ shortage situation will still exist.
Luke also shared other research he is working on, including finding appropriate metrics to measure the performance of OPOs across the country. CHEPS students and others in attendance were very interested in Luke’s research. They asked questions like “Will wealthy people get advantages on the organ waitlist?” and “How long can it be between the organ beingremoved and implanted?”
At the end of the Lunch and Learn, Amanda represented CHEPS thanking Luke for his presentation and giving him a small gift from CHEPS.
Sheridan Tobin presenting M-Safety’s work at the 2018 CHEPS symposium
|July 12, 2019:
The M-Safety team marked a big milestone in June as the patient safety displays they’d been working on went live on one hospital unit at Michigan Medicine! The display, which was developed through a collaboration between the University Hospital 8DNS unit at Michigan Medicine, a multidisciplinary team of researchers from Internal Medicine, Nursing, and Engineering, and CHEPS, shows real-time data on the presence and duration of medical devices and skin issues. Clinicians in the 8DNS unit are excited to be utilizing the displays. The goal of the displays is to improve provider awareness of medical device placement and skin issues, which should enable prompt delivery of risk-reducing interventions, such as medical device removal and targeted skin care or repositioning. You can learn more about the M-Safety project on the project page.
||July 10, 2019:
CHEPS PhD student Karmel Shehadeh successfully completed her PhD defense on Wednesday, July 10th. Karmel’s dissertation was titled “Stochastic Optimization Approaches for Outpatient Appointment Scheduling under Uncertainty.” The dissertation studies three challenging stochastic outpatient scheduling problems with broader applications within and outside of healthcare and proposes new and tractable stochastic optimization models and approaches for solving them. First, the dissertation proposes a new stochastic mixed-integer programming model that overcomes the computational challenges of outpatient procedures scheduling with random durations contrast to the existing models in the literature. Second, the dissertation studies a stochastic adaptive outpatient scheduling problem which incorporates the patients’ random arrival and service times. Finally, the dissertation proposes a tractable distributionally robust (DR) optimization approach to outpatient colonoscopy scheduling with bimodal and ambiguous colonoscopy duration.
Karmel’s PhD is in Industrial and Operations Engineering. CHEPS Associate Director and IOE Professor Amy Cohn and IOE Assistant Professor Ruiwei Jiang were her advisors. CHEPS and IOE students, faculty, and staff as well as many of Karmel’s friends attended the defense and celebrated her hard work and achievement with her afterward. While her family was not able to attend in person, they were able to watch the recorded version of her talk and share in the excitement of the day.
Karmel wrapped up her defense by thanking all who had supported her throughout her PhD work and in preparing for her defense. She said she feels honored and lucky to have worked with and known Prof. Cohn and Prof. Jiang, and thankful for all of their support and for teaching her tons of things that she cannot possibly thank them enough for. Most importantly, how a successful & impactful scholar and mentor should be. She is also thankful for her committee member Prof. Marina A Epelman for supporting her and contributing to the dissertation in many ways and for the insights of her cogent Prof. Anne Sales
Congratulations, Dr. Shehadeh!
||July 9, 2019:
CHEPS decided to expand its volleyball horizons by arranging a tournament with MLD3, another engineering research group MLD3. We actually played with two groups on campus the first being MLD3 (Machine Learning for Data-Driven Decisions), who develops machine learning methods within healthcare. The second was a group of rising Freshman in an organization called M-STEM. The group happened to be walking by as the tournament started and ending up joining in! It was a hot day outside, comfortable in the shade but scorching in the sun. The sand was almost unbearably hot on our feet. Shoes or socks were a must or you were jumping on or digging into the sand. We played every possible combination of games, with each group having two teams. Each team played every other team. Teams sitting out played rounds of 4 square, refined their volleyball skills on the sidelines, or sat in the grass and on the swings enjoying the summer jams. Ultimately, the two CHEPS teams faced off and both ended with 2 wins and 1 loss. So who were the ultimate champs? Guess we’ll have to find out next time.
|July 8, 2019:
CHEPS affiliate Jenna Wiens, Assistant Professor of Computer Science and Engineering, has been named the incoming Co-Director of Precision Health at the University of Michigan. The position will be effective on September 1, 2019. Professor Wiens has worked with CHEPS in her current role as Co-Lead for Precision Health’s Data Analytics & IT Workgroup which successfully expanded access to data and research tools across the university. CHEPS collaborated with her team on issues of cohort development and working to merge and effectively utilize data from disparate sources. Congratulations, Professor Wiens! We look forward to continuing to work with you in your new position!
||July 7, 2019:
On Sunday, July 7th, five CHEPSters decided to embark on a river tubing adventure down the Huron River. At a balmy 86 degrees, they began the journey at Argo park with a water-resistant* box of Costco pretzels and plenty of water to stay hydrated. But, after a perilous encounter with the white water cascades, the seemingly water-tight container was compromised and the fish began to dine on the CHEPSters’ last source of sustenance. Nonetheless, after a grueling hour of fighting off tree branches and sharp rocks, the crew survived the expedition to see another day.
|July 3, 2019:
On Wednesday, July 3rd, CHEPS students gathered together for the long-awaited Lunch and Learn on bears, presented by Theodore Endresen. Through this brief introduction to bears, Theodore not only met but exceeded the expectations of his co-workers.
Theodore began his presentation by describing classifications: There are 8 main types of bears and 2 proposed phylogenies. He then sketched out how appreciation of bears has manifested itself across different countries. China, for example, has a breeding facility for pandas, which is greatly responsible for the slowly increasing panda population.
Starting with his favorite bear, the panda, Theodore went into in-depth explanations of each bear type, mentioning each type’s most important attributes. Panda bears, for example, have the largest molars of any bear, whereas polar bears have the highest bite force of any bear. Interestingly enough, the sloth bear, a seemingly harmless bear based on its name, is the most dangerous bear and tends to initiate attacks immediately.
After each bear type description, Theodore provided CHEPS students with “survival tips”, often accompanied by comical strips emphasizing the danger that bears present. These survival tips brought out Theodore’s humor, which all CHEPS students know and love.
Towards the end of the presentation, Theodore described different stances on bear conservation. Most importantly, he reminded us that, despite the friendly depiction of bears in the media and animation, bears are, in fact, very dangerous.
|June 27, 2019:
Continuing our tradition of summer social events, CHEPS students took a break at the end of the workday to play various Nintendo Switch games. Many of them got into some intense competition with Super Smash Bros while others decided to do some racing in Mario Kart. In a close tournament battle, CHEPSter Malcolm Hudson came out on top as the Super Smash Bros champion, while Dean Golan, Fumi Abe-Nornes, Jake Martin and Trevor Hoffman finished close behind with honorable mentions.
|June 21, 2019:
CHEPS students gathered together on Friday, June 21st to hear our very own Julia Warner conduct a Lunch and Learn on effective meetings.
Julia started off the presentation by explaining how to schedule a meeting. She explained that it is important to always have a point person in charge, identify people whose schedules will be the bottleneck when planning a meeting, and to appropriately word emails to communicate effectively about meeting logistics.
She then described characteristics of a good meeting attendee, the top qualities being: provide the times you can arrive, review the agenda prior to the meeting, plan your outfit based on your meetings, and plan ahead to be on time.
Julia also talked about how to structure your agendas. Announcements should be first, and the least important items should be tabled last. It is important to include the assignments of the timekeeper, the scribe, and the facilitator. Additionally, “parking lot items”, items to be put on a later agenda, should be recorded and followed up on.
We ended the Lunch and Learn with an interactive whiteboard activity, brainstorming the Do’s and Don’ts of conference calls and the Do’s and Don’ts of dressing to meet with collaborators.
Julia reminded us at the end, to always end meetings on a positive note, by thanking everyone for their time and highlighting progress and accomplishments!
||June 19, 2019:
CHEPS students headed to the Ann Arbor Summer Festival (AASF), otherwise known as Top of the Park on Wednesday, June 19. They enjoyed dinner, snacks, and ice cream from AASF’s various food tents. Later they attended a free Block Printing & Letterpress Workshop in the annex tent. Each CHEPS student carved a block with unique designs. Trevor Hoffman created a cute “CHEPS @ TOP” print design, while Camille Phaneuf created a design with the skyline of New York City. Overall it was a great Ann Arbor summer event that the students partook in after a productive day of work.
||June 19, 2019:
CHEPS PhD student Donald Richardson successfully completed his PhD defense on Wednesday, June 19th, making him Dr. Richardson officially. Donald’s dissertation was titled “Operations Research Frameworks for Improving Make-ahead Drug Policies at Outpatient Chemotherapy Centers.” Delays are possible at each step of an outpatient chemotherapy infusion visit. These delays can negatively impact individual patients and have a ripple effect which can negatively impact staff and other infusion patients. Donald’s research, conducted with CHEPS and the UM Rogel Cancer Center, looks at ways to reduce those delays by helping hospitals determine which drugs can be made ahead and when in a way that saves time and creates little to no drug waste.
Donald’s PhD is in Industrial and Operations Engineering. CHEPS Associate Director and IOE Professor Amy Cohn was his thesis advisor. Current students, faculty, staff, and alumni from both IOE and CHEPS attended the defense along with Donald’s family and friends. Matt Rouhana, who worked on the chemotherapy project when it first started, even returned for the occasion! Donald concluded his presentation by thanking everyone who had supported him throughout his PhD including Prof. Cohn, his thesis committee, his collaborators at the UM Rogel Cancer Center, The Bonder Foundation, The SROP program, the Meyerhoff Scholars program, his family, and Peter and Josi who baked goodies for his defense! Congratulations, Dr. Richardson!
|June 18, 2019:
On Tuesday, June 18th CHEPS Director Jim Bagian led a Lunch and Learn on the Columbia and Challenger shuttle investigations which he took part in during his time at NASA. Jim first discussed why the Challenger failed before diving into the investigation process and how it led NASA to conclude that the unusually cold weather on the day of the launch was ultimately to blame for the unfortunate accident. He also talked about how NASA added new safety features for future missions with all the problem solving and testing that went into it.
Jim next discussed the Columbia shuttle accident. He emphasized the importance of looking at all data available before coming to conclusions. By doing this, his team was able to recover 38% of the Columbia shuttle, which helped in their investigation as to what happened. Within the shuttle’s wreckage, some items had virtually not suffered any damage, examples such as an ink jet printer and Tonopen (a medical instrument used to measure intraocular pressure) were virtually untouched and still worked normally after the accident. This led to an interesting discussion about why some items survived how understanding the reasons for their lack of damage played a part in making the design of future space vehicles safer in the future.
Overall, Jim’s talk emphasized how the investigation process and data collection played a vital role in analyzing both the Challenger and Columbia accidents. These processes made for an interesting Lunch and Learn!
|June 14, 2019:
On Friday, June 14th, CHEPS Director Jim Bagian spoke to CHEPS students on Risk, Professionalism, and Ethics in Medicine and Engineering. Dr. Bagian spoke to the necessity of clearly defining the goal of any undertaking and balancing the acceptable risk of failure in executing the intended plan to achieve the goal against the value to be realized if successful and the opportunity cost associated with the endeavor. Recounting real-world examples, Dr. Bagian spoke to the necessity of clearly communicating the hazards and risks associated with any undertaking to all concerned parties as an essential attribute of professionalism in making decisions grounded in logic, not emotion.
The importance of distinguishing hazards from risks was emphasized so that groups would be better equipped to make effective decisions. Commercial aviation was used as an example to illustrate that while one of the hazards of flying is death resulting from a crash, the risk of being killed in a crash while traveling on a commercial airliner is less than one in 14 million. This illustrated that in considering hazards, the truly important point is really the risk that a hazard will cause an undesired outcome rather than the existence of the hazard itself.
Dr. Bagian also spoke to the necessity of maintaining a good sense of teamwork among coworkers and colleagues. One of the critical elements of a well functioning team is the deliberate efforts to breakdown hierarchical barriers to communication. Dr. Bagian gave an example from his time as the Chief Patient Safety Officer and the director of the National Center for Patient Safety at the VA where he would intentionally travel to meet with others in the VA who were his subordinates at locations that were of the greatest convenience to them to demonstrate by action that he respected them and valued their cooperation rather than have them meet at locations that were more convenient to him. In this way, he felt that he was able to develop more meaningful and productive working relationships. He also spoke to being willing to openly acknowledge when help was needed in order to obtain the best performance from team members.
Being able to draw on Dr. Bagian’s vast knowledge and experience is an amazing opportunity for CHEPSters and his accomplishments are a great reminder of what can be achieved through hard work.
|June 14, 2019:
CHEPS and Industrial and Operations Engineering PhD candidate Karmel Shehadeh, along with co-authors Prof. Amy Cohn and Prof. Marina A. Epelman, has had a paper accepted for publication in the European Journal of Operational Research (EJOR). The paper, titled “Analysis of Models for the Stochastic Outpatient Procedure Scheduling Problem (SOPSP),” is motivated by the work Karmel and her team at CHEPS have done with the University of Michigan Medical Procedure Unit. The outpatient clinic performs a variety of procedures, including a large number of colonoscopies. The team is working to build higher-quality schedules that incorporate the variability in procedure durations and other patient characteristics; with this work, it is possible to improve patient and provider satisfaction, reduce costs, and even achieve better clinical outcomes. A valuable tool in creating such schedules is the ability to solve the simpler (and yet still challenging) SOPSP as an embedded sub-problem. Shehadeh, Cohn, and Epelman propose a new stochastic mixed-integer linear program (SMILP) that overcomes the challenges of solving this well-known complex stochastic, combinatorial, and multi-criteria optimization problem.
“Publishing this work in a top OR journal such as EJOR inspires me to continue working on developing tractable and implementable Engineering and Operations Research frameworks for solving challenging real-world optimization problems,” said Karmel. “However, the more important reason for feeling thrilled about publishing this work is knowing that it will provide a valuable long-run solution for issues that we all face during a medical appointment. I very much enjoyed this intellectually rewarding research adventure with Prof. Cohn and Prof. Epelman, and am thankful for their support.”
|June 12, 2019:
Now that many CHEPSters have graduated and will soon enter the real world, Anna Learis presented a Lunch and Learn on personal finance and affordable seasonal eating to aid everyone with this transition. When it came to budgeting, she discussed the 50-30-20 rule and the importance of knowing one’s own credit score. Additionally, she highlighted the importance of choosing a credit card that offers rewards that correlate to an individual’s normal spending habits. Now that our recent graduates won’t be eating ramen noodles daily, Anna also overviewed how to create an effective and healthy meal plan. In addition to a few flexible recipes, CHEPSters learned how to identify which fruits and vegetable were in season to help them make tastier and more affordable meals.
||June 11, 2019:
To continue our tradition of CHEPS summer socials, we held a competitive volleyball tournament in the North Campus Grove after work ended. After gauging everyone’s skill level, we broke up into five teams of four and held a double-elimination bracket with games to 11. During the event, we had some CHEPSters playing four square, drawing with sidewalk chalk, or enjoying time on the swings when they weren’t too busy slamming spikes on the court. At the end of the tournament, we had CHEPsters Amanda Moreno Hernandez, Nicholas Zacharek, Ryan Lentine, Fumya Abe-Nornes, and Laura Hatter represent the Grieving Pigeons in first place, followed by the Greasy Monkeys in second, and the Regular Sheep in third. This event was a great way for the new and old CHEPS students to get to know one another and develop some team-building skills while having a great time on the court!
||June 10, 2019:
In May 2019, CHEPS Masters student Hannah Strat attended the 2019 Michigan Israel Engineering Trek. This student-led trip to Israel was designed to introduce engineering graduate students from the University of Michigan to the Israeli tech industry. Hannah was one of 30+ engineering graduate students who had the chance to tour the country and meet with local Israelis working in a variety of technical fields.
Engineering highlights included touring the Sorek Desalination Plant, and meeting with engineers from the autonomous driving technology company MobilEye, the non-profit private space company SpaceIL, and the non-profit organization Milbat which applies creative solutions to expand the independence of people with disabilities. Other highlights included visiting Nahalal (one of Ann Arbor’s sister cities), Masada, the Dead Sea, and the Old City of Jerusalem.
|June 5, 2019:
CHEPS students, faculty, and staff met for a Lunch & Learn on Wednesday to hear about Rachel Moeckel’s career as a Health Systems Specialist in the VA Ann Arbor Healthcare System. Rachel is a CHEPS alum and graduated with a Masters in IOE with a HEPS concentration in 2017. After graduation, she discovered her current VA position through another CHEPS graduate! Now, she works on interdisciplinary teams to improve patients’ access to care throughout the VA. These projects lead change in a variety of departments, but Rachel has been working most frequently in surgery. Specifically, she tracks changes in access metrics, then collaborates with doctors, nurses, medical support assistants, administrative officers, and more to fix any issues that have arisen and that she has identified.
Rachel noted that CHEPS prepared her well for her position as a Health Systems Specialist, but she encourages recent graduates to also ask a lot of questions, engage in a variety of trainings, and immerse themselves in their new positions. That is how she grew to feel comfortable and competent at the VA and jumpstart her career! Rachel also recommended that CHEPsters find supportive managers to work for; from her experience, the people she works with makes the job productive, rewarding, and enjoyable.
In sum, the Lunch & Learn attendees enjoyed an informative session that provided advice for transitioning into post-graduation positions, as well as how to be successful in those roles. Thank you, Rachel, for returning to CHEPS to share your wisdom!
||June 4, 2019:
On June 4, 2019, the Institute for Healthcare Policy & Innovation (IHPI) had a Lunch and Learn seminar for students. The event was co-hosted by CHEPS Associate Director Professor Amy Cohn, Professor Ivo Dinov from the School of Nursing, & Dr. Sunghee Lee from the Survey Methodology Program.
During the first half of the seminar, each host gave their career story and explained the path that they took to get where they are today. As the hosts spoke, an unexpected theme of changing career paths became clear. Each of the speakers talked about the ways in which their paths had changed over the years and how they were happy with their direction, but it was different than they expected. For example, Professor Dinov talked about choosing mathematics over statistics for his undergraduate degree, even though he came from an accounting secondary school.
During the second half of the seminar, students were able to ask each speaker questions. Students seemed interested in the work of the speakers and the ways that they found to balance work and life in higher education.
||June 4, 2019:
In an environment such as healthcare, where the stakes are constantly high, it can be easy to resort to superficial knee-jerk resolutions that focus only on proximate causes of patient adverse events and close calls. In most organizations, close calls are even ignored and interpreted as events caused by good or bad luck and are not used in a proactive manner to identify and mitigate the threats to safe patient care that they represent. As systems grow increasingly complex, it is imperative that we choose to analyze the underlying contributing causes of a problem or vulnerabilities and mitigate them through actions that address the underlying systems-based contributing factors. It is important to go well beyond superficial actions that are limited to placing blame on individuals and focus exclusively on individually focused interventions such as training or changes in policy alone.
On Tuesday, June 4th, CHEPSters attended a Root Cause Analysis and Action (RCA2 = RCA Squared) training given by Director Jim Bagian and Program Manager Joe DeRosier. They developed this program which has been implemented in hospitals across the nation. Its premise may seem simple; break down an event until root causes and contributing factors are exposed, and identify system-based actions to address system vulnerabilities. The RCA2 process includes cognitive aids and tools to help teams consistently complete thorough and credible reviews.
RCA2 utilizes multidisciplinary teams with a combination of unique perspectives that meet to analyze adverse events with the objective being to minimize or eliminate the risk of future harm to patients. Traditional healthcare related investigations typically stopped at identifying causes such as human error or failure of an individual to follow a policy or procedure. RCA2 goes deeper to understand what contributed to the human error or why a policy or procedure wasn’t followed. Jim and Joe also detailed the importance of formulation and implementation of actions following these assessments (and how it wouldn’t be RCA2 without this). They highlighted the necessity of structural design changes that employ stronger actions that rely on characteristics such as forcing functions rather than those actions that only require individuals to rely on their memory such as only policy and procedure changes or training.
Above all, it is important to carry forward the mentality that RCA2 is built upon — a systems-based analysis to elucidate the root causes and contributing factors and the implementation of actions that mitigate these vulnerabilities. This is especially true in an environment such as healthcare, where patient safety is a constant top priority. Problems are multidisciplinary, multifaceted, and should always result in actions that concentrate on systems-based interventions that focus on prevention or mitigation of harm over the all too superficial and common responses that simply blame the individuals associated with the event in question.
|June 2, 2019:
The University of Michigan Rowing Team captured two bronze medals and finished in third place at the NCAA Championships held at Eagle Creek Park in Indianapolis, Indiana on June 1st and 2nd, 2019. Three CHEPS Students, Victoria Glunt, Kate Burns, and Emily Krebs, are members of the team. Congrats to them and the whole team on an excellent showing at the NCAA Championships! More information is available in the full story at MGoBlue.com.
||June 1, 2019:
On Saturday, June 1st, CHEPS students explored Detroit experiencing some of the things that make the city great. The students’ first stop was Eastern Market, one of the oldest and largest year-round public markets in the United States. The students enjoyed visiting the stands which contained things such as fresh food, plants, and art. They also enjoyed speaking with vendors and hearing their passion for their product. The next stop was El Asador Steakhouse, a restaurant located inside Mexicantown. They pride themselves on creating food from scratch that is locally sourced. The food was amazing, the students raved about the guacamole made fresh at the table. The last stop of the day was to the Detroit Shipping Company, an eatery, for handmade ice cream.
|May 31, 2019:
CHEPS staffer and resident Excel wizard Billy Pozehl led a Lunch and Learn on Excel Tips and Tricks on Friday, May 31. More than twenty CHEPS students and staff attended to learn from Billy and his vast experience using Excel. Most CHEPS projects, particularly Provider Scheduling projects, make heavy use of Excel for creating data files, visualizations, and sharing information with collaborators. Billy went over basic navigation shortcuts, logical and conditional formatting, data validation, basic lookup functions and more, ending with the reminder that “the less you use your mouse the faster you’ll be.”
|May 31, 2019:
CHEPS students and staff attend the Institute for Healthcare Policy and Innovation (IHPI) Director’s Lecture on May 31 with guest speaker, Julie Rovner. Ms. Rovner, a UMich alumna, is the Chief Washington Correspondent for Kaiser Health News and also hosts the “What the Health?” podcast. Dr. John Ayanian, IHPI Director, conducted a fireside chat with Ms. Rovner about health policy and politics, including looking forward to the 2020 election.
Ms. Rovner shared her knowledge on topics covering billing, prescription drug pricing, tobacco policy, and re-authorization of PCORI funding. She also provided an in-depth perspective on recently passed state-level abortion laws. A big focus of the discussion was also how 2020 Democratic presidential candidates are considering healthcare coverage, ranging from Medicaid expansion to how the US might transition to Medicare-For-All.
Ms. Rovner concluded her talk by encouraging health services researchers to continue pursuing evidence-based investigations that are critical to moving policy forward.
||May 29, 2019:
On Wednesday, May 29th students gathered for another installment in our weekly Lunch and Learn series to hear about various projects currently going on at CHEPS. This week we had the pleasure to hear from two recent CHEPS graduates, Justin Rogers and Theodore Endresen, about the Dermatology and Block scheduling projects respectively. The Dermatology project deals with creating a computerized tool to schedule dermatology residents each month in the dermatology clinic at the university hospital. The Block project, on the other hand, deals with scheduling residents in the internal medicine and pediatrics clinics in the university hospital. Head residents used to create these schedules manually which would take many days or even weeks of their time. With the help of these scheduling projects, we have been able to help them free up their time.
|May 29, 2019:
Recent CHEPS graduates, Anna Learis and Camille Phaneuf, attended the Precision Health Symposium on Wednesday to share the purpose of CHEPS with physicians and academics across the University of Michigan and Michigan Medicine. They presented a poster, titled ‘CHEPS: A Community of Scholars and Learners Improving Patient Care by Overcoming Complexity in the Healthcare System,’ and engaged in an afternoon networking session. Anna and Camille really enjoyed discussing the various projects that CHEPS students, faculty, and staff are involved in, and learned so much about other Precision Health initiatives underway across campus. They are so grateful for their experiences at CHEPS, and had a wonderful time communicating this sentiment to others! Overall, symposium attendees were excited about the multi-disciplinary teams that CHEPS promotes, as well as the solutions that students have been able to pose for solving complex problems.
||May 24, 2019:
In May 2019, a tradition returned to CHEPS: Baby Photos. Last done in 2017, students and staff uploaded pics of themselves as babies and then took guesses on which photo belonged to which person. The event was a fun and unique way for summer students to bond. This year’s Baby Photo event was organized by Anna Learis and included a friendly competition for a prize. On Friday, May 24, a baby photo reveal occurred; students discovered which people they correctly connected to their baby photo and which they did not. Many did exceptionally well, but Malcolm Hudson surpassed them all. He guessed all 27 photos correctly to win the competition and prize.
|May 22, 2019:
On Wednesday, May 22, Adam shared citation management options and discussed a process for conducting and documenting literature reviews. In particular, Adam recommends the Zotero Chrome Extension for a seamless and easy way to gather and store articles and other citations in Zotero. Other students also shared their challenges and best practices for conducting literature reviews. Students who took IOE 413 (Optimization Modeling in Health Care) discussed how they conducted literature reviews for their major class deliverable.
||May 17, 2019:
What a time to be a CHEPSter! Last Friday, CHEPS welcomed Ms. Merrill Bonder, Executive Director of the Seth Bonder Foundation and long-term CHEPS supporter and friend, for a lunch with students and staff members. Favorite memories from CHEPS were shared during what Professor Cohn called one of her favorite CHEPS days of the year. Among memories and fun stories, there was something that resonated. CHEPS is the place “you can check out any time you like, but you can never leave!”, said Merrill referring to all the CHEPSters around the world and how they stay in touch and involved with CHEPS while quoting the Eagles.
Merrill and her late husband, Dr. Seth Bonder, have helped to support students across the country for years. IOE and HEPS Masters student Trevor Hoffman shared a few words: “On behalf of Hannah and myself we wanted to get you a gift to show our appreciation. Being a first-generation college student myself, if not for your and the Bonder Foundation’s generosity I wouldn’t be able to be where I am today.” Longtime friends and colleagues Larry and Bev Seiford shared a few words about the Bonders and their vision. College of Engineering Dean Alec Gallimore also joined us and shared his appreciation for the Bonder Foundation and his memories of working with Dr. Bonder.
Ms. Bonder expressed the importance she sees in helping and mentoring students as they are the ones to dictate the future and leave a mark. PhD candidates Donald Richardson and Karmel Shehadeh expressed how Merrill has supported them in multiple conference presentations through their graduate career. Caring and affable, Merrill embodied the mission and support at the heart of the Bonder Foundation.
|May 15, 2019:
On Wednesday, May 15th students gathered for a lunch and learn to hear about the CHEPS Glaucoma and Surgical Instruments projects. Since we have several ongoing projects, these lunch and learns are a great opportunity for students to learn about what their peers are working on and to share thoughts and ideas across projects. Trevor Hoffman talked about the Glaucoma project which utilizes RFID tracking to capture real-time patient and provider location information enabling the team better model patient flow through the clinic in an effort to identify potential reductions in wait time. Hannah Strat discussed the Surgical Instruments project which works on the reprocessing of surgical instruments as well as fire safety in the operating room.
||May 14, 2019:
Tuesday, May 14th was the official first day of the summer semester at CHEPS. The day started with an orientation for our new students. They learned some of the ins and outs of CHEPS and got a brief introduction to all of our projects. In the afternoon we held kick-off meeting for the entire CHEPS crew, new and old. At the kick-off, students all introduced themselves with a fun fact, ranging from one student’s ability to sneeze on command to another student’s ability to twist their arm in a full circle. Yes, we’re a multitalented group! We also learned that we have several athletic students from rowers to football players! And we capped off the day with some fun. Anna Learis led a game of CHEPardy, a trivia game with a CHEPS twist.
|May 4, 2019:
“It’s the small actions we do, even if we’re not aware of them, that have the impact of shaping our lives,” said Bassel Salka, a CHEPS student graduating with a B.S.E. in Industrial and Operations Engineering, as he spoke at the College of Engineering graduation ceremony on Saturday, May 4th. He was also a speaker at the University of Michigan graduation ceremony at the Michigan Stadium on the same day.
At both ceremonies, Bassel spoke about his experience at the University of Michigan as a Muslim student, an engineering student, and a CHEPS student, as well as his commitment to community activism. In addition to his work at CHEPS, Bassel co-founded Michigan Lean Consulting and has served as co-president of the Arab Student Association and the Muslim Coalition. He spoke of the potential he and his fellow students hold to continue to make an impact on the world after graduation.
Bassel’s next step is working as a Next Generation Healthcare Delivery Engineer at the Johns Hopkins Applied Physics Lab. Congratulations on your graduation, Bassel. We look forward to following your future steps!
Video of Bassel’s talks at both graduation ceremonies is included below.
— Written by Liz Fisher, CHEPS Staff
|April 22, 2019:
CHEPS Alum Joe East, Director of Patient Access and Flow at Maine Medical Center, was kind enough to stop by CHEPS on his recent visit to Ann Arbor for a “Snack and Learn.” Joe spoke broadly about his experiences at Maine Medicine and how CHEPS had prepared him for his work there, as well as addressing more specific questions from CHEPSters.
Joe spoke to some of the key pain points he’s identified with incoming patient transfers at Maine Med, challenges which relate closely to those CHEPS students are working on in the AD ICU project which looks to ensure appropriate capacity in the cardiac ICU for aortic dissection patients. Joe sees two key components to patient transfers: accepting the patient and assigning them to a bed, noting that it’s not uncommon for a physician to accept a patient without realizing there’s no bed available for them. Improving the communication between hospital staff, especially across units, has proven key in solving these challenges at Maine Med.
In addressing a question about how to communicate with physicians, who generally have a less analytical background than engineers, Joe spoke to using data as a jumping off point. Joe spoke to using data to get physicians and engineers on the same page and using data as a common communication tool. Tying data to positive financial impacts and/or patient outcomes is also very important. Along similar lines, Joe advised that young professionals should get to know the language of the healthcare providers they work with. “Don’t make them dumb it down for you,” he said, meaning know the abbreviations and shorthand they use so they don’t feel like working with you is an arduous task.
Hearing from such a motivated and capable professional like Joe was a great reminder of the kind of work CHEPS is preparing us for and was inspiring to make sure we take advantage of all the great opportunities we have here. Thanks to Joe for the great visit and we hope to see you again soon.
|April 8, 2019:
CHEPS student and Biomedical Engineering undergraduate Emily Krebs is also a senior leader on the University of Michigan rowing team. In addition to being an Academic All-Big Ten honoree in her sophomore and junior seasons, she and the 1V4 boat won a bronze medal in the 2018 Big Ten Championships. Emily is featured in an article on MGoBlue.com titled “Scholar Stories: Krebs Seeks to Be Positive Influence in Healthcare, Rowing.” She discusses her rowing career, her academic career, and her desire to positively affect patients through her work in healthcare. The full article is available at MGoBlue.com.
||April 5, 2019:
CHEPS students went to Zap Zone on Friday, April 5th to officially kick off the weekend. The students started with an intense 4 v 4 game of laser tag before moving on to playing some cool virtual reality games. We can’t wait to go back! A big shout out to CHEPS student Caroline Owens for organizing a great social event!
||April 5, 2019:
Several CHEPS students participated in the Undergraduate Research Symposium on Friday, April 5th. The event showcased the diverse research undergraduates conduct at the University of Michigan and CHEPS was proud to have a strong showing. “When speaking with the check-in volunteers, they were amazed at how many posters we, as a collective, were presenting. I immensely enjoyed having the opportunity to speak with others about the BLOCK Scheduling Project and introducing them to one of the many applications of Integer Programming,” said Theodore Endresen, an Industrial and Operations Engineering (IOE) Undergraduate.
Caroline Owens, also an IOE undergraduate, thought the symposium succeeded in showing the breadth of research undergraduates are doing at the University. “I was surprised to recognize many of the other participants who I had not known were involved in research. Hearing about their experiences and the work they had accomplished gave me a greater appreciation for the breadth of the university and all that can be accomplished by undergraduate students,” she said.
Often, CHEPS students are presenting at healthcare or engineering specific events. Lauren Hirth, a Biomechanical Engineering (BME) Undergraduate, enjoyed the chance to connect with undergraduate researchers from a variety of fields. She said, “I enjoyed talking to people about my work that I would normally not talk to at the university, and who did not know about CHEPS. The Symposium was also a great way to see what research other students at the university have been doing, and to catch up with friends I knew from other experiences on campus.”
Riley McKeown, an IOE undergraduate, said, “I was not only able to engage other students by discussing the methodologies of the Shift Scheduling project, but I was also able to tell students from outside of the CoE about CHEPS! While presenting, I ran into old friends I hadn’t seen for a couple of years, it was great to catch up and share our work with each other!”
For Sheridan Tobin, a School of Public Health undergraduate, presenting gave her an important reminder about her research. “Presenting the poster and answering questions was a great reminder of the real-world impact that our project has. It was great to talk with different people who work in healthcare and in other research areas and hear that they were interested in the work we’re doing,” she said.
The following students presented CHEPS work:
— Written by Liz Fisher, CHEPS Staff
||April 2, 2019:
CHEPS student and IOE undergraduate Justin Rogers traveled to the Data Science for Social Good (ds4sg) Workshop hosted at Georgia Tech from April 1 – 2, 2019. The workshop focused on the application of data science techniques to problems of significant societal impact, such as healthcare, data privacy, renewable energy, and transportation. This workshop brought together student and professionals in a variety of disciplines (computer science, industrial and systems engineering, public policy, mathematics, economics, and psychology) and helped them to form meaningful connections through lightning talks, breakout sessions, and presentations.
Speakers included Rediet Abebe, Sean Barnes Ph.D., Kira Goldner, Sanmi (Oluwasanmi) Koyejo Ph.D., Destenie Nock Ph.D., Jennifer Lewis Priestly Ph.D., Kaitlin Rizk, Alba C. Rojas-Cordova Ph.D., and Eric Sodomka Ph.D. Each spoke about their research and how it related to the use of data science for social good. Research domains included algorithmic fairness, mechanism design, artificial intelligence, simulation, machine learning, and optimization.
||March 31, 2019:
CHEPS and Industrial and Operations Engineering (IOE) students Jhawan Davis and Donald Richardson attended the National Society of Black Engineers (NSBE) 45th Annual Convention in Detroit from March 27–31, 2019. According to the NSBE website, “The Annual Convention showcases Black students and professionals who have a passion for science, technology, engineering and math (STEM), who are high achievers in these fields and are channeling their dedication to advance their communities and society at large.”
Both Donald and Jhawan also appreciated how the conference shone a light on Detroit. Jhawan said there were, “over 14,000 attendees roaming around and realizing how amazing the city of Detroit actually is. Additionally, there were over 300 companies who participated in the career fair, hiring the best diverse talent in the country, providing a direct influence on the job market in Detroit, which actually revitalizes the city.”
Jhawan is president of the University of Michigan NSBE chapter, which brought home its 4th consecutive Chapter of the Region award this year. He helped to bring the conference to his hometown of Detroit and found the effort well worth it. “It means a lot,” he said. “I’m excited because, just driving around downtown – I went to high school ten minutes from here – and just seeing different signs like ‘welcome NSBE’ and all the beautiful black people walking around, it’s very exciting. And I’m happy people are getting to see the more positive views of Detroit. We’ve got a reputation for being hard-working. Apparently, our new nickname is the comeback city. I’m glad everybody else is becoming aware of that.”
Donald enjoyed his time working at the University of Michigan recruiting booth. “You’re there talking with prospective students through the entire process from navigating the application process to what students can do now to set themselves up for success in a PhD program. We almost have mini advising sessions. I came from an undergrad program, the Meyerhoff Scholars, that focused on preparing us for pursuing a PhD or MD/PhD, not everyone is fortunate enough to have that. Maybe they’re coming from a school where, as an underrepresented minority, they’re one of two in their program. So they can sometimes feel isolated and not as comfortable to ask questions or be aware obtaining a PhD is in their grasp. NSBE provides a space where you’re with a lot of people that look similar to you, a lot of people that are excelling and genuinely want to see you join them in doing the same. It’s a super friendly environment filled with peers and mentors that are doing everything they can to ensure you get the opportunities they had.”
Donald said that, in addition to taking the time to mentor younger students, he has benefited from the advice of junior faculty and young professionals attending NSBE. “Two years ago, I got advice that if you don’t know what path you’re going in post receiving your PhD regarding faculty vs. industry, make sure you set yourself up to be able to have those options open to you when you make that decision later.” He was especially excited this year to run into IOE and CHEPS alum Brandon Pitts who is now an Assistant Professor at Purdue University as well as other Meyerhoff scholars and professionals helping pave the way for him and many others.
||March 29, 2019:
On Friday, March 29th, we were expecting a Lunch and Learn with Mark Van Sumeren at CHEPS. Then we got a pleasant surprise, not just one but two Van Sumerens! Mark, a valued friend of CHEPS who recently moved back to Ann Arbor, brought along his son, Andy. Both Mark and Andy are alums of Industrial and Operations Engineering at the University of Michigan and work in healthcare consulting so they could not be more suited to deliver a CHEPS Lunch and Learn.
Mark is Managing Director of Health Industry Advisor LLC, which “offers health systems, medical device and health care suppliers the requisite critical thinking and expertise to address challenges [in healthcare], head-on.” Andy is a Lean Manufacturing Manager at GE Healthcare and operates his own consultancy.
After Andy and Mark introduced themselves and their work, students had plenty of questions to keep them talking through lunch and beyond. The two were able to provide thoughts on a wide range of topics including the differences between internal and external consulting, how to become an independent consultant, networking, self-promotion, and strategies to keep a project on track. They also told stories of the coolest experiences they’d had while consulting and threw in a few fun family stories, making it both an entertaining and informative lunch.
Andy stressed the importance of getting a wide range of experience and finding opportunities to learn the ins and outs of both internal and external consulting. He stressed that experiencing a project at all stages is the way to grow to be able to handle whatever is thrown at you. “The role you sign up for is not the job description you’ll actually have. The smaller the company, the more hats you’ll wear,” he said.
Mark offered students some solid advice as far as keeping projects on track. He said this starts before the project even officially begins. “The real art is, before accepting the job, really knowing what success is,” he said. He explained this meant not only having a firm understanding of what you want to do and what you’re good at but also defining the scope of the project so you know exactly what you will and won’t do. This also helps maintain your “say/do ratio” so that anything you agree to do, you are sure you can deliver on.
Thank you to Mark and Andy for the visit and the great conversation. We look forward to seeing you in CHEPS again soon!
||March 28, 2019:
We were delighted to have a Jim Molloy, long-time friend of CHEPS, visit the Center on March 28th. Jim is a Managing Director heading up the Not-For-Profit Health Care Group at Citi. His over 25 years of experience in the healthcare industry gave him a great deal to discuss with everyone here at CHEPS.
Jim spent his day in mentoring sessions with groups of CHEPS students, discussing CHEPS operations with Associate Director Amy Cohn, and meeting with members of the provider scheduling teams to provide his insights on their work. He was also kind enough to share everything from reading recommendations, job application tips, and career path advice with students.
Justin Rogers, Industrial and Operations Engineering undergraduate, said, “Jim offered great insight into the challenges that healthcare systems are facing, and how the skills of an IOE student can be utilized to solve these challenges.”
Students who will be on the job market soon also got some valuable perspective from Jim. “He was quite helpful in offering advice about ways to distinguish oneself when applying to jobs. I really enjoyed speaking with him and thought that he offered great mentorship in the time that we had together,” said Matthew Levenson, Industrial and Operations Engineering undergraduate.
Hannah Strat, HEPS masters student, also appreciated the chance to learn from Jim’s experience. She said, “Jim provided insight into the variety of industrial engineering career paths within the healthcare sector. We talked about the lifestyle difference between working for a hospital system vs a consulting firm.”
Camille Phaneuf, Neuroscience and Cognitive Science Undergraduate, walked away with some new project management techniques. She said, “Jim offered great insight on effective management styles, emphasizing the need to listen and to implement performance reviews – of oneself and others. In doing so, he explained how these techniques can help individuals and organizations reach their goals. Overall, the conversation was incredibly helpful, and I am excited to apply what I have learned!”
And, finally, Neil Gollapudi, Computer Science undergraduate, walked away with some universal advice. “One major insight I took from him, was that genuine interest often drives success in the field,” he said.
Many thanks to Jim for taking the time to meet with so many CHEPS students and share his experience!
|March 22, 2019:
CHEPS alum Young-Chae Hong has had his manuscript titled “Using Optimization Techniques and Multi-Disciplinary Collaboration to Solve a Challenging Real-World Residency Scheduling Problem” accepted for publication in the INFORMS Journal on Applied Analytics. CHEPS Associate Director Amy Cohn and CHEPS Research Area Specialist William Pozehl are co-authors on the paper along with Stephen Gorga, Edmond O’Brien, and Jennifer Zank.
The paper focuses on a collaboration between CHEPS and the C.S. Mott Children’s Hospital to address challenges of assigning medical residents to shifts within a pediatric emergency department. Specifically, it details the authors’ “integer programming formulation and the iterative, interactive approach in which [they used] this integer program as a tool within the broader process of schedule development.”
Congratulations to Young Chae on the paper’s acceptance for publication! We’ll share a link when it’s available.
||February 25, 2019:
CHEPS students, faculty, and staff met for a Lunch & Learn on Monday to hear about the use of lean thinking from Dr. Jack Billi. Dr. Billi is a Professor in Internal Medicine and Learning Health Sciences (Medical School), Health Management and Policy (Public Health), and Integrated Systems and Design (Engineering) at the University of Michigan. Lean thinking can positively affect the way team members think about problems in a way that improves the quality and efficiency of projects. More specifically, lean thinking involves seeking the root of the problem, separating the root from the goal state, and clearly identifying the gap between the current and future states so that the gap can be taken ownership of and subsequently addressed.
When considering a problem, Dr. Billi encouraged “rotating the gem” to see every face of the obstacle because granularly laying out the problem helps identify team members’ gaps in knowledge and their misunderstandings. In order to apply the lean thinking framework to the ongoing work at CHEPS, we walked through aspects of the Surgical Instruments and Aortic Dissection Intensive Care Unit projects. While doing so, Dr. Billi emphasized going to the (often physical) site of the problem to observe, to learn, and to ask ‘why’ questions. After all, “a problem understood is half solved.”
In sum, CHEPsters enjoyed an informative session of learning how to use the A3 template and lean thinking to mentor problem solving, enabling global thinking, and local action. Thank you, Dr. Billi, for sharing your wisdom!
||February 23, 2019:
On February 23rd, the Arab Student Association (ASA) held its annual Arab Xpressions show at the Power Center for the Performing Arts. The show consisted of music, dance, and skits that showcased the unique culture, experiences, and challenges of being Arab American. Bassel Salka, an IOE student finishing his fourth year at CHEPS, has been a member of ASA throughout his four years at Michigan and even served as the organization’s president last year. This year, he not only organized and choreographed dances for the event, but he also emceed. “It’s heartwarming to see how much the Arab community has grown during my time as a student,” Bassel said, referring to the increase from 300 audience members his Freshman year to 1400 this year.” As an engineering student it’s incredible to work with others from various academic and social backgrounds.” He hopes to see the community grow even more in the coming years as representation increases and more students are attracted to the event.
||February 22, 2019:
CHEPSters traveled to San Antonio, Texas, for the Society of Health Systems annual Health Systems Process Improvement Conference, which took place February 20-22. The conference brings together thought leaders in industrial engineering working to make a positive impact in healthcare.
CHEPS talks were:
CHEPS posters were:
CHEPS students took part in several sessions, and Computer Science undergraduate Kristine Wang won the “Best Student Poster” (and 2nd Place overall) for “Scheduling Resident Shifts in the CS Mott Children’s Hospital Emergency Department.” The conference kept students busy, but they took time to sample tacos from San Antonio food trucks, explore the city’s parks, and of course a stop at The Alamo!
— Written by Adam VanDeusen, Industrial and Operations Engineering PhD Student
|February 21, 2019:
On Thursday, February 21, Dr. Jenna Wiens spoke to attendees at the Michigan Institute for Healthcare Policy and Innovation’s (IHPI) ongoing research seminar series. Dr. Wiens is a Morris Wellman Assistant Professor of Computer Science and Engineering (CSE) at the University of Michigan and is interested in researching the intersection of machine learning, data mining, and healthcare. In her presentation titled “White Coat, Black Box – Augmenting Clinical Care with AI in the Era of Deep Learning,” Dr. Wiens described the exciting future of machine learning in healthcare as well as the challenges that still need to be tackled.
Dr. Wiens described the troubling circumstances facing the healthcare field in the US including a significant physician shortage, physician burnout, and frequent medical errors in hospitals. Although Dr. Wiens acknowledged that increasing computerization is actually a problem, with doctors using more of their time to enter data, she explained several promising applications of machine learning in healthcare. For example, machine learning can be used to detect patterns that sort a patient from high-risk to low-risk for a particular disease, leading to a decreased length of stay, transmission, costs, and improved outcomes. The question remains, however: “What do we have to do to make artificial intelligence (AI) work in healthcare?”
To address this question, Dr. Wiens expounded on several key principles of deep learning and the current technical challenges of applying machine learning to healthcare. Although these technical challenges remain part of a lively debate among the scientific community, it is clear that these conversations are necessary in order to ensure that AI properly augments clinical care. Dr. Wiens’ work remains at the forefront of developing the infrastructure for the integration of AI into healthcare.
|February 20, 2019:
A group of CHEPS students got together for a Lunch & Learn on Wednesday to learn about and practice using Tableau. Tableau is a tool for visualizing data and has been useful for presenting results from CHEPS projects. During the Lunch & Learn, students downloaded Tableau and some practice data and followed along with training videos to practice using the interface. It was a great opportunity to become more familiar with a powerful data tool. Thanks to CHEPS Master’s student Andrea McAuliffe for coordinating and facilitating!
|February 19, 2019:
CHEPS and IOE PhD student Donald Richardson and CHEPS Associate Director Amy Cohn are authors of “Modeling the Impact of Make-Ahead Chemotherapy Drug Policies through Discrete-Event Simulation” published at IEEE Xplore. Delays are possible at each step of an outpatient chemotherapy infusion visit. These delays can negatively impact individual patients and have a ripple effect which can negatively impact staff and other clinic patients. According to the abstract, the authors “present a discrete-event simulation model to predict the effectiveness of various make-ahead drug policies utilizing data from our collaborators at the University of Michigan Rogel Cancer Center (UMRCC).” A sign-in may be required to view the full paper at the link provided above.
||February 15, 2019:
CHEPS Associate Director Amy Cohn recently visited the University of Florida. She shared her experience addressing challenges in scheduling healthcare providers with multiple, ill-defined objective criteria in a talk titled “Solving Complex Combinatorial Scheduling Problems in Healthcare with Multiple Objective Criteria” at the Department of Industrial & Systems Engineering.
Dr. Cohn also enjoyed the opportunity to connect with University of Florida faculty including Elif Akcali, Katie Basinger, Michelle Alvarado, Xiang Zhong, Wayne Gian, and Hongchang Liu. And she was able to reconnect with Mustafa, a former student of her in IOE who is now pursuing a master’s degree at the University of Florida. “One of the many perks of teaching IOE 310 has been the hundreds of alums around the world that I get to keep in touch with!” she said.
She finished up the trip by taking some time for herself to run on the beach where she heard plenty of “Go Blue!” while wearing her Michigan gear. She was also able to spend a day with her parents and soak up some extra sun before returning to the Michigan winter.
|February 14, 2019:
Ruiwei Jiang, Assistant Professor of Industrial and Operations Engineering and a CHEPS affiliate, has received a 2019 National Science Foundation (NSF) Career Award for his project titled “Incorporating Decision-Dependent Uncertainty via Distributionally Robust Optimization: Models, Solution Approaches, and Applications.” His work will focus on evaluating the potential benefit of incorporating decision-dependent uncertainty and investigating new optimization approaches to maneuvering such uncertainty in industries such as power, healthcare, and transportation.
According to the NSF, “The Faculty Early Career Development (CAREER) Program is a Foundation-wide activity that offers the National Science Foundation’s most prestigious awards in support of early-career faculty who have the potential to serve as academic role models in research and education and to lead advances in the mission of their department or organization.”
|January 25, 2019:
A big welcome to Andreas, the newest member of the CHEPS family, who is already showing his CHEPS pride in this stylish onesie. Congrats Andreas’ parents Kathryn Schumacher, CHEPS alum, and Johannes Strom!
|January 24, 2019:
On Thursday, January 24th the Surgical Instruments team presented to over one hundred nursing staff at a Michigan Medicine nursing in-service. These regular meetings serve to keep nurses at Michigan Medicine up to date on the latest procedures, equipment, and research related to their work. The presenters were Abhi Bukkapatnam, LSA undergraduate; Lauren Hirth, BME undergraduate; Michael Kalmus, IOE undergraduate; Emily Krebs, BME undergraduate; and Hannah Strat, IOE/HEPS masters student.
“We presented our experiments, findings, and potential solutions from a project designed to understand and mitigate the fire and burn risks posed by fiber optic cords used in the operating room,” said Michael Kalmus, an IOE undergraduate who is part of the Surgical Instruments team.
The team tested several different fiber optic cords at various light settings with and without safety features such as the Stryker Safelight system and GloShield. Their work initially concentrated on the fire/burn risk that results when fiber optic cords are placed on top of surgical drapes or patients which was the initial hazard identified by Michigan Medicine. However, as they explained in their presentation, the team discovered that fiber optic cords placed near and not in direct contact with patients or drapes can cause fire/burns through the mechanism of radiation. This new understanding regarding the importance of radiation as a hazard substantially influenced the conclusions and recommendations of the group.
“It was a really good experience from start to finish from doing the experiments to concluding with this presentation that had direct impact on Michigan Medicine’s approach to mitigating the risk of fire and patient burn from this hazard,” said Kalmus who has been on the team since last January, around the time when the fiber optic cord research began.
|January 23, 2019:
CHEPS Director James Bagian is author of an editorial titled “How Safe is Safe Enough for Space and Health Care? Communication and Acceptance of Risk in the Real World” published in JAMA Neurology on January 23, 2019. (Link requires journal access.)
|January 8, 2019:
CHEPS affiliates Gian-Gabriel Garcia, Mariel Lavieri, Xiang Liu, and Mark Van Oyen recently published a manuscript titled “Using Kalman Filtering to Forecast Disease Trajectory for Patients With Normal Tension Glaucoma” in the American Journal of Ophthalmology. Garcia and Liu are PhD students in the Industrial and Operations Engineering (IOE) Department at The University of Michigan. Lavieri is an Associate Professor and Van Oyen a Professor, both in IOE. According to Garcia, the team “applied Kalman filtering – the same mathematics used for trajectory estimation in the Apollo space program – to forecast future disease trajectory for patients with Glaucoma.” The authors of the manuscript are Gian-Gabriel P.Garcia, Koji Nitta, Mariel Lavieri, Chris Andrews, Xiang Liu, Elizabeth Lobaza, Mark Van Oyen, Kazuhisa Sugiyama, and Joshua Stein.
||December 12, 2018:
CHEPS and IOE PhD student Donald Richardson presented a poster and delivered a talk at the INFORMS Winter Simulation Conference which took place from December 9-12, 2018 in Gothenburg, Sweden. “I felt a much stronger international presence than any other conference I’ve been to which is cool because you can see how operations research is done outside of the U.S. It’s surprisingly different sometimes,” said Donald.
Donald’s poster titled “Improving Make-ahead Chemotherapy Drug Policies in the Outpatient Infusion Center Pharmacy” covered his dissertation work to optimize drug preparation at the pharmacy to reduce patient delays. It covered predictive modeling, optimizing what chemotherapy drugs are pre-mixed, and the simulation to see how well different policies worked.
His talk titled “Improving Chemotherapy Make-ahead Policies through Discrete-event Simulation” went into more depth specifically on the simulation piece of the project. “I presented some rule of thumb policies we used and then emphasized that is a tool we can use to evaluate our model but you can evaluate anyone’s model for a more general outpatient infusion center as long as you have their data,” he explained.
Donald said one interesting aspect of the conference was speaking to people from a variety of countries about his research. “In different countries, some factors may have more weight or value,” he said. “Is it the cost to the patient? The cost to the provider? Patient time? That was an interesting conversation starter.”
He also enjoyed attending the PhD Colloquium Keynote by Stewart Robinson, Dean and Professor of Management Science at Loughborough. The Keynote focused on using models, particularly whether wrong models can still be useful.
He found some time to experience Sweden as well. “Across from the hotel was Liseberg, essentially it’s a huge amusement park, but in the winter months they still have most of the rides open but they turn it into a Christmas market, he said. “They have a whole bunch of vendors there from people who made Viking gear to trinkets and food items, stockings, anything you can think of. And, since it’s a Christmas market, they light up everything.” Donald even came back to the US through Paris and had enough time to go see the Eiffel Tower.
|December 10, 2018:
Our final talk of the 2018 Providing Better Healthcare through Systems Engineering Seminar Series was Dr. Mehmet A. Begen from the Western University in Canada discussing “Home Healthcare Scheduling: Applications and Challenges.”
Dr. Mehmet A. Begen is an associate professor of management science in the Ivey Business School at the Western University, Canada. He has research interests in management science/analytics applications, data-driven approaches and in particular scheduling and operations management in healthcare. He serves as the president of the Canadian Operational Research Society (CORS) and is visiting the U of M Ross School of Business for his sabbatical.
In his presentation, Dr. Begen spoke about how home healthcare has become a new trend in care delivery and has attracted substantial attention from researchers and practitioners. “Our population is aging and we need to deliver care to the aged at their doorstep,” said Dr. Begen. He added that his grandfather, a medical doctor in Turkey, used to carry his medical briefcase with him all the time visiting and treating patients at their homes.
Dr. Begen explained that in Canada, over 2.2 million patients received some level of home healthcare services in 2012. The new services have become very attractive as they promote quality of care and reduce cost. In such a setting, a patient receives one-to-one attention from their caregiver, whereas in a typical healthcare facility, the same caregiver is usually responsible for many patients. Further, the cost to care for terminally-ill patients in an acute-care hospital is estimated to be 40% more expensive than the cost of the same care in a hospital-based palliative-care unit and over 10 times more expensive than home healthcare.
Dr. Begen, then, spoke about his current research in which he uses mathematical modeling to optimally schedule homecare providers (e.g. physicians, nurses, physical therapists, etc.) to patients for a single visit or multiple consequent visits in a cost-efficient way. He concluded his talk by saying that patient-to-resource assignment/routing/scheduling in home healthcare setting introduces new thinking on caregiver’s work shifts, reimbursement, and performance measurement.
A video of Dr. Begen’s seminar is available to view.
Now, as we end this semester, we wish you and your dear ones a very happy and a warm holiday. We will be looking forward to seeing you again in our next season of the Providing Better Healthcare through Systems Engineering seminar series in 2019. Happy Holidays!
|December 3, 2018:
Dr. Brian George presented his talk “Does Surgical Training Need to be Re-engineered?” on Monday, December 3rd. This seminar was part of our ongoing Providing Better Healthcare through Systems Engineering Seminar Series. His focus was on the current assessment process of resident surgeons and how it fails to consider how well they actually perform in surgery. He and his team are researching methods to improve the assessment of residents in practice, as well as understand how current assessments correlate to early career performance and patient outcomes. One method he suggested for reviewing residents is the application SIMPL, which can be used on cell phones and could be done quickly, immediately after surgery.
Dr. George is driven by complications from surgeries that he believes are avoidable. He emphasized that it is usually not lack of ability or bad intentions, but lack of proper training. He believes that if the residents are regularly evaluated and given feedback for their performance they will improve. There is not much data available on the topic, but Dr. George and his lab are hoping to gather information to prove the inaccuracy of the evaluation system. He hopes that his work will improve patient outcomes by getting residents the training they need before they are in the field on their own.
Please join us on Monday, December 10th at 4:30 pm in 1123 LBME for our final seminar of 2018. Mehmet Begen will present “Home Healthcare Scheduling: Applications and Challenges.”
|November 30, 2018:
CHEPS alumnus Luke Stumpos returned to CHEPS on Friday, November 30th to share his experiences with current students. His Lunch and Learn, or Luke and Learn as we like to call it, focused on his job as a consultant at Improvement Path Systems (IPS).
“I didn’t know much about consulting or the travel lifestyle [when I was a student], so that’s what I decided to focus my talk on,” said Luke. He offered an overview of IPS and his experiences there and left plenty of time for questions from and discussion with attendees. He was able to share many valuable insights as well as some fun travel stories.
Bassel Salka, an IOE undergraduate and CHEPS student, asked about Luke’s experience with supply chain and Luke was able to offer examples from his experience working with supply chain in a large pediatric hospital. “There’s a very large human component to the supply chain,” he said. “It’s not just numbers.” He went on to speak about learning from clinicians why some of the needs for having supplies on hand might have differed from what he expected going in.
Many of the students who attended the talk are considering a career in consulting after graduation and were able to better understand some of the opportunities available to them through discussion with Luke. Additionally, his talk highlighted the importance one of our main focuses here at CHEPS, collaboration and open communication between engineers and medical practitioners.
||November 29, 2018:
A week after Thanksgiving, the CHEPS family got together to celebrate CHEPSgiving. The celebration began in the CHEPS offices. Attendees brought non-perishable food items to donate to Food Gatherers, a charity that works to alleviate hunger in the community. Then we all settled in in front of the crackling fire (courtesy of a YouTube video played on the conference room projector) to make paper snowflakes together to decorate the CHEPS offices. While some were more successful at snowflake making than others, all enjoyed sharing some fun and relaxing moments with the CHEPS family as a break in the busy holiday season and the end of the semester. Afterward, many of the students headed off to Good Time Charley’s to enjoy the Thursday burger special together.
|November 26, 2018:
On Monday, November 26th, Dr. Paula Anne Newman-Casey offered insights to her seminar audience regarding her recent work to modernize the Michigan glaucoma clinic and improve patient wait times. Throughout the talk, titled “The Intelligent Glaucoma Clinic: A passive RFID Time Study System to Optimize Patient Wait Times,” she explored the path she and her clinic took to first diagnose the origins of lengthy wait times, and then find a cost-effective, sustainable solution using portable RFID chips.
Dr. Newman-Casey, an assistant professor of ophthalmology and visual sciences at the University of Michigan Kellogg Eye Center, started with a brief background on glaucoma, then jumped straight into the problem at hand: “We’re trying to get people to come back for an asymptomatic disease (at least, to them), we’re giving them medications that cause side effects and cost money, and we’re asking them to wait in the clinic for hours to see us, to get those prescriptions, and get our advice.”
Walking the audience through her experiment, Dr. Newman-Casey explained the process for choosing reusable RFID chips implanted in clinician ID tags (the most cost-effective option, which would save thousands of dollars per year) and HITS’ work on Glimpse, a dashboard interface allowing for visualization of data indicating time spent in and out of each room by clinicians and patients. Using this data, their team is now able to make experimental changes to clinic procedures within a simulated version of the clinic, and determine with approximately 80% accuracy the impacts it will have on patient wait times in the actual clinic.
During the following Q&A, attendees offered feedback on different strategies to potentially improve the efficiency and accuracy of Dr. Newman-Casey’s data collection framework, as well as additional applications of the technology. “One of the issues that has come up in the operations meetings is asking, ‘if we added a technician, what would happen?’ So I think that is definitely something we would like to explore in the simulation model.”
This seminar was part of the ongoing Providing Better Healthcare through Systems Engineering Seminar Series, presented by CHEPS.
A video of Dr. Newman-Casey’s seminar is available to view.
|November 19, 2018:
On Monday, November 19th, Dr. Ruiwei Jiang presented at the CHEPS seminar series “Providing Better Healthcare through Systems Engineering”. Dr. Jiang is an Assistant Professor of Industrial & Operations Engineering at the University of Michigan. His research focuses on the theory of stochastic and robust optimization, integer programming, and their applications on power systems and healthcare operations.
During the seminar, Dr. Jiang discussed his nurse staffing optimization work. Nurse staffing is a crucial component of any organization due to the costs associated with nurse staffing and the staffing levels required for patient safety. Additionally, the ability to appropriately staff nurses is difficult because of the uncertainties in nurse demand and nurse absenteeism. Dr. Jiang spoke about a few current solutions some systems use to address nurse staffing challenges, included float pools and cross-training programs. He also provided a brief review of the literature and the limitations some of the existing models have. He then spoke about a few proposals his team has developed such as a distributionally robust nurse staffing model and the optimal nursing pool design. Dr. Jiang’s presentation was a great example of how systems engineering models can be applied to common operational challenges all healthcare institutions face.
|November 15, 2018:
“My involvement with IISE started off as a way for me to get involved in an organization that was related to my major, so Industrial and Operations Engineering (IOE), and to get more involved with the IOE Department as a whole,” said Justin Rogers, CHEPS student and IOE undergraduate. “IISE does a lot for its members and a lot for IOE as well so it’s a way for me to give back to the IOE Department.”
Justin, former President and current External Vice President of the University of Michigan IISE chapter, was recently awarded the 2018 IISE Irv Otis Scholarship. The Institute of Industrial & Systems Engineers (IISE) Detroit Chapter grants the scholarship to a student from one of their member schools each year who shows that “he/she is dedicated to the Industrial Engineering profession and IISE.” The award is named in honor of Irv Otis who, according to IISE, is “a very well respected past President of IISE GDC and the founder of the Industrial Engineering Institute of Research and Technology.”
“It came at a really good time and a really needed time,” Justin said. “I was thankful and excited. It was an opportune time because my tablet had just broken and I need it to do my school work. And this scholarship can pay for the tablet so everything’s worked out.”
Congrats, Justin, on a much-deserved award!
|November 12, 2018:
On Monday, November 12, 2018, attendees at the Providing Better Healthcare through Systems Engineering Seminar Series had the pleasure of listening to Dr. Corey Lester. Dr. Lester is a research assistant professor of clinical pharmacy at the University of Michigan College of Pharmacy whose research focuses on identifying and solving the challenges associated with medication use.
In his presentation, titled “Human Factors and Cognitive Engineering: A Pharmacist’s Perspective of Medication Safety,” Dr. Lester discussed the quality and safety of medication use as a function of health care provider and patient interactions focused on achieving optimal drug therapy outcomes. “Pharmacists use a patient-centered approach in collaboration with other providers on the health-care team to optimize patient health and medication outcomes,” Dr. Lester said.
The presentation provided a broad understanding of the current landscape of pharmacies and medication in the US, as well as introducing future research focused on improving pharmacist work and medication safety through different cognitive models. Dr. Lester described how 2022 healthcare spending could reach up to $5.1 trillion, with World Health Organization estimates putting medication safety at $42 billion in annual costs. Dr. Lester’s exploration of the foundations of human factors and cognitive engineering models is helping pave the way for medication use research and improving pharmacist workflows.
A video of Dr. Lester’s seminar is available to view.
Join us next week on Monday, November 19 at 4:30 pm in 1123 LBME when Ruiwei Jiang presents “A Data-Driven Distributionally Robust Optimization Approach for Appointment Scheduling.”
The Ansbacher Scholars in Boston.
Amy Cohn with CHEPS alum Spyros Potiris.
|November 9, 2018:
CHEPS Associate Director Amy Cohn recently spent several days in Boston as part of the Rudi Ansbacher Women in Academic Medicine Leadership Scholars Program. She was nominated for the program by Dr. Jim Bagian, CHEPS Director.
According to the University of Michigan Medical School, “This intensive 18-month leadership development program was initially designed to accelerate the development of women for senior positions in academic medicine and healthcare.” It is named after Dr. Rudi Ansbacher who was a Professor Emeritus of Obstetrics and Gynecology at the University of Michigan Medical School and showed a lifelong commitment to supporting and mentoring women in leadership roles.
Professor Cohn says the program has been provided valuable opportunities for her to learn from the women in her cohort as well as share her experiences from her work at CHEPS and collaborating across the healthcare system. A variety of interesting speakers presented new ideas, many of which she hopes to incorporate into the work CHEPS does in the future.
While in Boston, Professor Cohn also had the opportunity to meet with collaborators at MIT and Northeastern as well as have dinner with CHEPS alumnus Spyros Potiris. She was also excited to hear the last inning of a Red Sox game from outside Fenway Park.
“The week truly embodied the spirit of Dr. Ansbacher and his vision to support women in their professional development,” said Professor Cohn.
Donald with his poster at the MIF poster competition.
|November 7, 2018:
CHEPS and Industrial and Operations Engineering student Donald Richardson took first place at the Minority Issues Forum (MIF) poster competition during the 2018 INFORMS Annual Conference. He tied with Destenie Nock, a PhD Candidate in Industrial Engineering and Operations Research at UMass Amherst.
Donald’s poster was titled Simulating the Outcome of Make-Ahead Drug Policies at an Outpatient Chemotherapy Infusion Center. According to Donald, “We have developed a discrete-event simulation tool to evaluate a variety of policies for selecting which drugs to pre-mix for outpatient chemotherapy patients. By making patient-specific drugs ahead of appointment time, patient waiting time can be reduced. However, this comes at the risk of incurring waste cost if the patient defers treatment after arriving for their appointment and their drug must be discarded. We utilize data from the University of Michigan Rogel Cancer Center to validate our methods.”
Donald was honored to receive first place. He said, “I have been working closely with this project since I started here and I am extremely grateful and honored others find this work so impactful. I also am thankful for all of the past and current CHEPSters and medical professionals that have supported this work. MIF creates such a great community for minority scholars and others to come and support each other as we all navigate through graduate school and beyond.”
The CHEPS crew at INFORMS 2018.
|November 7, 2018:
CHEPS took over Phoenix, Arizona, at the annual meeting of the Institute for Operations Research and Management Sciences (INFORMS), which took place November 3-7, 2018. The conference brings together researchers and practitioners in operations research, industrial engineering, and analytics to share cutting-edge work with colleagues.
Presentations by CHEPS included:
Masters student John Cima said of his INFORMS experience, “The wide variety of sessions allowed me to explore other aspects of research and try to make connections to the work we do at CHEPS.”
Highlights of the conference included the Minority Issues Forum, which included posters by CHEPS PhD candidates Karmel Shehadeh and Donald Richardson. Donald’s poster won first place at the poster competition! Many CHEPSters also took a trip to the Arizona Science Center to gain some knowledge outside of conference sessions.
— Written by Adam VanDeusen, Industrial and Operations Engineering PhD Student
|November 1, 2018, 2018:
CHEPS Director Jim Bagian recently traveled to Washington D.C. to chair a panel at the “Seminar on the Next Generation of Patient-Focused Care: Healthcare System Integration for Coordinated Care.” The seminar was convened by the Board on Human-Systems Integration (BOHSI) of the National Academies, of which Dr. Bagian is a board member.
BOHSI is a standing committee under the National Academies of Sciences, Engineering, and Medicine. The National Academies has as one of its goals “to spur progress by connecting understandings of science, engineering, and medicine to advise national policies and practice.”
The panel Dr. Bagian moderated at the November 1, 2018 seminar was titled “Challenges and Gaps for Optimizing Patient-focused Coordinated Care.” Dr. Bagian’s panel included representatives from the National Cancer Institute, the Centers for Medicare & Medicaid Services, the MedStar Health Research Institute, and the Agency for Healthcare Research and Quality.
“We looked at care coordination and what are the factors that get in the way of optimal care coordination to benefit the patient and how to best use our resources for medical care for not just the individual patient but also the population writ large,” said Dr. Bagian. “This goal is often referred to as the ‘Triple Aim’. We’re looking particularly at care coordination because it’s the breakdown in communication among people, specifically the ones that both provide the care as well as those who receive care that is a major contributor to both waste of resources and more importantly to medically related patient harm.”
The panel discussed the areas that need more exploration to make a difference in patient-focused coordinated care. Additionally, they looked for opportunities where human-systems integration and human factors approaches could address challenges and gaps in coordinated care. They explored specific questions such as “What are the main design, implementation, research and policy challenges that need to be addressed in order to significantly improve patient-focused coordinated care?” and “How do we engage various stakeholders in identifying challenges and gaps and developing solutions to support care coordination at the interface?”
|October 30, 2018:
Congratulations to Rishindra M. Reddy, M.D., a long-time collaborator with us at CHEPS, who was recognized on October 30, 2018, as the José José Alvarez Research Professor of Thoracic Surgery.
The Alvarez family was affected by cancer in 2003 when José José Alvarez was diagnosed with stage four esophageal cancer. Mr. Alvarez came to Michigan Medicine to be treated by Mark Orringer, M.D., now the Cameron Haight Distinguished University Professor Emeritus of Thoracic Surgery. Throughout Mr. Alvarez’s treatment, the Alvarez family came to see Dr. Orringer as a member of their extended family. Though Mr. Alvarez died in 2005, the care that he received at Michigan Medicine meant a great deal to him and his family.
His wife, Mrs. Magda Alvarez, said, “The whole team on the floor was great. We had classes on care, access to a dietician, psychologist … we felt safe. U-M has the expertise on all aspects of the disease and supports the whole family.” The family hopes that, through the establishment of the José José Alvarez Research Professorship in Thoracic Surgery, eventually no one will have to go through what Mr. Alvarez went through.
Dr. Reddy is an Associate Professor at the University of Michigan Medical School and, according to Michigan Medicine, his “academic interests include improving outcomes for patients with thoracic cancers, molecular targeting for thoracic cancers, and resident and medical student education.” About his new appointment, he said, “There is a lot of history to this program. My goal is to live up to the legacy created by Dr. Orringer, my partners, and the faculty who led the way for us in surgery and thoracic surgery at the University of Michigan.”
|October 30, 2018:
The Rogel Cancer Center recently unveiled their renovated blood draw station. The station features more private areas for patients and the new design has resulted in significant decreases in wait times. Jennifer Slater, Onsite Phlebotomy Services Manager, said, “[CHEPS and other collaborators] played a vital role in this project and helped make it a reality! With 12 chairs functioning, we’ve seen a dramatic drop in wait times and are receiving positive feedback from patients. Although we are still working out the workflows, staff find the space more conducive to their needs.”
The Center for Healthcare Engineering and Patient Safety (CHEPS) has been collaborating with the Cancer Center for many years and students and alumni who have contributed to the project were excited to hear they’d made a positive impact for the Cancer Center and its patients. CHEPS Associate Director Amy Cohn recently presented at the Rogel Cancer Center National Advisory Board meeting discussing many ways the two Centers could collaborate in the future.
||October 29, 2018:
On Monday, October 29th, Dr. Walton Hancock spoke as part of the Providing Better Healthcare Through Systems Engineering Seminar Series. Dr. Hancock, a Professor Emeritus at the Department of Industrial and Operations Engineering and the School of Public Health Department of Health Services Management and Policy, spoke about quality and cost impacts of integrating hospital systems.
In his presentation, Dr. Hancock explained how hospitals in the US still need to optimize their operations especially in areas related to inpatient admissions, operating room scheduling, nurse daily staffing, ancillary staffing, outpatient and transport scheduling and hospital sizing as the current operations are inefficient and cost-rising. “There are more than 5000 hospitals in the US that have not fully utilized the tools that industrial engineering could provide to improve quality and reduce cost,” he added.
The talk included examples and real cases drawn from his +40 year-experience of how industrial engineers could optimize hospital systems and enhancing the quality of care.
There will be no seminar on Monday, November 5th. Please join us on Monday, November 12th at 4:30 pm in 1123 LBME when Corey Lester from the University of Michigan College of Pharmacy presents “Human Factors and Cognitive Engineering: A Pharmacist’s Perspective of Medication Safety.”
||October 26, 2018:
Maggie Steele and Ilka Rodriguez-Calero with the Center for Socially Engaged Design (C-SED) visited CHEPS on Friday, October 26th, to present a workshop titled “Performing Active Design Observations.” CHEPS students frequently perform observations in healthcare settings. Both new and returning CHEPS students benefited from the best practices and tools shared in the presentation.
Maggie, a masters student in the Design Science program and an Industrial and Operations Engineering (IOE) alum, and Ilka, a PhD student in Design Science, started the workshop by describing the roles observers can take and how those might affect the environment the observer is studying. They also emphasized the importance of differentiating between observations and interpretations.
“Humans are so good at coming up with patterns. We need to be aware of those things we are inferring and look for more evidence,” said Ilka. She explained that interpretations can still be recorded during observations, but they should be clearly marked and not taken for fact. To illustrate some of these concepts, the presenters showed a video of a busy market with a train coming through the center and asked the workshop attendees to note what they observed. Participants then discussed their observation through the lens of what was fact, what was interpretation, and what might require further study.
Ilka and Maggie went on to discuss some best practices for observation note taking and then introduced several observation frameworks which could be used as-is or adapted depending on the project. “I didn’t know the frameworks before today,” said Jordan Goodman, IOE undergraduate. “I think having that will be really helpful, because I’ll know what to look for.”
Finally, the presenters asked the students to walk outside and observe at a North Campus bus stop or location of their choosing and to report back. This exercise helped students put the concepts they had just learned to use. Many used an observation framework to take their notes. Discussion of these observations led into advice on how to synthesize observation data and translate it into useful information for your project. The afternoon concluded with a question and answer session in which Ilka and Maggie offered tailored advice on note taking and other subjects.
Many thanks to C-SED, Ilka, and Maggie for the enlightening presentation!
|October 25, 2018:
CHEPS Director Jim Bagian will be moderating a panel at the upcoming The National Academies of Sciences, Engineering, and Medicine “Seminar on the Next Generation of Patient-Focused Care: Healthcare System Integration for Coordinated Care.” The seminar is hosted by the Board on Human-Systems Integration (BOHSI), of which Dr. Bagian is a board member.
The seminar takes place on November 1, 2018. Dr. Bagian will host a panel titled “Challenges and Gaps for Optimizing Patient-focused Coordinated Care.” According to BOHSI, “The panel will discuss the main areas that need to be further explored in order to make a difference for patient-focused coordinated care. The panel will also review opportunities for human-systems integration and human factors approaches to address the challenges and gaps.”
The seminar will be held at the Keck Center in Washington, D.C. and there will also be an opportunity to view the seminar remotely. For more information about the seminar and to register or view remotely, visit http://sites.nationalacademies.org/DBASSE/BOHSI/DBASSE_189053.
||October 22, 2018:
On Monday, October 22nd, attendees at our Providing Better Healthcare through Systems Engineering Seminar Series had the pleasure of hearing Dr. April Maa, Associate Professor at Emory University School of Medicine in the Department of Ophthalmology, and Adam VanDeusen, PhD student in Industrial and Operations Engineering at the University of Michigan, share their work on improving eye care for the VA in Georgia.
According to the presenters, “Many patients, including United States veterans, face barriers to appropriate, affordable healthcare.” Dr. Maa and VanDeusen’s talk provided an interesting look at the optimization of telemedicine to provide better screenings for severe eye diseases such as glaucoma and diabetic retinopathy. They presented their work to optimize resources such as clinical space to make eye-care more convenient for veterans in Georgia. They discussed the VA’s Technology-based Eye Care Services (TECS) program, in which trained technicians perform visual disease screenings typically conducted by ophthalmologists.
Join us on Monday, October 29th when Walt Hancock presents “Integrating Hospital Systems: Quality and Cost Impacts.”
|October 12, 2018:
Donald Richardson, Andrea McAuliffe, Sheridan Tobin, and Adam VanDeusen along with CHEPS Associate Director Amy Cohn spoke at the October 12th meeting of the Institute for Healthcare Policy & Innovation (IHPI) National Advisory Board Meeting. The group introduced themselves and CHEPS to the board and spoke about utilizing engineering tools and skills to address system complexity in healthcare.
“One of the University of Michigan’s greatest strengths is its commitment to interdisciplinary collaboration,” said Adam VanDeusen, one of the student presenters. “This collaboration is exemplified in groups like IHPI, which not only brings together diverse faculty members from across the institution but also encourages meaningful student engagement in pursuit of important health services research.”
Amy Cohn began the CHEPS presentation by introducing herself and the Center. Donald Richardson, a PhD student in Industrial and Operations Engineering (IOE), discussed working to optimize processes at the Rogel Cancer Center and ICU process-flow improvement. Andrea McAuliffe, a Master’s student who is pursuing a dual-degree from the School of Public Health (SPH) and IOE with a concentration in Healthcare Engineering and Patient Safety, spoke about work with the Rogel Cancer Center, the School of Dentistry, and the Office of Patient Experience. Sheridan Tobin, undergraduate SPH student, spoke about working with Precision Health to improve recruitment for diverse patients in genetic research. Finally, Adam VanDeusen, IOE PhD student, spoke about improving access to healthcare as well as his work with the Depression Center on workplace mental health.
Thank you to our collaborators at IHPI for giving us the opportunity to share the work CHEPS is doing with their National Advisory Board!
||October 8, 2018:
This week attendees at our Providing Better Healthcare through Systems Engineering Seminar Series had the pleasure of hearing Dr. Jeff Fessler present his research on “Medical Imaging Inverse Problems Using Optimization and Machine Learning.” Dr. Fessler is the William L. Root Professor of EECS at the University of Michigan. His research interests are in statistical aspects of imaging problems, and he has supervised doctoral research in PET, SPECT, X-ray CT, MRI, and optical imaging problems.
Medical imaging systems like X-ray CT and MRI scanners produce raw data that must be processed by inverse problem solvers to yield interpretable images. The design of the image reconstruction algorithm can greatly affect image quality, and hence diagnostic accuracy, affecting patient health and safety. The research presented mainly focused on reducing the doses given to patients when they receive X-ray CT or MRI scans. This is great since reducing radiation received is definitely preferred, and there is less of a chance the patient will move around since the scan will not take as long. However, since the dosage is being reduced, the images are of much lesser quality.
The methods Dr. Fessler and his research team have designed bring the images to an equal quality of those with the original doses of radiation, but the time the algorithms take on the hardware provided have proved to be much too slow. Whereas before the images could be obtained in mere seconds or minutes, their algorithms take upwards of a half hour to an hour. When these images are needed as soon as possible, this simply will not suffice, especially considering the backup it can cause in the hospital. By exploring different optimization algorithms and machine learning methods, Dr. Fessler’s research team is finding quicker ways to obtain better images while reducing scan time.
Dr. Fessler’s slides are available to view.
There will be no seminar on Monday, October 15th due to Fall Break. Join us on Monday, October 22nd when April Maa and Adam Van Deusen present “Systems Engineering and Ophthalmologic Telemedicine: Preventing Blindness.”
||October 7, 2018:
CHEPS alum Sarah Bach ran the Chicago Marathon on October 7, 2018. She said that, despite a rainy day, the race was still a ton of fun! She did her longest training run of 20 miles over CHEPS Symposium weekend in Ann Arbor. Sarah mentioned that current CHEPS PhD student, Adam VanDeusen, deserves a shout out for running part of the 20-mile training run with her that weekend. And she thanks all of her CHEPS friends that wished her luck on race day!
Sarah was at CHEPS from September 2013 to December 2014 and is currently working as an Analytics Engineer at University of Chicago Medicine. Congrats on completing your marathon, Sarah!
|October 3, 2018:
“Creating resident shift schedules under multiple objectives by generating and evaluating the Pareto frontier” by CHEPS alum Young-Chae Hong along with Amy Cohn, Marina A. Epelman, and Aviva Alpert has been published in Operations Research for Health Care and is now available online. As described by the authors, “In this paper, we consider the problem of building monthly schedules for medical residents who provide shift coverage in a pediatric emergency department. In particular, given the multi-criteria nature of the problem, we focus on generating Pareto-dominant schedules from which the scheduler (typically, a Chief Resident) can choose.”
Young-Chae graduated from The University of Michigan with PhD in Industrial and Operations Engineering in 2017 and is now working at Ford Motor Company as a Data Scientist on their Supply Chain Analytics team. Congrats on the paper publication, Young-Chae!
|October 1, 2018:
Dr. Richard Hughes presented “‘Consumer Reports’ for Hip and Knee Replacement Implants Based on a Statewide Registry” for the third lecture of the Providing Better Healthcare through Systems Engineering Seminar Series on Monday, Oct. 1st. Dr. Hughes is a professor of Orthopaedic Surgery at the University of Michigan and the co-chair of Michigan Arthroplasty Registry Collaborative Quality Initiative (MARCQI). He also holds appointments in Industrial and Operations Engineering and Biomedical Engineering.
Dr. Hughes discussed the potential risks associated with hip replacement surgery and why it is important to apply quality improvement techniques, which are widely used in industry, to the healthcare system. MARCQI has built a statewide registry of hip and knee replacement procedures to provide data and analysis for hospitals, ambulatory surgery centers, and surgeons. This has created an opportunity to improve the quality of care provided to hip and knee replacement patients through collaboration and sharing of best practices. By answering questions regarding clinical indications, surgical techniques, perioperative management, and the appropriateness of total joint replacement and revision procedures, MARCQI is able to reduce the risk and improve the effectiveness of hip replacement surgery. Dr. Hughes presented MARCQI’s first annual report that provides survivorship data on hip and knee replacement implants, serving as a “consumer reports” guide for surgeons and patients to use in selecting devices. Dr. Hughes is an engaging and enthusiastic speaker; his lively presentation helped students, staff, and faculty from across the University who attended the presentation gain a better understanding of this topic.
Join us next week when Jeff Fessler presents “Reducing Dose in X-ray CT by Fast Optimization Algorithms and Machine Learning” on October 8th at 4:30 pm in 1123 LBME.
||September 24, 2018:
Monday, September 24th marked the second lecture in the 2018 Providing Better Healthcare through System Engineering Seminar Series as Dr. Maria E. Mayorga presented “Using Systems Engineering to Inform Public Health Policies: A Simulation Model to Assess the Impact of Insurance Expansion on Colorectal Cancer Screening.”
Dr. Mayorga visited from North Carolina State University where she is a Professor of Personalized Medicine in the Edward P. Fitts Department of Industrial and Systems Engineering. She is acclaimed for her work to incorporate patient choice into predictive models of health outcomes. In her presentation, Dr. Mayorga discussed her method for creating an individual-based simulation to test the effects of public policies on colorectal cancer screening rates. Her simulations were specifically used to analyze the possible effects of the Affordable Care Act on the colorectal cancer screening rates for North Carolina residents. Dr. Mayorga entertained questions from students, staff, and faculty from across the University who attended the presentation.
Join us next week when Richard Hughes presents “‘Consumer Reports’ for Hip and Knee Replacement Implants Based on a State-wide Registry” on October 1 at 4:30 pm in 1123 LBME.
||September 17, 2018:
The annual Healthcare Engineering and Patient Safety Symposium took place on Monday, September 17, 2018, in the Lurie Engineering Center. The symposium attracted approximately 200 guests from the College of Engineering, School of Public Health, School of Nursing, Michigan Medicine, the VA Health System, the Institute for Healthcare Policy and Innovation, and many others.
Presenters, many undergraduate and graduate students, shared twenty-four research posters and six informational posters. Many familiar faces were in attendance as well. CHEPS alumni mingled in the poster rooms. They were excited to reconnect with old friends, and to see how their work has evolved over the years.
Jim Bagian and Amy Cohn, CHEPS director and associate director respectively, gave brief remarks welcoming guests and alumni and praising the hard work of the students. They both made special thanks to the Seth Bonder Foundation for the continuous support of CHEPS and its students. Merrill Bonder, Executive Director of the Foundation, was there to witness how the Foundation support has resulted in fruitful research and health innovation.
Further, this year Peter Cohn announced the audience choice best-poster award winners in a creative way. Standing on top of a table, he announced “A Dynamic Approach to Improve Chemotherapy Pre-mix Policies” by Matthew See, Donald Richardson, Hwon Tak, and Amy Cohn as the first place audience choice winner. “Evaluating Dental School Faculty Clinical Supervision Using Simulation” by Carol Anne Murdoch-Kinch, Vidya Ramaswamy, Romesh Nalliah, Palaniappan Chellappan, Jordan Goodman, Lauren Hirth, Jakob Kiel-Locey, Riley McKeown, Adam VanDeusen, Zhipeng Xu, and Amy Cohn took second place. CHEPS alumna Elizabeth Olin won the “best tweet” prize. All of the winners were rewarded with Askanya chocolates. Askanya, the the first bean-to-bar chocolate factory in Haiti, is run by a University of Michigan IOE alumna.
Year after year, the CHEPS family keeps growing, attracting more high caliber students and interdisciplinary research collaborators from within and outside the university, all enthusiastic and set to serve healthcare. Hanan Al-Awadhi, a HEPS Master’s student, describes this by saying “CHEPS brings good people together!”
[View photos from the Symposium.]
|September 14, 2018:
As part of the annual CHEPS Symposium weekend, the CHEPS family gathered for dinner and conversation at Conor O’Neill’s. Not only was the food delicious, but there was also an impressive turnout, including current students, staff, alumni, and friends of CHEPS. Many CHEPS alumni traveled back home to Ann Arbor for the occasion and enjoyed reconnecting with previous team members and coworkers. Current students also had the opportunity to meet the alumni and learn about their careers and lives post-CHEPS. It was apparent at the event that CHEPS fosters lasting friendships as well as meaningful networks.
The students would especially like to give a special thanks to Gene and Liz for enabling the dinner at Conor O’Neill’s to happen!
|September 14, 2018:
At this week’s Lunch and Learn, University of Michigan alumni Mike and Bev Kahn talked to us about their extensive backgrounds in IOE, Systems Engineering, Data Quality, and communication. After the presentation, they offered advice and insight on topics including making a memorable impression at the upcoming career fair. They also both graciously offered their time to provide feedback on student poster presentations prior to the CHEPS Symposium. A huge thank you to Mike and Bev for giving back to University of Michigan students!
|September 13, 2018:
CHEPS alum Spyros Potiris has gone back to school! Specifically, he’s joined the MPH program in Health Management at the Harvard School of Public Health. He’s pictured on his first day in the program.
Spyros graduated from UM in December 2013 with a master’s degree in Industrial and Operations Engineering and a concentration in Healthcare Engineering and Patient Safety through CHEPS. For the past 4 years, Spyros has held various positions at the Dana-Farber Cancer Institute in Boston.
Spyros told us earlier this summer that, “Industrial Engineers bring a unique approach and skill set to address major challenges in healthcare. Combining my IE background with a strategic perspective on healthcare operations and a better understanding of healthcare policy gained through the MPH program will allow me to guide institutions in delivering safe, affordable, accessible and efficient care.”
Best of luck in your new program, Spyros!
|September 10, 2018:
The Providing Better Healthcare through Systems Engineering Seminar Series kicked off on Monday, September 10, featuring a talk from James Bagian titled, “Patient Safety Challenges and Ways to Overcome them with a Systems Approach.” Dr. James P. Bagian is the Director of the Center for Healthcare Engineering and Patient Safety (CHEPS) and is a Professor in the Department of Anesthesiology in the Medical School and the College of Engineering at the University of Michigan. The seminar was attended by members from across the University community, including the College of Engineering, Medical School, and School of Public Health.
Dr. Bagian spoke about Route Cause Analysis and Action (RCA^2). This is a technique that he developed during his time at VA to increase patient safety. This is a systems approach to finding problems in healthcare delivery as well as techniques to find a solution. The talk also touched on ways to build a culture of safety within a health organization.
Please join us next week on September 17th for the 2018 Symposium on Healthcare Engineering and Patient Safety starting at 5pm on the 3rd and 4th floors of the Lurie Engineering Center.
|September 10, 2018:
Gian-Gabriel Garcia, IOE PhD student and CHEPS collaborator, has been awarded the INFORMS Health Applications Society (HAS) Bonder Scholarship. According to INFORMS, “The purpose of the scholarship is to promote the development and application of process modeling and operations research analyses to healthcare design, delivery and operations by identifying young and promising researchers during their doctoral studies.”
“I feel honored to receive this prestigious award among the other very qualified candidates,” said Gian-Gabriel. “I am passionate about applying Operations Research to important healthcare problems and I hope that this award enables me to expand my professional network and perform this type of research for years to come. I am grateful for the guidance I’ve received from others, especially from my advisor Dr. Lavieri and collaborator Dr. Broglio, who have been critical in helping me to identify important problems and developing impactful solutions to those problems.”
Gian-Gabriel provided the following description of his research. “Traumatic Brain Injuries (TBIs) present a significant public health challenge in the U.S., with over 25 million TBIs resulting in death or hospitalization annually. Recently, the focus has sharpened on concussions, the most common type of TBI. Concussions are postulated to develop into serious long-term consequences, including cognitive impairment, depression, and neurodegenerative disease. While concussion management plays a critical role in mitigating the short- and long-term effects of concussion, it is still in its formative stages which leads to an over-reliance on physician experience. Therefore, the focus of my research are to address major challenges in concussion management by (1) using large observational data sets to design guidelines for concussion diagnosis decisions and (2) determine the optimal timing for return to pay/work when the clinical data includes self-reported symptoms which may be biased by patient objectives.”
|September 4, 2018:
CHEPSter and Industrial and Operations Engineering (IOE) PhD student Adam VanDeusen is the winner of the 2018 Seth Bonder Fellowship in IOE. The fellowship was originally established by Dr. Seth Bonder and continues through the generosity of The Seth Bonder Foundation. The award supports one IOE graduate student each year who is conducting applied operations research.
“I am very grateful to the Bonder Foundation for the continued support for advancing the field of applied operations research,” said Adam. “The Bonder Fellowship will be extremely helpful in progressing my research to improve access to healthcare services. Access to care is a critical public health issue and our interdisciplinary approach can help inform policy decision-making in this area.”
||August 31, 2018:
August sees the end of a productive and fun summer here at CHEPS. On August 1st, we enjoyed a visit from Louise Knabe, Chief Project Officer of Ariadne Labs. Her full-day visit included a Lunch & Learn, sitting in on project team meetings, and meetings with CHEPS students, faculty, and staff.
CHEPS students also enjoyed the opportunity to volunteer at Discover Engineering this month. They ran the Resident Shift Scheduling Game for students from 8th to 10th grade. Anna Learis noted that it was a similar program that sparked her interest in Industrial and Operations Engineering when she was in high school. “By introducing high school students to how IOE can make a real-world difference, I hope some of them found the same interest in the major that I have,” she said.
In addition, CHEPS and the UofM INFORMS chapter held a meeting of the Healthcare Operations Research (OR) Journal Club. This month they discussed “Ambulance redeployment and dispatching under uncertainty with personnel workload limitations.” Students also had the chance to attend Researchpalooza, which was hosted by the Michigan Medical School Office of Research. The event featured offices and labs from throughout the Medical School and University. The event also included free ice cream for all attendees which was much appreciated given how hot August has been this year in Michigan!
CHEPS isn’t just a place to work. In addition to all their project work, CHEPSters enjoyed spending time together outside of the office, especially on the traditional Social Thursdays. As Jakob Kiel-Locey put it, “It’s just awesome to meet so many other motivated undergrads and a ton of people within IOE and other majors. And we always have a good time together so it’s kind of like hanging out with a bunch of your friends and you’re doing cool stuff.”
In early August, students enjoyed several rounds of volleyball at the North Campus volleyball court. August also saw many students heading off for summer vacations before the start of the fall semester. However, there weren’t too many goodbyes because we’ll be seeing a lot of familiar faces in September! We did enjoy a summer wrap-up party with ice cream, snacks, and a pretty competitive game of Cranium.
It’s hard to believe next week is September but we’re looking forward to starting a new semester of hard work, fun, and some exciting events like our Healthcare Engineering and Patient Safety Symposium on September 17th and our Seminar Series which begins on September 10th with a talk from CHEPS Director Jim Bagian.
|August 9, 2018:
CHEPSters enjoyed several rounds of volleyball on a sunny summer afternoon. Taking advantage of the beautiful weather, the team made their way down to the beach volleyball court on the North Campus Grove and enjoyed a friendly competition. CHEPSters Jordan Goodman and Sheridan Tobin shared the MVP honors. HEPS alum and staffer Billy Pozehl joined the fun and made some great plays.
|August 8, 2018:
CHEPS students had the opportunity to attend Researchpalooza, which was hosted by the Michigan Medical School Office of Research. Representatives from 91 offices and labs had tables at the event. Attendees were able to learn about the work that takes place at the different departments within the medical school and beyond. CHEPS students visited tables of some of the departments they currently work on projects with, like the Dentistry and Pediatrics, as well as other departments like Bioinformatics and Molecular Imaging (to name a few). There was even free ice cream for everyone who participated.
|August 5, 2018:
Roshun Sankaran joined CHEPS as an undergraduate pre-med student in 2014 and continued to work with CHEPS as he pursued a master’s in Public Health. On Sunday, August 5th, 2018, the CHEPS alum recognized the start of his first year of Medical School at The University of Michigan with a White Coat Ceremony. According to the Medical School, “This tradition, known as the White Coat Ceremony, marks an educational milestone: Entry into clinical medicine. Our incoming medical students gather in the presence of their families, mentors, guests, faculty members and leaders of the Medical School to formally receive the cloak of their future profession — the white coat.”
Roshun is pictured with his parents who attended the ceremony to help him celebrate his achievements. CHEPSters will have a chance to congratulate Roshun in person in September at our alumni reunion and Symposium on Healthcare Engineering and Patient Safety.
||August 3, 2018:
CHEPS students had the opportunity to volunteer this week at Discover Engineering. The program offers students from 8th to 10th grade the opportunity to explore a variety of engineering disciplines through engaging, hands-on activities. CHEPS students ran the Resident Shift Scheduling Game as part of the Industrial and Operations Engineering track. Students in the track also had the chance to learn about ergonomics and get a tour of the biomechanics lab.
“It was great to see the students developing strategies for filling out the schedule by hand,” said Riley McKeown. “We were very impressed by the progress some of the students were able to make in filling out the schedule, and the students were even more impressed when they saw how quickly the program was able to create a schedule with no errors!”
Anna Learis truly appreciated the chance to share part of what she does at CHEPS with the visiting students. She said, “Volunteering with Discover Engineering is extremely personal to me because it was through a similar camp that I learned about IOE and began framing my college search around a strong IOE program. By introducing high school students to how IOE can make a real-world difference, I hope some of them found the same interest in the major that I have!”
||August 1, 2018:
Ariadne Labs is named after Greek mythological figure Ariadne, who is known for helping Theseus through a labyrinth by giving him a ball of string he could use to track his path. CHEPS had the pleasure of hosting Louise Knabe, Chief Project Officer of Ariadne Labs, on Wednesday, August 1, 2018. Louise said the fictional goddess of the labyrinth is a fitting comparison because “taking an incredibly complex problem and trying to find a really simple solution” is the goal at Ariadne Labs.
According to Ariadne’s website, “Ariadne Labs focuses on the most critical moments in people’s lives: childbirth, surgery, and serious illness care. Our mission is to create scalable health care solutions that deliver better care at the most critical moments in people’s lives, everywhere.” CHEPS Associate Director Amy Cohn had the opportunity to visit Ariadne earlier this year. Louise’s visit was an excellent opportunity to continue building a relationship between Ariadne and CHEPS.
Louise had a full day at CHEPS which included meetings with CHEPS students and collaborators, participating in the Glaucoma team’s weekly meeting, and delivering a lunchtime seminar. Her seminar began with an introduction to Ariadne and her role there. As Chief Project Officer, Louise does whatever needs to be done to make the organization run. She and her team work to make sure Ariadne delivers on all commitments in the most effective way possible.
As an example of Ariadne’s work, Louise described the development and dissemination of their Safe Surgery Checklist. She emphasized that their process is to 1.) identify the problem, 2.) design a simple solution, 3.) test the solution, and 4.) spread the solution. Their vision is the global adoption of their solutions and to come up with solutions that can be workable and adaptable for every patient, every time, everywhere. Like CHEPS, Ariadne takes a multi-disciplinary approach, involving experts from a variety of specialties from around the world at each step in their process.
After her presentation, Louise had a Q&A and conversation with CHEPS students which included a discussion about how Ariadne Labs could further incorporate engineers into their work. At the end of her visit, Louise said that she truly appreciated the collaborative spirit and focus on problem-solving she encountered at CHEPS.
CHEPSters thank Louise for a day of productive and intellectually stimulating conversations. We hope CHEPS and Ariadne can continue to connect.
|August 1, 2018:
The CHEPS Glaucoma Team was invited to a Center for Eye Policy and Innovation (CEPI) presentation by Michelle Hribar at the Kellogg Eye Center. Michelle works at Oregon Health Science University as an Assistant Professor and has a master’s in Industrial and Operations Engineering and a PhD in Computer Science.
The presentation, “Improving Ophthalmology Workflow Using Data Analytics”, focused on her research, which uses electronic health record timestamps to assess clinic flow and reduce wait times. One of the solutions they came up with through their analysis was a scheduling template that improved workflow and decreased bottlenecks.
Before the presentation, Michelle Hribar sat in on meeting with the Glaucoma Team to give insight into our project in the Glaucoma Clinic, using RFID readers to map patient flow and reduce wait times. It was great to learn about her experience in projects with similar goals and the original ideas they have come up with to improve the patient experience.
||July 30, 2018:
Time flies when you’re staying busy and having fun. We’ve been doing plenty of both this month at CHEPS! It’s hard to believe we’re headed into the last month of the summer semester.
Our Brunch and Learns have continued to be a fabulous way for students to share their expertise with one another. The wide variety of experience and backgrounds our community has is one of the things that makes CHEPS so special. Brunch & Learns offer everyone the chance to both share and learn skills. This month, Heather helped our students with the best ways to format their research posters; Billy discussed the use of metrics, and Anna delved into value stream mapping. The skills learned in Brunch and Learns as well as informally through the many collaborations at CHEPS benefit students in many ways. As CHEPSter and IOE PhD student Donald Richardson said, “This invaluable experience working with such a culturally and academically diverse team has allowed me to develop and hone strong communication/technical work translation, leadership, organizational, and general project engagement skills which can be utilized in my career across multiple domain areas.”
Lunch and Learns are an opportunity for student teams to keep all of CHEPS updated on what they’ve been working on throughout the summer. This month saw presentations from RITMO and SCOPES. RITMO aims to improve the transportation systems that get people, specifically underserved communities, to and from the University of Michigan Hospital. SCOPES focuses on improving endoscopy scheduling to minimize overtime, minimize waiting, minimize doctor idleness, maximize patient access to healthcare, and maximize appointment slot utilization.
We also took a week off of Lunch and Learns to see a talk by Jonathan Cohn, titled “The State of the Healthcare Debate,” hosted by the Institute for Healthcare Policy & Innovation (IHPI). The talk offered an excellent overview of how healthcare has evolved over the years in the United States, where it stands now, and where it might go in the future.
In addition to all our scholarly activities, there have been some fun social events! July saw the return of CHEPardy, everyone’s favorite CHEPS trivia game, as well as a trip to the Dexter Blueberry Farm. CHEPSters picked a whopping 40 pounds of blueberries on our visit to the farm. In addition to each person taking some home, many went home with CHEPS Associate Director Amy Cohn who has promised that her son Peter will be baking some delicious blueberry pies for all of CHEPS! Peter’s baked goods are a lesser-known but extremely appreciated benefit of working at CHEPS.
We always enjoy celebrating the accomplishments of our CHEPS community members. Theodore Endresen has been awarded a Clyde Johnson Memorial Scholarship from the Industrial and Operations Engineering Department! This is especially exciting and fitting for a CHEPS student because Clyde Johnson was a pioneer in healthcare engineering. And CHEPS SROP student, Heather Hawkins, shared an excellent poster at the SROP poster session.
Unfortunately, August approaching also means saying goodbye to some fellow CHEPSters as some leave for the summer. The good news is, many will return to CHEPS for future semesters and those who are moving on will stay in touch. Once a CHEPSter, always a CHEPSter! As HEPS Masters student John Cima said, “CHEPS had given me friends that make working at CHEPS one of the most enjoyable things that I have ever done. The people here are so smart and kind. There is no other place I would rather spend my time.”
We’re looking forward to an equally productive and exciting August!
||July 26, 2018:
Heather Hawkins, worked at CHEPS this summer as part of Rackham Graduate School’s Summer Research Opportunity Program (SROP). She finished her summer at CHEPS by showing a poster at the SROP poster session and giving her visiting parents a tour of CHEPS. They had the chance to sit in on a Brunch & Learn session on SCOPES, one of the projects Heather focused on this summer.
Below is what Heather had to say about her time here at CHEPS.
“CHEPS has been an adventure. As a student from Bradley University located in Peoria, IL, I was accustomed to a small campus and a small student body. When I came to Michigan, I was worried I would get lost both literally and figuratively. However, I was pleasantly surprised to find my small community within a much larger one in CHEPS. The students, faculty, and staff are warm and inviting and were more than happy to answer any and all of my questions. And I have truly enjoyed getting to know all of the CHEPSters during our weekly Lunch & Learns and CHEPS Thursdays.”
“CHEPS has also served as a great gateway experience to research at UM. During my time here, I had the opportunity to work on DERMA and SCOPES, two scheduling projects focused on provider scheduling and patient scheduling respectively. The former taught me several invaluable communication skills and C++. The latter put me in touch with Karmel Shehadeh, a PhD student at UM, who has been a guide to me as I journey toward my own PhD. Both of these projects have taught me the value of terminology as well as the intricacies of teamwork. Thanks to this experience, I am excited to begin the application process to UM and to see everyone here at CHEPS again.”
|July 26, 2018:
Theodore Endresen is a 2018 recipient of the Clyde Johnson Memorial Scholarship from the Department of Industrial and Operations Engineering (IOE). The scholarship is named in honor of Clyde Johnson who, in the early 1960s, led an effort, along with Dean Wilson, to collaborate with the University of Michigan Hospital to establish the first industrial engineering group within a hospital to improve its operations.
“I put a lot of effort into my coursework every year and was excited that my academic advisers recognized this by awarding me the Clyde Johnson Memorial Scholarship,” Theodore said. “Clyde Johnson was a pioneer in the healthcare engineering industry at Michigan and, as a student who works for the Center for Healthcare Engineering and Patient Safety (CHEPS), it is truly an honor to be associated with his name.”
|July 24, 2018:
For the Brunch and Learn this week, CHEPS student Heather Hawkins, who is with us from Bradley University this summer as part of the Summer Research Opportunity Program (SROP), discussed the formatting of research posters.
Content and format are two of the most important elements of the research poster. A few examples of bad content are 1.) too much content, which leads to no one wanting to read it; 2.) leaving no space on the edge or using too many charts, both of which make the poster look narrow and are not pleasing to the eye.
The content of a good poster includes a clear visual abstract of 200-800 words, not the entire project with a lot of technical language. A nice poster also uses fewer words in the title but makes the title appealing and attention-grabbing. Around half of the content should be the results and the other half can include the methods used, introduction, and conclusion.
Formatting a poster involves many factors. For instance, using color wisely can make a big difference. It’s best to use three or less main colors. Colors like white and black are always a safe choice. Typefaces are another important factor; posters should use a consistent font style and size. The recommended font sizes are 72-120 pt. for the title, 36-72 pt. for the subtitle, and 24-48 pt. for normal content. Besides the color and typefaces, the layout of the poster is also important. A good poster usually has 3 or 4 columns and the graphics should be diagonally or horizontally symmetric to balance the poster’s visual weight.
Heather offered five final takeaways: 1.) do not use your full abstract on the poster; 2.) don’t be limited to boxes, try other shapes; 3.) use handouts and samples; 4.) try the “arm test” on the font size, which means print the poster on a paper and hold it with straight arm, if you can see the text clearly then it’s good; 5.) finally, get feedback from colleagues and friends to improve your poster!
||July 19, 2018:
For this week’s social event, CHEPSters ventured out to the Dexter Blueberry Farm for some delicious, hand-picked blueberries. Everyone grabbed a bucket and marched out to the plentiful fields to find some enormous berries. A hidden blackberry bush was found amongst the blueberry bushes and everyone happily added some blackberries to their buckets. The team took a break from picking berries to engage in some blueberry tossing contests and fun conversation. Blueberries sold for $2 per pound and all the CHEPSters and Associate Director Amy Cohn picked an estimated 40lbs of blueberries! The average pie requires around 1.5lbs of blueberries so everyone is looking forward to baking some delicious pies and blending some tasty smoothies with all the fresh fruit. Another successful and rewarding CHEPS social event is in the books!
|July 19, 2018:
Instead of the normal Thursday Lunch & Learn, CHEPSters attended Jonathan Cohn’s seminar, The State of the Healthcare Debate, hosted by the Institute for Healthcare Policy & Innovation (IHPI). The Research Auditorium was packed with a variety of students, faculty, and staff.
To begin, Cohn described how healthcare evolved in the U.S. over the years: Americans first received health insurance from their employers, usually big companies. However, many employed by small companies, younger and older people, poor people, or people living with a disability were not covered by this system. Medicare, for the elderly, and Medicaid, for children and pregnant women, were created to help combat this issue, but millions were still without coverage. These individuals turned to insurance companies who quickly realized their customers had a very high risk (high cost) of healthcare, and the companies began discriminating against these high-risk customers. The Democratic party, backed by President Barrack Obama, tried to enact a universal healthcare policy, but their first attempt didn’t leave the Senate floor. However, the state of Massachusetts gave Obama and his party a new hope and a new plan.
Massachusetts’ system was simple: provide Medicaid to the poor, control the cost of healthcare systems, and The Three-Legged Stool. One leg is to not discriminate against high-risk individuals and require benefits for every insurance plan. The second is to require everyone to be on this insurance system. Lastly, subsidies would be provided for those who could not pay for their own healthcare. They hoped that this bill would be more attractive to the Republicans. Conservatives had a few changes, most notably that states had majority control of implementation. Over the years, Cohn explains, those states that wanted the Affordable Care Act to work thrived under the Affordable Care Act, but those that didn’t want it to work found the Affordable Care Act to be lacking.
Like any product or service, quality healthcare is expensive, and attempting to pay for it with less money, Cohn says, is impossible. Still, the Republican party recently came up with a plan that, at the end of the day, wasn’t significantly better than Obamacare, Cohn said. Cohn describes the public’s reaction: The plans weren’t that different, and people liked being on Medicaid. Looking to the future, Cohn sees two paths: completely repeal Obamacare or completely enact it. He notes that once the public receives a benefit, the government is hard pressed to take it away from them. “There’s a lot of people unhappy with where healthcare is today, but not a lot of people who want to go back,” he said. Universal healthcare is not perfect and will probably undergo several alterations; however, it is also probably here to stay.
|July 17, 2018:
For the Brunch and Learn this week, Billy Pozehl, CHEPS Research Area Specialist, discussed the use of metrics within the provider scheduling template. He provided an overview of both what a metric is conceptually and realistically how CHEPS implements metrics within its projects.
Conceptually, metrics are defined as a linear system of equations that should be minimized within an optimization problem. Projects within CHEPS, such as BLOCK, use metrics to minimize requests denied for their overall objective. On the other hand, the infrastructure to practically implement the idea of metrics resides within the CHEPS provider scheduling template. Here, students can find a means of defining a metric (through MetricParams.txt) by specifying a metric name, lower bound, upper bound, weight, and variable type. Moreover, the template provides the functionality to build the metric such that the CPLEX library and corresponding decision/auxiliary variables can interpret it (implementing a metric definition function), and to understand the values that were solved by converting the CPLEX variables into C++ variables. Overall, metrics are an integral part of the provider scheduling projects here at CHEPS.
|July 12, 2018:
For this week’s Lunch and Learn, the SCOPES team discussed their project. SCOPES, which stands for System of Concepts for Optimization and Personalization of Endoscopy Scheduling, focuses on developing a tool to evaluate several outpatient scheduling templates and policies based on but not limited to: minimizing overtime, minimizing waiting, minimizing doctor idleness, maximizing patient access to healthcare, and maximizing appointment slot utilization. The team is developing a Dynamic Scheduling Simulation Tool in Excel to evaluate and compare several scheduling templates and policies. For the future, the team will collect data on the number of patient types and on the appointments request rate for each patient type. They will also create a simulation scheduling tool in Python and convert the simulation model into a scheduling tool to determine optimal template-policy pairing for any clinic.
|July 10, 2018:
At this week’s Brunch and Learn, CHEPS student Anna Learis presented a crash course on value stream mapping. She explained how value stream maps can be used to visually outline a system’s process flow in order to help identify, and eventually eliminate, waste. After her presentation, students broke into teams and practiced using these skills by drawing out rough drafts of value stream maps for some current CHEPS projects.
||July 6, 2018:
On July 6th, Brian and Kate Lemay welcomed Owen Atlas into the world as the newest member of the CHEPS family. Owen proudly wears his CHEPS onesie and looks forward to working with CHEPS someday in the future.
Brian and Kate met in IOE 425 “Decision Analysis.” Kate earned both her BS and MSE in IOE from Michigan. Brian completed his dissertation, “Addressing Challenges in Healthcare Provider Scheduling,” and earned his Michigan IOE PhD in 2017. His paper “New Methods for Resolving Conflicting Requests with Examples from Medical Residency Scheduling,” co-authored by Amy Cohn, Marina Epelman, and Steve Gorga, received the Murty Prize for best optimization paper by an IOE student and was published in the Production and Operations Management journal.
Brian currently serves as a Major in the U.S. Air Force where he runs the Analyses, Assessments, and Lessons Learned division of Air Force Special Operations Command. Following his current assignment, Brian will return to the United States Air Force Academy (his alma mater) where he will teach Operations Research in the Department of Management.
|July 5, 2018:
The RITMO team presented at this week’s Lunch and Learn. The goal of this project is to improve the transportation systems that get people, specifically underserved communities, to and from the UM Hospital. By analyzing census and patient data, the team has been able to classify different areas of the Ann Arbor community based on risk. The team has also analyzed travel time between the UM Hospital and communities in Ann Arbor for both personal vehicles and public transportation using Google’s API. With all this information, the team can pinpoint areas where transportation systems need the most improvement.
|June 29, 2018:
At this week’s Lunch and Learn CHEPS students had the privilege to hear about CHEPS Director Jim Bagian’s experiences working at NASA. He focused on his experiences understanding the Challenger and Columbia disasters.
First Dr. Bagian discussed the Challenger disaster and the aftermath of recovering fragments of the shuttle on the ocean floor afterward. He discussed how the crew most likely survived the break up of the shuttle but could not survive the impact from hitting the ocean as there was no ejection system to escape the shuttle. Because there was no emergency evacuation system, Dr. Bagian worked on designing one. He discussed the methods and process he took to design a telescoping pole that would allow one to escape the shuttle.
Then Dr. Bagian discussed his involvement in assessing the aftermath of the Columbia disaster, where a piece of foam broke off and struck the side of the shuttle. He showed us footage of the crew prior to the crash and showed us how they tracked and collected the debris across Texas. He also showed us a video of them testing the ability of foam to break through a shuttle.
Thank you to Dr. Bagian for a fascinating talk!
||June 27, 2018:
This week, four CHEPSters volunteered at the Industrial and Operations Engineering (IOE) workshop for Xplore Engineering, an Engineering camp providing hands-on experiences to children of a variety of ages.
The students helped the children work in a workshop simulating a candy factory assembly line, consisting of stations including assembling the products, wrapping them with paper and placing them on a conveyor belt, labeling the product, wrapping the candy with a ribbon, and undergoing quality control to make sure products were not defective. Between rounds, children had the opportunity to make changes to the process to be able to produce more candy in the same amount of time.
The children instantly got engaged with the activity and started communicating with each other to try to see where bottlenecks occurred and how the process could be improved. Overall, the children were happy to be there, parents were thankful for the volunteers, and the CHEPS students had fun spreading their enjoyment of IOE with others.
|June 26, 2018:
June has been another exciting and productive month here at CHEPS. Our twice a week summer Lunch and Learns have morphed to Tuesday Brunch and Learns and Thursday Lunch and Learns, proving that CHEPSters are ready for both learning and food at all times of the day. Topics this month have ranged from projects like MSafety and Glaucoma to practical tips on computer use and design. Every Brunch/Lunch and Learn provides a valuable opportunity for students to share expertise and collaborate.
Today, students learned some design principles from Malcolm Maturen. While the skills developed at the Brunch and Learn will be valuable for academic and professional presentations, this morning they practiced by designing slides describing their superhero alter-egos.
This week’s Lunch and Learn promises more exciting content. CHEPS Director Jim Bagian will be discussing both healthcare and his experiences as an astronaut with CHEPS students. Jim along with Joe Derossier, CHEPS Program Manager, also led an RCA2 training earlier this month, giving students and other attendees a chance to learn from their expertise in the topic.
In between events like those above, days consist mainly of project work and project team meetings. For insight into just a few CHEPS projects, past and present, see our in-progress project page. We’ll be updating it throughout the summer and beyond.
While everyone is working hard this summer, it’s nice to have the occasional break to enjoy hanging out with each other too! When we don’t have a Lunch & Learn, lunches have proved a good time to take a short break and catch up on The World Cup together. And, we’re looking forward to the return of CHEPS Trivia (or as alum Ryan Chen suggested “CHEPardy”) for this Thursday evening’s social event! Anna Learis premiered CHEPS Trivia last month and it is back by popular demand.
|June 26, 2018:
At this week’s Brunch and Learn, CHEPS student Malcolm Maturen presented about principles of design. During the presentation, he went over various ways to effectively use color, font, and alignment in order to convey information. He also expressed that consistency is of the utmost importance in design. After going over these topics, Malcolm had a surprise activity for all of his fellow CHEPS students – designing PowerPoint slides for their superhero alter egos. Thanks to Malcolm, everyone at CHEPS was able to learn some helpful design principles and have some fun to kick off the work day!
Below are a few sample slides from the activity.
|June 22, 2018:
CHEPS student Adam VanDeusen shared his research with K-12 STEM teachers who were visiting campus on June 22 to take part in the REACT (Research Education and Activities for Classroom Teaching) Workshop. This workshop is led by students in Macromolecular Science and Engineering and shares the meaningful research being conducted at the University of Michigan with teachers who participate in lab tours, activities, and research talks. Adam gave a brief overview of operations research methods and applications and then discussed his work on access to eye care for veterans.
A video of Adam’s talk can be viewed below.
|June 21, 2018:
For this week’s Lunch and Learn, the M-Safety Project 1 team discussed their project. M-Safety Project 1 focuses on improving provider awareness of catheters. The team shared that there are few signs in patient rooms regarding the existence of catheters, so many providers are unaware that patients have a catheter in place. When catheters have been in for too long, infections can occur, so it is important that providers have information readily available about catheters. The team is working to create a display that accurately shows catheter and skin wound information near the patient’s bedside, so providers have easy access to the information. The display should convey the important information in an efficient and attractive way. The team has gone through multiple iterations of the design to ensure it meets provider criteria.
||June 20, 2018:
CHEPS Associate Director Amy Cohn attended the INFORMS International Meeting in Taipei from June 17th -20th, 2018 where she delivered a talk titled “Challenges in Residency Scheduling.” She also had the opportunity to enjoy the plenary talk by Oleg Gusikhin, Technical Leader at Ford Motor Company and Lecturer in Industrial and Operations Engineering (IOE) at The University of Michigan, on “Smart Production of Smart Vehicles.”
IOE alum Richard Chen was attending the conference as well and, as a native of Taiwan, was able to serve as tour guide for some of the Cohn family excursions that took place after the conference. Professor Cohn also enjoyed the chance to catch up with another IOE alum, Wanshan Zhu. In addition to the conference, highlights of the trip included hiking Elephant Mountain, visiting the old mining town of Jiufen, enjoying the view from the top of Taipei 101 which is the eighth tallest building in the world, and, of course, eating soup dumplings and mochi.
|June 19, 2018:
At this week’s Brunch and Learn, CHEPS student Kristine Wang presented a few techniques of basic error checking in C++. CHEPSters learned practical applications such as verifying the size of input files and finding variables of the wrong data type. Thanks to Kristine, students wanting to learn to code will have some skills to prevent bugs from occurring in their programs.
|June 18, 2018:
A few CHEPS students volunteered to help out with the Girls in Science and Engineering (GISE) summer day camp here at U of M. 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. The campers were able to learn about engineering through several interactive activities, including an Emergency Department (E.D.) Simulation.
The simulation is a game that teaches important principles of Industrial and Operations Engineering. The campers were each assigned a role in the game; some were patients, triage nurses, E.D. physicians, etc. The objective of the simulation was to get as many patients through the hospital in a given time period. After each round of the simulation, the girls were able to make one change to improve the system.
Right away, the campers seemed excited with their role-playing and were 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 Industrial and Operations Engineering and saw how they were used in a real-world example.
||June 15, 2018:
In an environment such as healthcare, where the stakes are constantly high, it can be easy to resort to knee-jerk resolutions that focus on proximate causes of patient adverse events and close calls. As systems grow increasingly complex, however, it is imperative that we choose to analyze the underlying contributing causes of a problem, rather than superficial actions that place blame on individuals and focus exclusively on individually focused interventions such as training.
On Friday, June 15th, CHEPSters attended a Root Cause Analysis and Action (RCA2) training given by Director Jim Bagian and Program Manager Joseph DeRosier. This program was developed by Jim and Joe and has been implemented in hospitals across the nation. Its premise may seem simple; break down an incident until the actual root causes and contributing factors are exposed, and develop a series of actions to address them. Unfortunately, often the bureaucracy and complexity of systems get in the way of this approach. RCA2 is complete with tools to address administrative barriers.
RCA2 focuses on a multidisciplinary team, with a combination of unique perspectives, that meets to assess an adverse. By going past areas most investigations typically stop at, such as human error or lack of policy, RCA2 creates an environment where a systems-based assessment exposes factors that contributed to an event. Jim and Joe also detailed the importance of action following these assessments; structural design changes are stronger actions than those actions that require individuals to rely on their memory such as policy and procedure changes or training.
Above all, it is important to carry forward the mentality that RCA2 is built upon. This is particularly a responsibility in an environment such as healthcare, where patient safety is a constant top priority. Problems are multidisciplinary, multifaceted, and should always result in actions that concentrate on systems-based interventions that focus on prevention or mitigation of harm over blame of individuals associated with the event in question.
||June 13, 2018:
The social event at CHEPS this week was a visit to the Ann Arbor Summer Festival to watch Annie & Rodd Capps perform. Ann Arbor Summer Festival takes place on Ingalls Mall in front of Rackham Auditorium and runs through July 1st.
CHEPSters gathered in the grotto and on the lawn to listen to the music, eat, drink and socialize. There were food stalls from Ann Arbor restaurants and a good sized crowd hanging out. CHEPSters are looking forward to other events at AASF, such as late-night movies, classes, and more live performances!
|June 12, 2018:
Timely access to outpatient healthcare, and in particular to specialty care, is a significant challenge nationally. Although insufficient numbers of providers/appointments can contribute to this, existing capacity may also be scheduled inefficiently. CHEPS collaborated with Dr. Amy Rothberg of the Metabolism, Endocrinology, and Diabetes (MEND) clinic at the University of Michigan in order to develop a methodology to more deeply understand the relationship between scheduling policies, patient cancellation behaviors, and capacity utilization.
This work resulted in a paper titled “Access and Utilization: Methods for Analyzing Appointment Scheduling in Outpatient Specialty Care Clinics,” which the authors have just submitted for peer review. You can learn more on the MEND project page.
||June 7, 2018:
After a day of hard work and team meetings, CHEPSters headed to the Nichols Arboretum together to visit the peony garden. The garden is a summer highlight in Ann Arbor and late May to early June is the ideal time to see the peonies in bloom.
After enjoying the peonies, the group traveled further into Nichols Arboretum and happened across Fairy Woods and Troll Hollow, an area that invites visitors to build a home for fairies or trolls that may be visiting the area. CHEPSters constructed a dwelling fit for the most discerning fairy or troll, complete with a tree stump to sit on. The visit concluded with a brief attempt at playing Frisbee that ended in everyone putting their teamwork skills to use to successfully rescue a Frisbee from an incredibly tall tree.
|June 7, 2018:
For this week’s Lunch and Learn, CHEPSters gathered to learn about the Glaucoma project. The Glaucoma project implements cutting edge Radio Frequency ID (RFID) technology to track patients and providers at the Glaucoma Clinic at the Kellogg Eye Center. The major goal of the project is to investigate and optimize patient wait times using a variety of methods. The past couple years of the project have focused on designing and implementing the RFID system to collect relevant user data. Moving forward, the team will work to analyze collected data and test optimization strategies.
|June 7, 2018:
CHEPS students Dima Chaar and Sheridan Tobin volunteered at the Precision Medicine World Conference 2018 Michigan, hosted at the University of Michigan, from June 6 to June 7, 2018. The conference coincides with the launch of the University of Michigan’s Precision Health Initiative (PHI), a multidisciplinary initiative involving U-M’s Medical, Engineering, Pharmacy, and Public Health schools.
While assisting at the conference to help it run smoothly, Dima and Sheridan had the opportunity to learn first-hand about the latest research in precision medicine and cutting-edge strategies and solutions that are contributing to the future of healthcare. The conference also gave the CHEPS students the opportunity to network with academic and industry leaders in this field. A highlight of the conference was hearing opening remarks from U-M President Mark Schlissel and a keynote address from NIH director Dr. Francis Collins. Dima and Sheridan look forward to bringing all of the valuable things they have learned back to their PHI project team!
|June 5, 2018:
At today’s Lunch and Learn, led by Billy Pozehl, CHEPS students met a learned how to remote login into the center’s computers to improve data security. They also discussed ways to improve the workflow and workspace with suggestions about new computers, accessories, and office equipment.
|May 31, 2018:
This summer, CHEPS is holding a Lunch and Learn series where CHEPSters share with each other both the knowledge and the expertise developed while working on different projects at CHEPS. On Thursday, Wesley Chen, a HEPS master’s student, Muhammad Ugur, an undergraduate student in CS, Malcolm Maturen, and Malcolm Huson, both undergraduates in IOE, presented on the Surgical Instruments project.
Wesley started the talk by explaining how they aim in the Surgical Instruments team to assist fellows at the Central Sterile Processing Department (CSPD) of Michigan Medicine to achieve their reprocessing goal. Excited by the initial outcomes and the quality of the CHEPSters’ work, CSPD sought additional support from the team on fire safety in the surgical room, technical consultancy for adopting new technology designed for testing insulation integrity of electrosurgical instruments, and creating a cleanability dashboard on which challenges related to surgical instruments cleaning are quantified.
The session concluded with an intercultural celebration. Hanan Al-Awadhi, a HEPS master’s student, shared with the other CHEPSters a tradition that is practiced during the middle of Ramadan in Kuwait. Gargee’an is a celebration that is observed in the Gulf region on the 14th and 15th nights of Ramadan where children dress in traditional outfits and go door-to-door to receive sweets and nuts from neighbors while singing traditional songs. CHEPSters, who manage to excel in every task, managed too to sing the Gargee’an song in Arabic for Billy. Everyone at once sang “Sallim “Billy” ya Allah, Khallah li omha ya Allah” meaning “Oh God, protect “Billy” from every evil, let him have a long life for the sake of his mother.” Then came the time to enjoy the Gargee’an treats brought by Hanan!
|May 31, 2018:
It’s hard to believe the end of May is upon us. Some might think things are quiet on the University of Michigan campus at this time of year but CHEPS is in full swing. With fewer classes, summer offers an opportunity for CHEPSters to focus more fully on their CHEPS projects, meaning we stay incredibly busy.
In addition to focused work on our wide variety of projects, this week we kicked off a series of summer Lunch and Learn sessions for CHEPS students. Karmel Shehadeh led an informational workshop on LaTeX and Overleaf, an interface for technical writing, on Tuesday. On Thursday, the Surgical Instruments team updated the rest of CHEPS on their progress. Lunch and Learns throughout the summer will help students learn valuable skills and share their work, ideas, and suggestions with one another.
While working hard, students are still finding time to have fun. We enjoyed a lunch with a long-time friend of CHEPS, Merrill Bonder of The Bonder Foundation on Wednesday. Her visits are always a highlight! And, at the start of Thursday’s Lunch and Learn, HEPS master’s student Hanan AlAwadhi shared candy and a traditional song with her fellow CHEPSters to introduce us to Gargee’an, a celebration that is observed in the Gulf region on the 14th and 15th nights of Ramadan where children dress in traditional outfits and go door-to-door to receive sweets and nuts from neighbors, while singing traditional songs.
We’re looking forward to a fun and productive June as well!
|May 30, 2018:
College students are great at a handful of things; making ramen, procrastinating, and coming up with novel solutions. Unfortunately, due to the circumstances of our environment, we often lack the means of transitioning these ideas from abstract thoughts to concrete reality. Between a lack of resources, packed schedules, and the relative absence of a professional network, students frequently find a plethora of barriers on the path of knowledge and independence.
It is often only through the altruistic acts of diligent and empathic professionals that allow many of us to move in the directions we wish to. This week, we were lucky enough to welcome Merrill Bonder; head of the Bonder Foundation and long-term CHEPS friend. After much hard work, Merrill and her late husband Seth have helped to support students across the country for years.
CHEPS student and IOE undergraduate Alexander Mize said, “Meeting Merrill and listening to her husband’s legacy was surprisingly inspiring for only a 2-hour lunch. Seth Bonder’s passion for mentoring students touched on my own passion in helping younger children. Hearing how the Bonder Foundation continues to support students in Florida and at U of M is an amazing principle to carry on as I continue down my career path.”
Merrill took time and care to emphasize the importance she sees in aiding students and the rippling effect that mentorship can have on the future of young minds. Simple and consistent actions can change a person’s entire desire to study and achieve more than baseline requirements. Students and staff took time to reflect on how the CHEPS network has directly benefitted from this, as we now have involved alumni spread across disciplines and states.
In place of desiring deservedly-large amounts of thanks and praise, however, Mrs. Bonder made sure to reiterate the overarching mission of support that extends beyond her foundation. As direct benefactors of this passion and general pursuers of knowledge, the human responsibility is now ours as well. It is the duty of each and every one of us to continue this legacy of sharing, mentoring, and aiding those around us.
|May 29, 2018:
On Tuesday, May 29th, IOE PhD student and CHEPSter, Karmel Shehadeh, lead a workshop on LaTeX for CHEPS students. Karmel taught the use and basics behind LaTeX with her crash course session. The proficiency and functionality of LaTeX far surpass Word in terms of professional and research related necessities, so the Lunch and Learn was extremely helpful for the students. Thanks, Karmel!
|May 24, 2018:
CHEPS students gathered for trivia and snacks on Thursday, May 24, 2018 to kick off another exciting and productive summer at CHEPS. Students had a great time playing trivia and welcoming new students while catching up with returning members of the team. The two rounds of trivia included categories such as songs of summer, Michigan sports, city skylines, and movies. After trivia, the students got dinner together for some more summer fun.
||May 22, 2018:
On May 19th to 22nd CHEPS students and staff had the opportunity to attend the Institute of Industrial Systems Engineering conference in Orlando, Florida. According to the IISE website, “IISE is the world’s largest professional society dedicated solely to the support of the profession and is an international, nonprofit association that provides leadership for the application, education, training, research, and development of industrial and systems engineering.” Students and staff had the opportunity to learn and engage with other professionals and students about their field of study and interests. While at the conference, students were able to attend presentations and posters presented by both professionals and students in industrial and systems engineering.
While at the conference, several of the students had the opportunity to give 20-minute presentations that showcased the work they are presently doing for CHEPS. Justin Rogers, an undergraduate student in Industrial Operations Engineering, presented his work titled, “Creating a Computerized Tool to Schedule Dermatology Residents Each Month”. Matt See, an undergraduate student studying chemistry, presented his work titled, “An Approach to Improve Chemotherapy Make-Ahead Policies.” Trevor Hoffman, an incoming Master’s student in Industrial Operations Engineering, presented his work titled, “Classifying and Reducing Wait Times Using Radio Frequency Identification Technology.” Wesley Chen, a Master’s Student in Industrial Operations Engineering, presented his work titled, “Introduction of a Standardized Decontamination Process in Sterile Processing Departments.” Donald Richardson, a PhD student in Industrial Operations Engineering, presented his work titled, “Improving Chemotherapy Make-ahead Policies through Discrete Event Simulation.’ Junhong Guo, a PhD student, presented his work titled, “Methods to Reduce Solving Time of a Rotation Scheduling Problem.” Lastly, William Pozehl, a CHEPS staff member, presented his work titled, “Optimizing Resident Call Assignments.”
Junhong said, “The conference was fantastic. I really appreciated this opportunity to share our work with the peers and colleagues from different institutions. In addition, I also got the chance to meet with other doctoral students, especially those senior PhDs who are going to graduate very soon, which helped me learn a lot about the current trend of the academic research and job market’s interests.”
Other students also had fantastic experiences at the conference. Trevor said, “I found the sessions I was able to attend very interesting, but what I appreciated most was hearing about another project dealing with using technology in a clinic setting to track patients. It also confirmed that our method for the Glaucoma project might be working a bit better than expected.”
In addition to attending presentations and poster walkthroughs, IISE gave students plenty of networking opportunities. Our Michigan engineers were able to mingle with other students from schools across the nation and met some students from as far away as Mexico.
CHEPS student Trevor enjoyed attending IISE because it gave him more insight on the connection between healthcare and industrial and system engineering. HEPS masters student Wesley really liked how diverse Industrial Systems Engineering can be and how it can really relate to anything.
Outside of the conference, students were able to enjoy the warmth of the Florida sun while lounging near the pool. The conference was held only a boat ride away from Universal Studios so students were able to take trips down to the City Walk of Universal Studios. Overall, this trip was not only a great way to learn more about industrial systems engineering but also a great way to connect with other CHEPS students.
|May 19, 2018:
Congrats to Leslie McDonough on the birth of her son, Finnegan Robert! Leslie spent some time with CHEPS when she was a medical student at The University of Michigan. We’re pleased to welcome someone as adorable as Finnegan Robert to the extended CHEPS family and are delighted to see he’s already showing his Michigan Spirit.
|May 18, 2018:
Congratulations to our most recent CHEPS graduates: Tristan Clark, Erick Dagenais, Jiaoyang Li, Josh Lustig, Dale Malette, Ian McKenzie, Samantha Roth, Hwon Tak, and Bill Zang! We can’t wait to see what the future holds for each of them. Read their reflections on their time at CHEPS and see what their post-CHEPS plans are below.
Jiaoyang (Summer) Li
|May 8, 2018:
CHEPS students, while enjoying refreshing ice cream floats, attended a webinar titled “How the Internet of Things is Enabling the Medical Device Market.” This hour-long talk given by Joe Pleshek, President & CEO of Terso Solutions, and Mark Van Sumeren, Managing Director at Health Industry Advisor, LLC, focused on the increased use of RFID and Internet of Things technology in the supply chain management of the healthcare sector. They discussed the possible cause of this trend and the effect on the market as a whole as well as the differences between traditional supply chain management and healthcare supply chain. They also offered ideas on how to improve or initiate the use of this technology in today’s market and into the future.
|May 3, 2018:
CHEPS students had the opportunity to attend the MIDAS (Michigan Institute for Data Science) Transportation Research Challenge Symposium. At this event, students listened to and participated in a discussion on different aspects of using data sciences for transportation problems that are being solved here at the University of Michigan. During the poster session, CHEPS student John Cima presented a poster on the impact of public transportation in Ann Arbor and access to the healthcare system. Attending this symposium and talking to others there gave these students ideas on how to improve their transportation research going into the summer.
|April 24, 2018:
Healthcare Engineering and Patient Safety (HEPS) masters alum Rachel Moeckel has accepted a position at the VA Ann Arbor Healthcare System as a Health Systems Specialist (Access Coordinator). Rachel graduated from The University of Michigan in Fall 2017 with a masters degree in Industrial and Operations Engineering with the HEPS concentration. The VA Ann Arbor Healthcare System provides healthcare services for veterans in southern Michigan and northern portions of Ohio. The main hospital campus, which is located in Ann Arbor, is a referral center for specialty care and holds 109 acute care beds and 40 Community Living Center (extended care) beds.
|April 11, 2018:
CHEPS and the University of Michigan’s INFORMS chapter have collaborated to launch a Healthcare Operations Research (OR) Journal Club. The journal club is intended for graduate students and highly-motivated undergraduates working in healthcare applications to discuss the latest OR methods that are being applied in the field.
Papers recently reviewed include Robust Postdonation Blood Screening Under Prevalence Rate Uncertainty (El-Amine, Bish, and Bish) and Data Uncertainty in Markov Chains: Application to Cost-Effectiveness Analyses of Medical Innovations (Goh et al.). Great discussions about these papers have helped bring new ideas to how students can formulate their research.
Participation in the first sessions has ranged from undergrads to post-doctoral researchers. We look forward to continuing to discuss innovative healthcare OR articles over the summer!
|April 1, 2018:
CHEPS alum Spyros Potiris (pictured here with CHEPS Associate Director Amy Cohn) has just been admitted to the MPH program in Health Management at the Harvard School of Public Health.
“Industrial Engineers bring a unique approach and skill set to address major challenges in healthcare,” Spyros said. “Combining my IE background with a strategic perspective on healthcare operations and a better understanding of healthcare policy gained through the MPH program will allow me to guide institutions in delivering safe, affordable, accessible and efficient care.”
For the past 4 years, Spyros has held various positions at the Dana-Farber Cancer Institute in Boston. He is currently the program manager for the EHR operations team, focusing on designing and implementing initiatives to improve EHR-dependent processes, and promoting organizational efficiency in clinical and revenue cycle operations.
He says of his time at Dana-Farber, “I enjoy collaborating with diverse groups of organizational leaders to improve operational performance and the quality of services delivered at Dana-Farber Cancer Institute.”
Spyros graduated from UM in December 2013 with a master’s degree in Industrial and Operations Engineering and a concentration in Healthcare Engineering and Patient Safety through CHEPS.
“Through CHEPS, I had the opportunity to work on real healthcare challenges in a multidisciplinary environment, which helped me transition smoothly into my professional career, and be able to hit the ground running,” he said. “On top of that, I got to meet many students who shared the same interests as me, and make great friends along the way!”
|March 6, 2018:
CHEPS Associate Director Amy Cohn recently visited Northwestern University to give a talk on “Modeling and Implementation Challenges in Scheduling Medical Residents” and share the work we’re doing at CHEPS with colleagues and students. While there, she was able to have a mini-reunion with former CHEPS student Moses Chan, now a PhD student at Northwestern. She enjoyed hearing about his research and his new home. All of us here at CHEPS hope he’ll be returning to Ann Arbor for the CHEPS symposium and reunion in the fall!
||February 23, 2018:
From February 21st to 23rd 2018, multiple CHEPS students and staff had the opportunity to attend the Society for Health System’s ‘Healthcare Systems Process Improvement’ conference in Atlanta. The conference was attended by professionals in both academics and the healthcare industry as well as students from around the world. While at the conference, the students were able to attend and present at sessions on topics like patient safety and process improvement.
Several of the CHEPS students gave talks about their own research during the conference sessions: Adam VanDeusen, a PhD student in Industrial Operations Engineering, presented his work titled, “Applying Systems Engineering Methods to Address Healthcare Access.” Billy Pozehl, a staff member at CHEPS and HEPS master’s alumni, presented on his scheduling work, “Applying Optimization Techniques to Surgical Call Scheduling.” Lastly, Chloe Smither, an Industrial Operations Engineering senior, presented on her work, “Clinic Scheduling for a Dermatology Residency Program.”
Chloe Smither said, “The SHS conference was a really rewarding experience, and I am very grateful to have had the opportunity to attend the conference. I thought my presentation went well, and I enjoyed the chance to talk to people about the specifics of the project during the questions portion. It was definitely exciting to share the work we have done on the Dermatology project. I also learned a lot from other speakers through their thoughts and research on improving healthcare systems.”
Other CHEPS students participated in poster sessions during the conference. Industrial Operations master’s student John Cima presented his poster on “Public Transportation and its Effect on Access to Healthcare.” Lauren Hirth, a junior in Biomedical Engineering, presented her research in a poster titled, “Developing and Implementing a New Standard Process for the Decontamination of Surgical Instruments.”
In addition to their presenting experiences, the students also engaged in many other networking and learning opportunities. Student Adam Van Deusen reflected that “the SHS conference was a great opportunity to meet peers and reconnect with colleagues at other institutions.” He also enjoyed attending the SHS sessions. Adam’s favorite session of the conference was from James Hereford, President and CEO of Fairview Health Services, who presented on the quality improvement force at his organization.
CHEPS student Lauren Hirth enjoyed meeting other conference attendees while presenting during the poster sessions. Lauren loved being able to discuss her research with a variety of professionals that work in the health systems field. She explained, “the projects I’m involved with through CHEPS seem to be very unique on Michigan’s campus, but at SHS it was exciting to be surrounded by people with long histories within the field.” Lauren also commented that she enjoyed hanging out with the other CHEPS students in Atlanta.
Outside of the conference, the students were able to relax a bit and enjoyed seeing Atlanta. The group was even able to connect with a couple of recent CHEPS alumni that now work in the city. Over dinner, students were able to get to know the alumni and hear about their work. It was a great opportunity to strengthen the CHEPS network while reconnecting old friends and cultivating new relationships.
||February 17, 2018:
On February 17, 2018, CHEPSter Bassel Salka and members of the Arab Student Association (ASA) held Arab Xpressions, an event focused on celebrating Arab culture, addressing stereotypes, and uniting the University of Michigan Arab community through an entertaining evening. The program included seven dance groups, four student talent showcases, a fashion show and much more. Abdul El-Sayed, a Michigan alumni and Rhode Scholar, was a guest speaker.
“I put my heart and soul into it,” Bassel said. “It was really cool to see the community come together.” He stressed the importance of recognizing multiple cultures and identities that fall under the Arab category. “When people think of Arab they think of one thing but really what we think of as “Arab” is so different depending on the region you are talking about. For example, North African Arabs are different than those from the Levant. So with so many different unique cultures, we’re trying to be as representative as possible of everyone”. He says the group is continuing to try to expand that representation and inclusion in next year’s event.
This year was by far the largest Arab Xpressions event to date. When Bassel became a member of the ASA as a freshman, the Arab Xpressions event was held in the Michigan Union and drew a crowd of about 300 people. Last year, when Bassel joined the board of the Arab Student Association, the group stepped up organization and built a program focused more heavily on Arab culture. The event moved to Mendelssohn Theater and the audience grew to around 600 attendees.
That momentum continued to build this year. Bassel, now co-president of the ASA along with Rasha Jawad, worked with over twenty students to organize and plan this year’s event. They sold over 1300 tickets, effectively selling out the Power Center. In addition to dance groups, talent showcases, and a fashion show, the event focused on important community conversations.
“Although it’s fun to enjoy the music and dance of our culture, we also wanted the event to also focus on Arab American identity; this resulted in some more serious aspects of the show. Serious topics included talking about portrayal in the media, addressing stereotypes, and describing Arab student activism on campus. An example of a topic that was discussed was the We Exist Campaign. Essentially, this movement calls for a Middle Eastern/North African box to be added on University forms so that we can have our students’ progress documented and receive the proper resources allocated by the University,” Bassel explained.
“The most rewarding part of the show was having so many students find a sense of community,” Bassel said. “There’s something special about being with people who share the same values, have the same kind of experiences, and speak the same language as you. Being able to give students the opportunity to meet people like them, that was really cool.”
There was another group of attendees Bassel appreciated as well. “It was really rewarding to see a lot of my non-Arab friends enjoy the event, especially those from CHEPS. We had about nine people from CHEPS come out. They were amazed to learn more about a culture they weren’t as familiar with. We were able to change the rhetoric that you usually hear on the news so that was really beneficial.”
Arab Xpressions will continue to grow. Bassel says the group is looking at ways to hand over leadership of next year’s event and get even more students involved. Many of the people who were involved this year will serve as mentors to the new group.
|February 3, 2018:
CHEPS students Anna Learis, Riley McKeown, and Justin Rogers attended the Great Lakes IISE Regional Conference at the Ohio State University from February 2nd to February 3rd, 2018. The conference gave attendees the chance to network with and listen to speakers from industries, take plant tours to learn about processes and potential employers and start forming their own professional networks with other up-and-coming students.
The group won one of the competition awards for an assembly line competition. They were also awarded best dressed at the conference.
Anna Learis said, “What I enjoyed about the conference was the opportunity to network with other IOE students from different schools in the region, such as Wayne State and OSU. Additionally, there were speakers from many industry sectors and learning about their different career paths and histories was a very engaging opportunity.”
||February 2, 2018:
Center for Healthcare Engineering and Patient Safety (CHEPS) Associate Director Amy Cohn traveled to the University of Wisconsin – Madison to give a lecture on CHEPS and the research taking place at the University of Michigan at the intersection of healthcare and engineering on February 2, 2018. She was hosted by Gabriel Zayas-Caban, formerly a post-doctorate research fellow at CHEPS and now an assistant professor of Industrial and Systems Engineering at the UW – Madison. He works with the Wisconsin Institute for Healthcare Systems Engineering (WIHSE), an institute similar to CHEPS.
In addition to delivering a talk, Professor Cohn was able to meet up with graduate students in the WIHSE program. She also met with Maicen Stuart, a student interested in pursuing graduate studies at the University of Michigan, as well as two University of Michigan alums, Jinshan Li and Shiyu Zhou, both of whom are now on the faculty at UW – Madison. The visit was a valuable opportunity to compare notes about CHEPS and similar programs happing at the UW – Madison, where a lot of work integrating healthcare and systems engineering is taking place, just as it is here at The University of Michigan.
WIHSE is hosting the 2018 WIHSE Conference, a day-long event bringing together practitioners and researchers in healthcare and engineering to conduct research, create new knowledge, and design better systems in healthcare, on May 2, 2018. If Professor Cohn is able to attend, she looks forward to spending time in Madison when there isn’t a -10 degree windchill.
|January 15, 2018:
Donald Richardson and Bassel Salka were honored at the North Campus Deans’ MLK Spirit Awards Ceremony & Reception on Monday, January 15, 2018. The Martin Luther King Spirit Awards are given to students, student organizations, and faculty members at the University of Michigan North Campus who exemplify the leadership and vision of Dr. King through their commitment to social justice, diversity, and inclusion.
Donald has supervised several undergraduate and master’s students conducting research at the Center for Healthcare Engineering and Patient Safety (CHEPS). He’s served as a mentor to students in both CHEPS and The Department of Industrial and Operations Engineering (IOE). He serves as a graduate student coordinator in IOE and also assists with the IOE Diversity Initiative which strives to both recruit and retain underrepresented groups in the department.
Recently, Donald organized and led an on-campus event for eighty 10th and 11th-grade students from the Ypsilanti and Detroit area. The students took part in multiple on-campus lab tours and participated in various STEM-focused actives. During the summer of 2016, he worked as a graduate student assistant with the Summer Research Opportunity Program (SROP) where he oversaw multiple program activities as well as mentored over 40 underrepresented undergraduate students throughout their summer research experience while continuing his own research.
“I really wasn’t expecting any recognition for mentoring both high school and undergraduate students or my various leadership roles at UM. To me this is just one of my passions to do whatever I can to make sure other students interested in STEM, especially underrepresented minorities, can be afforded similar opportunities as myself,” said Donald. “One quote/proverb I always think about when it comes to service is ‘To whom much is given much is required.’”
Bassel often serves as a resource for new CHEPS students. Fellow CHEPS student Anna Learis said, “During project meetings, he would ensure that everyone had a chance to input their ideas and oftentimes made a point to introduce new members to the rest of the staff. I noticed that whenever a prospective new IOE student approached our supervisor Amy Cohn, she would habitually put them in touch with Bassel so that he could answer their questions and show off our work.”
Bassel is the co-founder of UMICH MLC, the first Lean consulting group on campus. He’s also part of PhiDE, the only pre-medical fraternity on campus, and works as an Orgs Study Group Facilitator for Science Learning Center. During his Freshman and Sophomore year, Bassel twice raised over $1,500 and participated in Alternative Spring Break trips to Camp For All in Burton Texas, a camp dedicated to providing assistance to children with physical and mental disabilities. He organized and lead the trip, choosing applicants from the Muslim Student Association (MSA). In addition, as Social Chair of the University’s MSA, he has continuously worked to build a sense of community on campus.
Bassel is also the president of the Arab Student Association and, in his two years as leader, has taken the annual cultural show from 400 guests to over 1300. In addition, he started the Middle Eastern and North African Consortium (MENA Consortium), a group of students that are leaders in their respective MENA organizations who meet regularly to assist one another and build community. One of the projects they are working on is establishing a Middle Eastern/North African box on all University applications so that more students can have representation in the University.
“It feels great being recognized for work on campus that I am so passionate about,” said Bassel of his MLK Spirit Award.
Congratulations to both Bassel and Donald for the much-deserved recognition!
||January 12, 2018:
On Friday, January 12, 2018, CHEPS welcomed students, returning and new, to campus in a cozy meeting that marked the official kickoff of CHEPS activities in Winter 2018. Amy Cohn, associate director of CHEPS, extended her warmest welcome to the growing family of CHEPS students. She discussed important policies, procedures, and expectations of CHEPS and CHEPSters. She, also, introduced Julia Warner who joined the CHEPS family in December 2018 as a project manager. Ms. Warner will be working along with students to ensure that their research is well managed.
Jim Bagian, CHEPS director, on his part too welcomed all the excited students, reminding them of the CHEPS spirit and giving them some advice on professional conduct.
And, as usual, this semester CHEPS students come from very diverse academic backgrounds, covering almost all the different majors offered at U of M in engineering, computer sciences, and medicine. Students who have experienced working at CHEPS before return because of the unparalleled opportunities. We are incredibly proud of our growing family.
After the meeting, CHEPSters enjoyed a delicious dinner arranged by the CHEPS administrative assistant, Gene Kim. They enjoyed, too, some traditional sweets from Kuwait that Hanan Al-Awadhi, an IOE graduate student and a returning CHEPS student, brought in. Everything was in place for socializing, mingling with new friends and catching up with old ones. It was the perfect setting to play trivia together.
Now, with a successful kickoff, CHEPSters are ready to write a new chapter including research breakthroughs, interdisciplinary collaboration, and friendship while improving the safety and quality of healthcare delivery! Welcome, 2018!
|January 9, 2018:
CHEPS Director Dr. James Bagian, along with Douglas Paull, a VA surgeon and co-director of VA’s Ann Arbor-based National Center for Patient Safety (NCPS), wrote an invited editorial titled “Handovers During Anesthesia Care: Patient Safety Risk or Opportunity for Improvement?” which is published in the January 9, 2018 issue of The Journal of the American Medical Association (JAMA) as a response to a study published in the same issue by Jones et al.
Jones et al describe how complete handovers among anesthesiologists were associated with significantly poorer patient outcomes and conclude that complete handovers should be minimized.
Instead of minimizing complete handovers and viewing handovers as a vulnerability, Bagian and Paull recommend in their editorial to address underlying root causes – especially the use of explicit communication techniques and tools, in order to turn handoffs from a potential patient safety risk into an opportunity for improvement.
||January 5, 2018:
On Friday, January 5th, CHEPS hosted two alums, Joanna (Fleming) Blackmer and Jason Card, now working at the Johns Hopkins University Applied Physics Lab (JHU/APL). The two shared a presentation and held a discussion during a lunch and learn event. “One of my favorite things about CHEPS is our alums’ willingness to come back and mentor current students,” said CHEPS Associate Director Amy Cohn.
Joanna worked as a graduate research assistant for CHEPS and earned an MSE and BSE in Industrial & Operations Engineering from the University of Michigan. Since graduating in 2014, she has contributed to multiple projects in the National Health Mission Area as a health systems engineer at the Johns Hopkins University Applied Physics Lab. She has supported the Patient Centered Medical Home, Value Based Care, Trauma Center Verification and Designation, Dental Enterprise Patient Safety and developed the Medical Home Port Management Tool (acuity-based forecasting tool).
Jason Card is a CHEPS alum with MSE and BSE degrees in Industrial & Operations Engineering from the University of Michigan. Since graduating in 2013, he has supported health systems optimization projects through performance improvement techniques, database design, population health analysis, simulation modeling, and change management. He is part of the Health Systems Engineering Group at APL with experience supporting a variety of clinical and ancillary services.
Joanna and Jason weren’t the only alums at the event. Eli Sherman was in attendance and said, “As a CHEPS and UM alum is was great to come back to visit and see that CHEPS is doing better than ever, continuing to lead the way in innovation in healthcare through its own work and by educating those that will drive change in the years to come.”
Jason and Joanna provided an overview of APL and its history as an advisor to the U.S. Government. They discussed APL’s Research and Exploratory Development Department, which oversees the health initiatives, and talked about life as an APL health systems engineer and analyst. They presented a high-level overview of current and past projects.
Donald Richardson, a CHEPSter and IOE PhD student in attendance, enjoyed learning more about the history of APL. “I didn’t realize (1) JHU/APL was initially started to help support the military in WWII by finding a way to better protect ships from air attacks. (2) Ever since they have been contracted with the government as a support lab and not focused on selling their services/products like a consulting firm. This complements the healthcare application projects very well by avoiding being salesmen and just focusing on helping the patients/medical professionals,” he said.
IOE undergraduate student, Riley McKeown, appreciated learning more about Joanna and Jason’s day to day work. He said, “It was great to learn from Jason and Joanna about projects they are working on to improve communication between multiple doctors treating the same patients, as well as the challenges they have faced during the implementation process.”
“I thought the Lunch and Learn was great,” said Michael Kalmus, also an IOE undergraduate. “I enjoyed learning more about the broad scope of the APL, value-based care and the interesting projects Joanna and Jason are currently working on. I also enjoyed hearing their insights on challenges in healthcare and how they are using analytics and systems engineering to solve them (i.e. creating a dashboard that allows different providers to access a patient’s medical records easily).”
Thank you to Joanna and Jason for returning to CHEPS and offering such an interesting lunch and learn presentation!
|December 11, 2017:
Our final talk of the Fall 2017 Providing Better Healthcare through Systems Engineering seminar series featured Dr. Sung Won Choi from the University of Michigan Medical School presenting a talk titled “Multi-dimensional, Highly Time-resolved Big Data Approach for Disease Prediction.”
Dr. Sung Won Choi is an Associate Professor of Pediatrics and Communicable Diseases at the U of M Medical School and, in 2017, she was named the inaugural Edith S. Briskin / Shirley K Schlafer Research Professor of Pediatrics. She has a research interest in translational medicine, more specifically in the field of blood and marrow transplantation (BMT). She is recognized for her work in translating the use of histone deacetylase inhibition in BMT patients for prevention of a devastating complication known as graft-versus-host disease (GVHD).
In her presentation, Dr. Choi spoke about one of the major unmet challenges in today’s care, individualized prediction of disease and disease-related events. In traditional care settings, disease-identification is symptom-based and unidimensional. For many patients with no evident symptoms or symptoms that are common across many diseases, this means a late onset of treatment. Patients with GVHD, a complication following the receipt of donor tissues (blood and marrow transplants) from a genetically different person, for example, suffer most from the late diagnosis. GVHD patients exhibit similar symptoms to other diseases such as skin rash, shortness of breath, weight loss and general fatigue, yet due to a unique condition. In GVHD, the donor immune cells attack the host body’s cells, including lungs, liver, and skin cells. Disease identification is only possible with the use of biomarkers.
So, in order to offer more patient-centered, more personalized care for blood and marrow transplantation patients, Dr. Choi in a joint effort with collaborators from machine learning (Dr. Wiens), medical oncology (Dr. Tewari), computational biology (Dr. Li) and mechanical engineering (Dr. Kurabayashi) at the U of M is using complex computational methods to collect multi-parameter, highly time-resolved data that would enable her and her team to make accurate short-term disease predictions, and then to start the medical intervention as early as possible (pre-symptoms state).That would make, she said, the intervention more effective, more personalized, and more patient-centered!
Now, as we adjourn this season, we wish you and your dear ones a very happy and a warm holiday. We will be looking forward to seeing you again for next year’s Providing Better Healthcare through Systems Engineering seminar series. Happy Holidays!
||December 4, 2017:
This December, the Providing Better Healthcare through Systems Engineering seminar series started off the month with a talk on “Block Scheduling for Medical Residents” featuring Dr. Amy Cohn, Dr. Garth Strohbehn, & Mr. William Pozehl.
Dr. Cohn is a professor of Industrial & Operations Engineering at the University of Michigan and the Associate Director for the Center for Healthcare Engineering and Patient Safety (CHEPS). Her primary research interest is in robust and integrated planning for large-scale systems, predominantly in healthcare and aviation applications.
Dr. Strohbehn is a general internist and chief medical resident at the U of M Health System. He has been a member of the Internal Medicine Residency Program since 2014 and, along with three colleagues, chief resident since June 2017, where his major shared responsibilities include scheduling, training, mentoring and advocating for resident well-being. His primary research interest is in medical education, more particularly in educational systems redesign, novel educational methods (visual arts and mindfulness), and clinical research education.
Mr. Pozehl is a researcher at CHEPS. His work focuses on enhancing care delivery through building models to schedule care providers with the goals of improving schedule quality and reducing the burden of constructing these schedules.
In a joint talk, the speakers explained how scheduling medical residents to appropriate medical shifts remains a challenge to many academic health centers, including Michigan Medicine. These schedules must balance between institutional, professional, and educational requirements, in addition to individuals’ preferences (e.g. day-off requests). Many of these schedules are constructed manually, a time-consuming and error-prone process. Furthermore, manually-developed schedules tend to exhibit some degree of bias. Thus, in order to maintain the highest morale and well-being of the residents, and to enhance quality of patient care, the team developed a customized linear programming model that is capable of capturing the competing needs and the ever-evolving requirements of numerous residency programs at U of M, constructing schedules for more than 400 residents and 150 services annually. The automated scheduling significantly reduces time spent to construct a single schedule and improves schedule quality. The lecture concluded with a very thought-provoking discussion on how linear programming models could positively impact clinical practice while developing deep knowledge of complex systems in healthcare.
We look forward to seeing you in our last seminar for this season, Monday December 11, 2017 with a talk on “Multi-dimensional, Highly Time-resolved Big Data Approach for Disease Prediction” by Dr. Sung Won Choi from the University of Michigan Department of Pediatrics.
|November 27, 2017:
On November 27, 2017, Dr. Sachin Kheterpal spoke as part of the Providing Better Healthcare through Systems Engineering seminar. Dr. Kheterpal is an Associate Professor of Anesthesiology and Associate Dean for Research Information Technology at the University of Michigan Medical School. His career has been focused on the novel use of IT and electronic health records for patient care, quality improvement, and research. He is recognized as a national leader in perioperative large dataset clinical research and has published numerous articles, editorials and book chapters regarding intraoperative management and long-term postoperative outcomes. Using innovative techniques to integrate administrative, EHR and registry data across institutions, he leads the Multicenter Perioperative Outcomes Group, a research and quality improvement consortium of more than 40 anesthesiology and surgical departments.
In his presentation, titled “From Big Data to Small Decisions: Fulfilling the Potential of Precision Health,” Dr. Kheterpal discussed the new precision health initiative that the University of Michigan launched. It’s an initiative that spans all the schools and colleges of the U of M campus and brings together different disciplines to advance the prevention, diagnosis, and treatment of disease. This initiative works to support the university’s mission and commitment to research, education, and service. He then spoke about the five work streams: Research, Cohort development, Data & Analytics/IT, Health Implementations, and Education & Training. He next spoke about how the initiative is still in its infancy and has planned over the next several years for growth.
The work that Dr. Kheterpal and those involved with the initiative will do has amazing implications for the future of healthcare at the University of Michigan
Please join us on Monday, December 4th, 2017 as Dr. Amy Cohn, Billy Pozehl, and Dr. Garth Strohbehn speak on “Block Scheduling for Medical Residents.”
|November 20, 2017:
On November 20, 2017, the Providing Better Healthcare through Systems Engineering seminar had the pleasure to welcome Dr. Geoff Barnes to come talk to us about Health Systems Engineering and Implementation Science: Using the Best of Both Worlds to Standardize Periprocedural Anticoagulation.
Geoffrey Barnes, MD, MSc, is a cardiologist and vascular medicine specialist at the University of Michigan. He completed his undergraduate degree in Biomedical Engineering at Washington University in St. Louis, followed by medical school, residency and fellowship training at the University of Michigan. He has been on faculty at the University of Michigan since 2014. He co-directs the Michigan Anticoagulation Quality Improvement Initiative (MAQI2), a collaborative of six health center anticoagulation clinics aimed at improving care for patients across the state of Michigan. Informed by his undergraduate engineering degree, he strives to use logical models to understand and improve healthcare delivery systems. His current research is focused on improving the delivery of anticoagulation care for patients undergoing surgical procedures.
In his presentation, Dr. Barnes introduces challenges in regard to the use of blood thinners for different health conditions. Blood thinners are used because a patient has a higher risk of blood clots in the heat or arteries. As blood clots, it can lead to heart attacks or even a stroke. However, there are challenges when it comes to using blood thinners. As blood thins, blood clots less which poses difficulty when it comes to possible surgeries while on blood thinners. For patients who are on blood thinners and need surgery, doctors advise patients to stop taking blood thinners a few days before because the effect of the drug does not start and stop immediately. Doctors have introduced medicine to bridge the gap between taking blood thinners to surgeries and back to taking blood thinners. However, the authors think that the new medicine will instead create an urgent need for an expansion as well as an evolvement of those traditional clinics, as there are three major purposes the new clinic could serve.
Join us next week for a talk on “From Big Data to Small Decisions: Fulfilling the Potential of Precision Health” by Sachin Kheterpal, MD, MBA.
|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.”
||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!
|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!
||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:
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.
|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.”
|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.
|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:
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.”
|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.
|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.
Please join us on September 25th for a talk titled, “The Bloodmobile Routing Problem,” presented by Dr. Grisselle Centeno.
|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.
||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!
|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.
|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!
||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.”
||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.”
||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.
|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!
|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.
|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!
|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.
|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!”
|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!
|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!
|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.
|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!
|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!
|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.”
|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!
|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.
|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.
|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!”
|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.
|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!