Analytical methods for integrating state-of-the-art healthcare quality frameworks into decision-making
Abstract
In 2001, the Institute of Medicine proposed the use of six quality aims to guide healthcare
improvement efforts. These aims specify that healthcare should be effective, efficient, safe, timely,
patient-centered, and equitable. Since then, academics, practitioners, and policy-makers have made
countless efforts to improve the quality of healthcare systems; however, most of these efforts still
focus on a single dimension when measuring a system's performance. This dissertation
investigated the integration of the Institute of Medicine quality aims into operational decisionmaking
through the design and evaluation of possible solutions for two problems from different
healthcare settings. The first part of this dissertation analyzed and evaluated analytical approaches
to integrate simultaneously all six aims of quality into performance assessment of trauma care. A
novel multi-criteria approach based on deterministic dominance theory and a traditional single
composite approach were analyzed and compared in terms of the categorization of the trauma
centers. Based on the results, an approach is proposed to integrate the six quality aims into the
performance evaluation of trauma care by adjusting an initial composite to include the aim of
equity. The second part of this dissertation analyzed and characterized the short-term inpatient care
work planning problem considering the IOM quality aims. This study, proposed an optimization
model for the problem considering an optimization criteria consistent with the IOM quality aims.
Research opportunities to support the analysis of the inpatient care work planning problem were
identified based on the results of the case study. Further, the study proposed a methodology to
develop unit-specific practical heuristics for the problem. The results of this two-part study
provided insights for decision-makers about the practical challenges and significant benefits of
integrating the Institute of Medicine quality aims into operational decision-making in healthcare
settings.
Description
Thesis (Ph.D.)-- Wichita State University, College of Engineering, Dept. of Industrial, Systems and Manufacturing Engineering
This dissertation is embargoed till the end of August 2020.