1. Patient Flow and Service Delivery Presentation to USC Health Collaborative Randolph W. Hall Senior Associate Dean for Research Epstein Department of Industrial and Systems Engineering University of Southern California

2. Patient Flows Movement of patients through a healthcare system When the system works well, patients flow like a river When it fails, patients flow like a reservoir Unless patient needs to remain in the system for health reasons, reservoirs are bad, rivers are good A queue represents the accumulation of patients awaiting service (examination, test, treatment, etc.) A queue could also be a specimen awaiting analysis, a request awaiting a file transfer, etc,

3. Consequences Wasted time on part of customer Reduced efficiency in service Patient suffering Degradation in patient condition Disabilities, Medical Consequences Failure to receive treatment Lost customers Dissatisfaction

4. PATIENT FLOWS IN JURIESILLNESSES WAITING TREATMENT DISCHARGE HOSPITAL RENEGE/BALK SPILLBACK TREAT ELSEWHERE OR FOREGO

5. LAC/USC Collaborative Currently engaged in top to bottom review of service delivery in hospital Steps include focus groups with RNs,schedulers,MDs,analysts,administrators Charting service processes Evaluating quality of data sources, creating initial assessment of problem areas and opportunities Vision is to expand: make LAC/USC a teaching hospital for process reengineering in health care

6. Other Health Work in Viterbi School of Engineering Medical device technology: Alfred Mann Institute, BMES NSF Center, particularly neural interface Imaging technology via MRI and Ultrasound; anatomical and functional imaging with applications in neuroimaging, oncology, and gene expression. Cardio-vascular studies, development of implantable micro-sensors Biomedical Simulations Resource (BMSR) develops modeling and simulation for use by the biomedical research community.