Applying systems engineering principles in improving health care delivery

BACKGROUND: In a highly publicized joint report, the National Academy of Engineering and the Institute of Medicine recently recommended the systematic application of systems engineering approaches for reforming our health care delivery system. For this to happen, medical professionals and managers need to understand and appreciate the power that systems engineering concepts and tools can bring to redesigning and improving health care environments and practices. OBJECTIVE: To present and discuss fundamental concepts and tools of systems engineering and important parallels between systems engineering, health services, and implementation research as it pertains to the care of complex patients. DESIGN: An exploratory, qualitative review of systems engineering concepts and overview of ongoing applications of these concepts in the areas of hemodialysis, radiation therapy, and patient flow modeling. RESULTS: In this paper, we describe systems engineering as the process of identifying the system of interest, choosing appropriate performance measures, selecting the best modeling tool, studying model properties and behavior under a variety of scenarios, and making design and operational decisions for implementation. CONCLUSIONS: We discuss challenges and opportunities for bringing people with systems engineering skills into health care.