Collaborative Research: Modeling and Analysis of Rapid Response Operations to Improve Patient Care and Safety: A Systems-Theoretic Approach"

The number of potentially preventable hospital deaths in the US is astonishingly high: The Institute of Medicine report “To Err is Human” estimates that this number is upward of 100,000 per year. This prompted a nationwide initiative to create and deploy Rapid Response Teams (RRTs) to quickly evaluate, triage, and treat patients with clinical signs of deterioration to reduce the frequency and severity of negative outcomes. To ensure a successful implementation of RRTs, the early identification, better recognition, timely and appropriate treatment, and proper structural organization of care providers are of critical importance. The objective of this project is to contribute to this initiative by establishing an analytical framework for modeling the rapid response process in acute care delivery and using this framework to improve the efficacy of rapid response operations and patient safety. Specifically, the following problems will be addressed: Analysis: Performance evaluation of the existing rapid response operations. Continuous Improvement: Bottleneck identification in the existing rapid response operations. Design: Developing optimal workforce configuration and response activation protocols. Application: Model validation and implementation of the results at the University of Kentucky Chandler Hospital (UKCH). The approach of this research is based on analytical investigation of the stochastic processes that describe the rapid response operations for patients with signs of clinical deterioration. Such processes will be modeled as complex networks with split, merge and parallel structures. No analytical methods are available to study such systems. Therefore, the challenge of this research is in developing effective methods to deal with the complexity of system modeling, analysis, improvement, and optimization based on the collected data. The results will be applied at UKCH, where the preliminary work has been carried out. The PI from University of Wisconsin - Madison (UW) has been involved in production system research and practice for 18 years and worked in healthcare delivery systems while on the faculty of University of Kentucky (2006-2010) and UW Madison (2010-present). The PI from UKCH has 30 years experience in medical practice and management, and is now serving as Chief Nursing Executive in UKCH. They have been collaborating to improve healthcare system efficiency and quality for the last 5 years. These experiences provide a solid foundation for the success of the proposed collaborative research. The intellectual merit of this research is the establishment of a novel system-theoretic method to study the rapid response process in acute care delivery. Such a method will enable us to uncover the fundamental principles governing care delivery processes and utilize them to improve the efficacy of rapid response operations and patient safety. The successful completion of this research will lead to new directions in healthcare systems research. The broader impact of the research is in providing quantitative methods for analysis, improvement, and operation in healthcare facilities. The methodology is also transferable to other systems with high variability and severe cost of failures, such as civil emergency response systems, critical supply chains and information networks, etc. The results obtained will be implemented in UKCH and disseminated through papers and presentations. The students will receive significant exposure to important healthcare problems and gain practical experiences. Women and minority students will be actively recruited and outreach activities will be carried out for K-12 students.