1. MidWest Mountain VERC Overview
Peter A. Woodbridge, MD, MBA
Director, MidWest Mountain Veterans Engineering Resource Center
ACOS for Quality and Medical Effectiveness, Nebraska Western Iowa VA Health Care System
Assistant Professor, Health Services Research and Administration, UNMC College of Public Health

2. The Veterans Engineering Resource Centers (VERC)
Rooted in a research / medical center operations collaboration
Grounded in NAE/IOM 2005 recommendations*
Proof of concept – engineering student projects
Highly visible transformative improvements
Four VERC with budgets of ~$500K to $1.5M each established June 2009
Funded with medical care appropriations
Resource centers
Provide applied operations systems engineering support
Engage faculty to develop novel operations systems engineering in support transformative improvement
* NAE/IOM, Building a Better Delivery System: A New Engineering Health Care Partnership. 2005

3. MWM VERC: Multi-VISN / Multi-University / HSRD Partnership
14 mid-west and mountain states
1.2M Veterans
24 medical centers
HSRD
IDEAS REAP
CRICC REAP
Affiliated Universities
ASU
Creighton University
MSU
NMSU
NDSU
U Colorado, Denver
U Iowa
U Minnesota
U Nebraska, Lincoln
UNMC
U Wisconsin, Madison
27 faculty

4. Why a Multi-VISN, Multi-University VERC?
Intractable healthcare systems problems
Defy simple process improvement or managerial solutions
Generate unintended disruption of other systems
Require consideration of process, structure, and patterns
Solutions fail to spread and / or be sustained

5. MWM VERC Vision: The Healthcare Work Place of the Future
All staff have the knowledge, capabilities, and desire to strive continuously for excellence
Educate healthcare workers in systematic approach to value improvement
Make healthcare an attractive career for graduating engineering students
Systems and processes are engineered for excellence
Error-proofed, error-recovering and self-healing
Integrated as patient-centered systems rather than linked, discrete processes
Expertise, not bounded by geography, coalesces to solve intractable healthcare systems problems in diverse, multi-talented, teams

6. Achieving Excellence Healthcare is “complex” – not “complicated*”
Processes, structures, and patterns matter*
Process – the steps to taken to complete a task
Structures – the policies, equipment, etc. that support processes
Patterns – the organizational context surrounding the processes and structures (e.g., relationships, beliefs, traditions, etc.)
*Paul Plsek “Complexity and the Adoption of Innovation in Health Care” AHRQ, 2003

7. MWM VERC: Organizational Goals
Provide support across the entire SR/QI continuum
“Essential” SR / QI knowledge projects
Applied engineering projects
Academic engineering projects
Ensure a pipeline of OSE to enter VHA service
Provide OSE support for SR collaboration and knowledge sharing

8. The Role of SR/OSE

9. VERC Improvement Metaphors
Essential
SR / QI
Applied Engineering
Academic Engineering
Share knowledge
Discover knowledge
Create knowledge
Train
Assist
Consult
Spread and sustain
Improve
Innovate
Quality assurance
Quality planning
Quality improvement
Reactive
Corrective
Preventive
Fix past
Optimize present
Improve future
Defined
Concrete
Conceptual
Off the shelf
Customize
Develop

10. MWM VERC Goals & Projects:
T21 – “Develop capabilities and enabling systems to drive performance and outcomes”
Essential SR / QI Projects
Educate the healthcare work force of the future
Improvement methods ontology
Lean healthcare implementation and training
Applied OSE Projects
EHR documentation in support of PCMH
Inpatient staffing optimization
Reusable medical equipment ISO-9000 compliance
Technical engineering assistance consultation service
Academic OSE Projects
SR virtual collaboration social computing environment
Teamwork during emergencies

11. SR Virtual Collaboration Social Computing Environment

12. MWM VERC Goals & Projects:
T21 – “Expand access for Veterans including women and rural populations”
Applied OSE
Advanced scheduling
Centralized vs. decentralized scheduling
Clinic space optimization
Academic OSE
Agent based modeling of rural health access
Improve rural mental health access and effectiveness through tele-medicine

13. MWM VERC Goals & Projects:
T21 – “Design a Veteran-centric healthcare model and right sized infrastructure to help navigate the healthcare delivery system”
Applied OSE
Patient centered medical home collaborative
Clinic telephone response optimization collaborative
Improving clinic visit efficiency
Academic OSE
Dual care for rural veterans
Coordinating care across the continuum

14. Status Report MWM VERC Projects OSE Engagement
Active projects: 19
VERC funded projects: 15
Project deliverables received to date: 139
OSE Engagement
Funded OSE faculty: 15
Funded OSE universities: 9
OSE trainees engaged in VHA MWM VERC projects
Undergraduates: 15
Masters students: 18
PhD students: 10
Post Doctoral: 2

15. The MWM VERC Leadership Team
Peter Woodbridge, MD, MBA, Director
Jennifer Wagner, PhD, DD Academic Engineering & Research
Chris Masek, DD Applied Engineering
Mike Rubin, MD, AD Academic Engineering & Research
Brian Hertz, MD, AD Applied Engineering
Staff
Eric Aldinger, Administrative Officer
Bryan Gamble, Project Manager
Gary Kiel, Program Analyst
Ann Fetrick, Research Coordinator
TBD. Lean Program Manager
TBD, IE Chicago
TBD, IE Phoenix

16. Comments?
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