Good luck with the rest of the semester!

Title: A Three Step Approach for Analyzing Workflow in Hospital Emergency Departments

Abstract: 108 patient care episodes were observed in three emergency departments to evaluate a health information exchange initiative. Each patient care episode is denoted by a workflow representation. The collected data was then analyzed using three methods: descriptive summary, visualization and clustering. Each of these methods individually are useful to analyze workflow. In this presentation, we will discuss how using these methods together can be complementary to characterize patient care.

• Myself
• Ancker, Jessica; Weill Cornell Medical College
• Vest, Joshua; Georgia Southern University, Jiann-Ping Hsu College of Public Health
• LaVenture, Martin; Minnesota Department of Health, Office for Health Information Technology
• Ross, Stephen; University of Colorado School of Medicine, Medicine

Here is the abstract of the panel.

The promises of health information exchange (HIE) systems include improvement in patient outcomes and organizational performance. However, these large systems interact with clinical work environments in multiple complex ways creating challenges for systematic evaluation. Practical challenges include difficulties of integrating evaluation activities into the ongoing medical practice. Methodological challenges include reliability and validity concerns of the collected data due to a high level of variability and complexity in clinical settings. Theoretical challenges include a lack of comprehensive, robust conceptual frameworks that will guide HIE evaluation studies. This panel will address these challenges in evaluating HIE systems. The panel will also discuss important aspects of HIE systems that should be studied in an evaluation endeavor, the use of relevant theories, and strategies to overcome the aforementioned challenges. This panel will contribute to research and practice by discussing the strengths and weaknesses of evaluation strategies in the context of five HIE systems implemented in Wisconsin, New York, Texas, and Minnesota.

Completing my PhD degree is probably the most challenging activity of my first 32 years of my life. The best and worst moments of my doctoral journey have been shared with many people. It has been a great privilege to spend several years in the Department of Industrial and Systems Engineering at University of Wisconsin-Madison, and its members will always remain dear to me.

My first debt of gratitude must go to my advisor, Dr. Patricia Flatley Brennan. She patiently provided the vision, encouragement and advise necessary for me to proceed through the doctorial program and complete my dissertation. I want to thank Patti for her unflagging encouragement and serving as a role model to me as a junior member of academia. She has been a strong and supportive adviser to me throughout my graduate school career, but she has always given me great freedom to pursue independent work.

Special thanks to my committee, Dr. David Zimmerman, Dr. Mary Murray, Dr. Dan Bolt, and Dr. Doug Wiegmann, and Dr. Ben-Tzion Karsh for their support, guidance and helpful suggestions. Their guidance has served me well and I owe them my heartfelt appreciation.

Members of Health Systems Engineering Lab. also deserve my sincerest thanks, their friendship and assistance has meant more to me than I could ever express. I could not complete my work without invaluable friendly assistance of the participants of the EDLinking project. I should also mention Wisconsin Dairyland Chapter of Health Information Management Systems Society for allowing me to be part of a great professional community.

My friends in US, Turkey and other parts of the World were sources of laughter, joy, and support. Special thanks go toRupa Valdez, Kerem Akartunali, Yichuan Grace Hsieh, Can Bora, Hikmet Tuncsoy, Gungor Family, Loose Family, Haluk Sengun, Joel Walker, Patricia Sanhueza, James Switzer, Kaan Durukan, Ayse Pinar Gurses, members of hoofers outing club. I am very happy that, in many cases, my friendships with you have extended well beyond our shared time in Madison.

I wish to thank my parents, Hatice Ozkaynak and Sait Ozkaynak and my grandpa Arif Gur. Their love provided my inspiration and was my driving force. I owe them everything and wish I could show them just how much I love and appreciate them. My wife, Asli Alkan Ozkaynak , whose love and encouragement allowed me to finish this journey. She already has my heart so I will just give her a heartfelt “thanks.” I also want to thank to my in-laws for their unconditional support. Finally, I would like to dedicate this work to my lost relatives including Grandma Serife Gur and grandaunt Fadime Altinteril, who left us too soon. I hope that this work makes you proud.

This Summer my advisor (Patti Brennan) offering a class entitled Nursing and Health Informatics. I will be assisting Patti for this online course.

• Dr. Patricia Flatley Brennan (Chair)
• Dr. David Zimmerman
• Dr. Mary Ellen Murray
• Dr. Dan Bolt
• Dr. Douglas Wiegmann

My committee members provided highly valuable feedback and I expect to submit the final version of the thesis to the Graduate School by the end of June. I feel very fortunate to be able to include these faculty in my committee. I am grateful to them for their support and guidance.

The department of Industrial and Systems Engineering organized a luncheon for Spring and Summer PhD graduates. We had fun. Here are some pictures from the event:

I was honored by HIMSS Foundation with the 2010 Health Information management Systems Scholarship.  I will be recognized along with other honorees at the HIMSS Awards Banquet on February 22, 2011 at the Rosen Shingle Creek Hotel in Orlando, held in conjunction with the HIMSS11 Annual Conference & Exhibition.

The description of the scholarship appears on the HIMSS Web site.

Here is the abstract.

Studying sequence in non-routine work environments such as emergency departments is beneficial, yet challenging. Understanding sequence of activities is important from the work analysis and design perspective because the output from each activity may influence another. In addition, the emergency department work includes competing goals; for example, various administrative and care activities are conducted in varying sequences. Known work methods focus on routine work. The purpose of this study is to explore the sequence patterns of activities in emergency departments by using hierarchical clustering. We captured and examined initial stage of patient care in three Midwestern emergency departments through systematic direct observations. The sequences of activities for 108 patients were recorded. The preliminary analysis showed a high level of variability. A subsequent cluster analysis was useful to explore structures and highlight patterns. Understanding these patterns is important to design implementation of systematic interventions that will improve efficiency as well as health outcomes. The findings of this exploratory study will also help us develop further confirmatory hypothesis. Additionally, we will discuss the findings in the context of a health information exchange project.