Augmenting systems-level implementation of patient-reported outcomes for depression care through the use of structured analysis and design technique.

Background: Health systems increasingly need to implement complex practice changes such as the routine capture of patient-reported outcome (PRO) measures. Yet, health systems have met challenges when trying to bring practice change to scale across systems at large. While implementation science can guide the evaluation of implementation determinants, teams first need tools to systematically understand and compare workflow activities across practice sites.

Guiding the Lean Design of a Hospital's New Laboratory: A Case Study.

Purpose: To present the process used by a clinical laboratory to guide the design of their new facility, part of a major campus expansion at a pediatric hospital.

Objective: The primary objective was to generate information about arrangement and allocation of laboratory space and functional flows in the early phases of the expansion project.

Background: Seattle Children's Hospital has increased the capacity of their primary campus in response to growing demand for specialized services.

A learning health systems approach to integrating electronic patient-reported outcomes across the health care organization.

Introduction: Foundational to a learning health system (LHS) is the presence of a data infrastructure that can support continuous learning and improve patient outcomes. To advance their capacity to drive patient-centered care, health systems are increasingly looking to expand the electronic capture of patient data, such as electronic patient-reported outcome (ePRO) measures. Yet ePROs bring unique considerations around workflow, measurement, and technology that health systems may not be poised to navigate.

Predicting the Future: Using Simulation Modeling to Forecast Patient Flow on General Medicine Units.

Background: Hospitals are complex adaptive systems within which multiple components such as patients, practitioners, facilities, and technology interact. A careful approach to optimization of this complex system is needed because any change can result in unexpected deleterious effects. One such approach is discrete event simulation, in which what-if scenarios allow researchers to predict the impact of a proposed change on the system.

Design and implementation of a combined influenza immunization and tuberculosis screening campaign with simulation modelling.

Rationale, Aims And Objectives: Design and implement a concurrent campaign of influenza immunization and tuberculosis (TB) screening for health care workers (HCWs) that can reduce the number of clinic visits for each HCW.

Method: A discrete-event simulation model was developed to support issues of resource allocation decisions in planning and operations phases.

Results: The campaign was compressed to100 days in 2010 and further compressed to 75 days in 2012 and 2013.

Neither snow nor rain: contingency planning by a clinical reference laboratory courier service for weather related emergencies.

To optimize transportation processes, we present herein a contingency plan that coordinates interim measures used to ensure continued and timely services when climate based events might cause an interruption of the usual specimen transportation processes. As an example, we outline the implementation and effectiveness of a contingency plan for network laboratory courier automobile transportation during times of mountain pass highway closure. Data available from an approximately 3-year period from October 10, 2010 through August 29, 2013 revealed a total of 690 complete closures in the eastbound or westbound lanes of the Interstate-90 highway in the Snoqualmie Pass area in the state of Washington.