University of Wisconsin-Madison College of Engineering Annual Report 2003
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Industrial Engineering

David Gustafson

Paths to recovery: Initiative addresses issues in substance-abuse clinics

At 11 a.m., the telephone rings in a substance-abuse clinic. One ring, then two, three, four. Finally, a machine answers and the caller awkwardly leaves this important message: "I am an addict and I need help."

An answering machine? It's true — even in some of the best substance-abuse clinics, says David Gustafson, (far left), professor emeritus and member of the Center for Health Systems Research and Analysis (CHSRA). He views the answering machine as a lost opportunity for these clinics to engage patients the moment they make that first call. And it could be part of a larger set of organizational systems that negatively affect patients' access to and success in substance-abuse treatment programs.

Gustafson and CHSRA researchers are leading a $9.5 million Robert Wood Johnson Foundation initiative, called Paths to Recovery, that will identify and improve these systems. Aiming to increase patient success and staff satisfaction, the effort focuses on several "paths to recovery," including a patient's first clinic contact, patient scheduling, family involvement in treatment, paperwork reduction, and staff development.

In many cases, both large substance-abuse networks and small clinics operate with limited staff on a shoestring budget, yet they manage some success with the resources they have, says Gustafson. One of the project's goals is to help those clinics work better with their resources.

For 18 months, process consultants in the research group will work on each "path" with 15 to 20 clinics nationwide. The group also will bring together clinic staff and systems experts in three learning sessions, organize educational teleconferences, and update with data, information, ideas and case studies. Oregon Health and Sciences University will evaluate the program.

E-procurement tool benefits B-to-B interactions

Although many of Rockwell Automation's worldwide customers hoped to implement e-procurement systems that improve ordering and fulfillment transactions in the company, after the systems were in place, the results weren't as successful as Rockwell hoped.

Working with researchers from the college's Global E-Business Consortium (CGEC), Rockwell staff learned the breakdown wasn't necessarily technological, but often the result of organizational glitches. Additionally, CGEC researchers developed an assessment tool to help Rockwell determine its customers' readiness for adopting an e-procurement system. The tool establishes benchmarks for companies at the development, rollout and adoption phases of their e-procurement strategies. And after they've implemented the system, the tool also provides a "scorecard," so that companies can tell which aspects are working or not working, and why.

Professor and CGEC Director Raj Veeramani says that because the tool really identifies various areas of risk, it can apply to many companies and many situations. "The tool relates to any type of business-to-business interaction," he says. "So you can tailor it easily."

Improving outpatient surgical success rates

With attempts to reduce medical costs — particularly hospital costs — the number, speed and complexity of outpatient surgeries increases, says Professor Pascale Carayon. And that means the number of patient safety issues — ranging from patient records not arriving in time for a surgery to an operation on a wrong body part — also increases.

With intern Phil Ayoub, Research Scientists Ann Hundt and Carla Alvarado, Assistant Professor of Population Health Sciences Maureen Smith, and Assistant Professor Ben-Tzion Karsh and Professor Patti Brennan, Carayon is working with five Madison outpatient surgery centers to improve the processes through which both patients and clinical staff must go before, during and after a surgery. Conducted with the Madison Patient Safety Collaborative, whose coordinator, Amanda Borgsdorf, is a member of the research team, the project is funded via a three-year, $600,000 grant from the U.S. Agency for Healthcare Research and Quality.

The research focuses on improving patient pre-operation assessments and post-operation follow-up. To start, the group asked employees to complete a questionnaire to identify patient-safety issues and workplace factors that either hindered or facilitated their job performance. And to understand the patients' perspective, they followed several patients through their day at a center.

As they implement solutions, the researchers are collecting data about the level of communication internally and between center staff and workers at the patients' referring clinics. They also are conducting surveys to learn whether patients understood pre- and post-surgery instructions. Though the solutions are specific to each clinic, the researchers are documenting their processes, data and tools for more general use, says Carayon.


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Copyright 2003 The Board of Regents of the University of Wisconsin System
Date last modified: Tuesday, 14-Oct-2003 16:40:00 CDT
Date created: 14-Oct-2003