Designing an integrated surgical care delivery system

There is a continuous increase in the diversity of efforts aimed at improving healthcare delivery systems in the United States. Over the last decade, a wide range of philosophies and management strategies have been embraced by an increasing number of healthcare organizations, with the principal goal of improving productivity and the quality of care while reducing the associated costs. These have had a significant impact on various healthcare services, including the delivery of surgical care. These philosophies and strategies are composed of scientific techniques and methods, a majority of which can be classified under the Industrial and Systems Engineering (ISE) field of study. Most of these techniques were founded in the manufacturing industry and have been undergoing a gradual transition and re-application in service industries like healthcare. For the most part, these techniques have proved to be instrumental in engineering radical changes and improvements in the ailing healthcare industry. It is also observed that their gradual adoption has been associated with trends and 'waves', with each new technique being the 'industry-buzz' of the moment.; This research seeks to contribute to the growing efforts on the application of ISE tools in the healthcare industry. First, an attempt is made to illustrate how various techniques can be used to engineer tangible benefits into the processes for surgical care delivery. Axiomatic Design (AD) concepts are leveraged to synthesize redesign changes, which are then applied to a conceptual model of the surgical system. The model is developed using a Petri Net (PN) technique and subsequently validated, verified and analyzed using PN heuristics. A Dependency Structure Matrix (DSM) approach is then used to evaluate information flow in the redesigned system. The outcomes of this redesign depict process improvements with the potential to enhance the quality of surgical care while enabling close to 70% productivity gains in surgical scheduling. As a result, this research proposes a general framework for the systematic redesign of processes, especially when all changes need to be tested and verified before implementation. The techniques identified within this framework are ideal for the successful completion of the 'design' and ' plan' phases when pursuing operations management philosophies like Six-Sigma and Total Quality Management (TQM).