INCOSE Text below:
The International Council on Systems Engineering believes a systems approach could help stop the outbreak in West Africa and improve infection control in the US. INCOSE recently criticized the handling of Dallas Ebola patient Thomas Eric Duncan’s case. Duncan was seen and released from a Dallas hospital that did not accurately diagnose his symptoms in part because of communication breakdowns and flaws with electronic health records.
“A systems approach would have helped lessen or eliminate many of the issues in this case and the Ebola crisis in general, by ensuring that everyone involved in any part of the system was aware of the other parts of the system and that access to information was made available to everyone,” says INCOSE President David Long. “Engineering a coordinated system is key to ensure there are no missteps and each patient receives effective care.”
Bohdan Oppenheim, professor of systems engineering at Loyola Marymount University in Los Angeles, explains that systems thinking considers all systems that may be in play—doctors, patients, medical devices, waste disposal, and others—and considers how they interact together and as a whole. “The goal is to have all processes, people, and structures work together effectively,” he says.
“An engineer’s approach to this problem would ensure that no details are overlooked, and that actions are as effective as reasonably attainable,” adds Dr. Michael Appel, anesthesiologist and chief patient safety officer for the Northeast Georgia Health System. “Put another way, a mere flurry of activity will not solve this problem; only suitable actions will.”
Unfortunately, formal systems engineering is not yet used widely in health care, according to Oppenheim. But efforts are being made by INCOSE to change that.
“We need to understand and apply not only the medical aspects of Ebola—diagnosis, treatment, illness life cycle, medicines—but also illness containment along the entire timeline, from the first suspicion that an individual may be infected to…disposal of the body if the patient should die,” Oppenheim says. “This will involve the collaborative work of multiple parties—all sitting around the same table—systems engineers, doctors, nurses, the patient, emergency medical response teams, waste disposal teams, language translators, police, TSA, safety experts, the CDC, and FDA.”
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