EIND 506: Design of Healthcare Delivery Systems
Feel free to contact one of the course instructors for a PDF copy of the course syllabus.
Credits: 3 Credit Lecture
Delivery Methods: Brightspace LE
Faculty:
Pre-Requisite Courses: NRSG 604 (for nursing students), EIND 458 (for IE students), or instructors’ permission.
Course Description
The purpose of NRSG608/EIND506 is to introduce the roles of Clinical Nurse Leader (CNL), Doctor of Nursing Practice (DNP) and Industrial (or systems) Engineer (IE) in healthcare; examine the major systems within healthcare organizations which affect care delivery; and provide experience and tools for working effectively in interprofessional teams to redesign healthcare delivery systems. This interprofessional course targets nursing students pursuing certification as a CNL or DNP, and IE students who intend to work in the healthcare sector. Students will learn strategies for analyzing and improving processes, coordinating interdisciplinary healthcare teams, enhancing healthcare quality management, and reducing health risk through medical error elimination.
Course Objectives:
- Examine the roles of the Clinical Nurse Leader, Doctor of Nursing Practice and Industrial Engineer as each relates to organizational leadership, effective advocacy, and the delivery and integration of care.
- Evaluate core hospital systems which drive the quality, timeliness, and cost of care using systems engineering concepts and tools.
- Examine issues related to coordinating and leading healthcare teams in collaborative problem-solving.
- Compare quality, risk management, and patient safety strategies among select client populations.
- Describe interrelationships among clinical information systems, communication accuracy, error reduction, and healthcare system operations.
- Assess internal and external forces including cultural factors that affect healthcare delivery across various settings.
Course Texts:
Required:
- Nelson, E. C., Batalden, P. B., & Godfrey, M. M. (2007). Quality by design: A clinical microsystems approach. San Francisco: Jossey-Bass. (Appendices available online at clinicalmicrosystem.org)
- Nelson, E. C., Batalden, P. B., Godfrey, M. M., & Lazar, J. S. (2011). Value by design: Developing clinical microsystems to achieve organizational excellence. San Francisco: Jossey-Bass
- Assigned Web readings.
Recommended:
- Sobek, D. K. & Smalley, A. (2008). Understanding A3 Thinking: A Critical Component of Toyota’s PDCA Management System. New York: Productivity Press.
- American Psychological Association (2009). Publication manual of the American Psychological Association (6th ed.). Washington, DC: Author.
- IOM (Institute of Medicine) (2011). Engineering a learning healthcare system: A look at the future: Workshop summary. Washington, DC: The National Academies Press. (available online).
- Niles, N. J. (2015). Basics of the U. S. health care system. Burlington, MA: Jones & Bartlett.
General Course Plan:
This course is designed to promote exploration and reflection of content relevant to the CNL, DNP and engineering roles in the healthcare delivery system, and is delivered using primarily asynchronous format (Brightspace LE). Content has been divided into learning circles that span 1-2 weeks. Collay, Dunlap, Enloe and Gagnon (1998) describe learning circles as small communities of learners who come together to support each other in the process of learning. This collaborative approach to learning is an especially effective way to build the community of learning in the virtual classroom. The learning circle provides the structure that will enable students and faculty to examine selected content and issues introduced in this course and share their knowledge with other students through guided discussion and reflection. Each learning circle includes an introduction of the topic with learning objectives, inquiry questions that guide students into the literature, selected readings, discussion or other activities, strategies for linking learning to daily life, and suggestions for additional reading.
Assignment Guidelines:
The assignments for this course are designed to help students achieve the course objectives. Criteria for each of the assignments are described below. Grading will be based on the percentage indicated in parentheses. All written work is to be prepared in APA format, 6th edition. Assignments are due on the date and time specified in the class calendar. Late papers will not be accepted without prior consent of the faculty.
- Class participation (20%):
Students are expected to be actively engaged in all discussions and activities guided by the learning circles as well as pre and post assessments. Display of preparation through reading / thinking, quality and timeliness of initial submitted work, and level and timeliness of of participation, and collegiality of dialog provides the basis for evaluation. Peer review may also be considered in the evaluation.
- Reflective Essay (10%):
At the end of the semester you will be required to submit a reflection essay that details your experience in the course, how you have met the objectives of the course, as well as provide feedback. The essay must be submitted to Brightspace, due Sunday of week 15, by 11:59 pm MST.
- Learning Circles (70%):
There will be a total of 9 Learning Circles (LC’s) in this course. They require you to work collaboratively to learn about a particular process and systems engineering tools through readings and observation. As shown on the course schedule below, 4 LC’s will be one week in length while 5 will be two weeks in length. Each of the two-week LC’s require clinical observation in addition to reading, submission of work products, online discussion and interprofessional interaction. Nurses will be tasked with applying a systems engineering tool to the system observed (current operation), identifying improvement opportunities, and visualizing an improved way of working. Engineers will be tasked with helping nurses apply the tools correctly and working collaboratively to develop better delivery systems designs. Nursing students must arrange for clinical observations at a suitable facility. The instructors will arrange tours for engineering students.
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Grading: |
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A = |
90 – 100% |
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B = |
80 – 89.9% |
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C = |
70 – 79.9% |
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D = |
60 – 59.9% |
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F = |
< 60% |
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Evaluation:
- Participation (Learning Circle) 15%
- Reflective Essay 10%
- Pre and Post tests 5%
- Learning Circles 70%
- Total 100%
Course Content:
Introduction: Forces influencing healthcare delivery systems in the US
Structure of the US Healthcare System
Interprofessional Team Roles Organizational structures/departments
Scope of Practice/Delegation Interprofessional care planning
Collaborative problem-solving Teamwork
Patient Flow Admissions processes
Medication delivery systems Reimbursement Strategies
Supplies management Regulation/Documentation
Billing / revenue cycle
Healthcare Systems Re-engineering
Systematic problem-solving Process mapping
Data visualization and analysis Flow and work design principles
Risk assessment and analysis Informatics/Outcomes Management
Systems Engineering Tools & Concepts
A3 Reports and problem-solving PDSA / PDCA / Deming Cycle
Value stream mapping Flow charts / swim lane charts
Fishbone diagrams 5 Why’s
Pareto charts Checklists
Descriptive statistics Data visualization
Kanban / pull systems Visual management