In 2007, Mayo Clinic in Rochester, Minnesota, engaged Advance Management Group (AMG) to develop a reporting system that would provide timely feedback on key performance indicators (KPIs) for their 15 dialysis care facilities. One critical KPI is the percentage of dialysis patients with hemoglobin (Hgb) levels in a target range. In fact, payment for services is now largely based upon that percentage. Now completed, the project gave rise to an important system dynamics application.
“Hemoglobin enables every cell in the body to breathe,” explains Jim Rogers, CEO of AMG. “It’s critically dependent on EPO, a hormone that controls production of red blood cells that deliver it to the body. The kidneys of dialysis patients don’t produce EPO as healthy kidneys do, so physicians administer synthetic EPO exogenously to achieve and maintain adequate hemoglobin levels. The problem was existing EPO protocols did not account for the dynamics of hemoglobin production.”
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"Implementing change inside a health care institution is like redesigning a bicycle while you're riding it," says Bruce Gresh of Simulation Associates. For the past 15 years, Gresh has been working with senior executives to model and evaluate their organizational strategies, an exercise that has been made even more challenging by the Patient Protection and Affordable Care Act (PPACA) of 2010. With its details and rules still to be determined, the PPACA is forcing trustees, administrators, physicians, and nurse executives to think through potential changes and what they will mean for their organizations.
"There is growing realization that the longstanding pay for volume model isn't sustainable and it's going to eventually go away," says Gresh. "Hospitals and other health care facilities have become good at delivering more care in order to make more money, but the PPACA begins to change incentives from pay-for-volume to pay-for-health. Senior health care executives and physicians need tools that can help them think about the future, play strategies out over time, and build alignment around change," says Gresh. "Systems Thinking and simulations that include a whole system perspective help them step away from their immediate day-to-day concerns and help them think about the future and build alignment to support change."
"Schools are complicated places," says Susan Fairchild, Director of Data and Applied Research at New Visions for Public Schools. That's an understatement for any school district. It's certainly true that New York City Schools face the complexities of constantly changing graduation standards, tight budgets, understaffing, and large, at-risk student populations. In 2007, New Visions was selected to help 77 New York City schools that serve 38,000 students achieve an 80% graduation and college readiness rate.
New Visions starts with the premise that data matters; that when educators can see patterns they can intervene and make students successful. "For example," says Fairchild, "we know that kids who aren't doing well at the end of their freshman year are at higher risk of doing poorly during the next three years of high school or even dropping out. The sooner those high risk students are identified, the better the chances of helping them improve their grades and stay in school."
"Introduction to Dynamic Modeling with STELLA and iThink" Cambridge, MA — October 17-19, 2011 Whether you are new to Systems Thinking or it's been a while since you've used the STELLA or iThink software, this two and a half day workshop provides the most efficient way to come up to speed with the dynamic modeling approach. We'll draw upon years of real-world experience to help build your skills and facilitate modeling an issue of your own choosing.
"Intermediate Dynamic Modeling with STELLA and iThink" San Diego, CA — January 12-13, 2012 Register early to ensure a space in our popular intermediate workshop which is offered just once a year. Designed for experienced modelers or those who have already participated in our introductory course, this two day workshop will take your knowledge to the next level. Faculty will use a wide variety of case studies as vehicles for addressing key dynamic modeling topics and advanced software functionality.
To learn more or to register, email Anna Pippin at support@iseesystems.com or call (603) 448-4990.
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