Appendix E
Workshop Agenda

Harnessing Operational Systems Engineering to Improve Traumatic Brain Injury Care in the Military Health System

June 11–12, 2008

Keck Center of the National Academies, Room 201

500 Fifth Street, N.W.

Washington, DC 20001

Workshop Goal: To demonstrate the potential value of operational systems engineering (OSE) to improve the care of traumatic brain injury (TBI) in the Military Health System (MHS).

DAY 1

8:00

Welcome and Introductions

Norman Augustine, M.S.E., Lockheed Martin Corp (ret.) and Planning Committee Co-Chair (NAE)

Judith Salerno, M.D., M.P.H., Executive Officer, Institute of Medicine

S. Ward Casscells, M.D., Assistant Secretary of Defense for Health Affairs



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Appendix E Workshop Agenda Harnessing Operational Systems Engineering to Improve Traumatic Brain Injury Care in the Military Health System June 11–12, 2008 Keck Center of the National Academies, Room 201 500 Fifth Street, N.W. Washington, DC 20001 Workshop goal: To demonstrate the potential value of operational systems engineering (OSE) to improve the care of traumatic brain injury (TBI) in the Military Health System (MHS). DAy 1 8:00 Welcome and Introductions Norman Augustine, m.S.E., lockheed martin Corp (ret.) and Plan- ning Committee Co-Chair (NAE) judith Salerno, m.D., m.P.H., Executie officer, institute of medi- cine S. Ward Casscells, m.D., Assistant Secretary of Defense for Health Af- fairs 

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 SyStEmS ENgiNEEriNg to imProvE trAumAtiC BrAiN iNjury CArE SESSION I: BACkgROuND AND OvERvIEW Session Objective: To provide a general background on the goals of the workshop, the current system of care for traumatic brain injury in the military, and general utility of operational systems engineering tools and techniques in other health care areas. Session moderator: Norman Augustine 8:20 Traumatic Brain Injury Case Histories from the Military: “Survive, Thrive, Alive” video 9:00 Medical Aspects of Traumatic Brain Injury robert labutta, Col, m.D., medical Corps, uS Army, tBi Senior Executie (interim) Defense Center of Excellence for Psychological Health & traumatic Brain injury 10:15 The “As Is” System for TBI Management in the Military Health System michael S. jaffee, Col. (s), m.D., (uSAf) National Director, Defense and veterans Brain injury Center 11:15 Operational Systems Engineering Examples from Other Health Areas William P. Pierskalla, Ph.D., Anderson graduate School of manage- ment uniersity of California, los Angeles (NAE) SESSION II: WORkINg gROuPS FORMuLATE ANALySIS PLANS FOR IDENTIFIED MHS TBI CARE SySTEM ANALySIS ISSuES Session Objective: To demonstrate the kinds of approaches, methods, and information that can be developed by OSE practitioners to assist TBI care providers and managers. After receiing guidance from the planning committee, fie multidisci- plinary working groups will conene to deelop analysis plans for future oSE studies that could adance understanding of selected major chal- lenges facing the tBi care deliery system. 11:45 Target TBI Care System Analysis Issues for Working groups Seth Bonder, Ph.D., the Bonder group (NAE)

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 APPENDix E 1:15 Working groups Session 1 Each working group will be asked to develop brief analysis plans for future operational systems engineering studies that could be used to assist providers and managers address important challenges facing the TBI care delivery system. Each working group will work on pre-selected challenges in one of five major categories of TBI care analysis issues identified by the planning committee: (A) new TBI knowledge; (B) detection and screen- ing of TBI conditions; (C) TBI care coordination and com- munication; (D) TBI care demand; and (E) TBI care system capacity, organization, and resource allocation. Working group Meeting Rooms: Working Group A: Developing New TBI Knowledge [Keck 206] Working Group B: Detection and Screening of TBI Conditions [Keck 207] Working Group C: TBI Care Coordination and Communication [Keck 208] Working Group D: TBI Care Demand [Keck 213] Working Group E: TBI Care System Capacity, Organization, and Resource Allocation [Keck 201] 4:30 Working group Interim Reports and Discussion moderator: Norman Augustine 5:30 Adjourn to Reception and Working Dinner 5:45 Reception and Working Dinner keck Center Atrium keynote: Insights from vanderbilt’s Journey toward System- Supported Practice William Stead, m.D., Associate vice Chancellor for Strategy/trans- formation and Director of the informatics Center at vanderbilt uniersity medical Center (iom)

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 SyStEmS ENgiNEEriNg to imProvE trAumAtiC BrAiN iNjury CArE DAy 2 8:00 Welcome and Recap of the First Day Denis Cortese, m.D., mayo Clinic and Planning Committee Co-Chair (iom) Norman Augustine, m.S.E., lockheed martin Corp (ret. ) and Plan- ning Committee Co-Chair (NAE) SESSION II (Cont’d): WORkINg gROuPS FORMuLATE ANALySIS PLANS FOR IDENTIFIED MHS TBI CARE SySTEM ANALySIS ISSuES Session Objective: The five multidisciplinary working groups will recon- vene to formulate “analysis plans” for two or more identified TBI care system analysis issues. 8:15 Working groups Session 2 (in Breakout rooms) Working group Meeting Rooms: Working Group A: Developing New TBI Knowledge [Keck 206] Working Group B: Detection and Screening of TBI Conditions [Keck 205] Working Group C: TBI Care Coordination and Communication [Keck 208] Working Group D: TBI Care Demand [Keck 213] Working Group E: TBI Care System Capacity, Organization, and Resource Allocation [Keck 201] SESSION III: REPORT OuT OF BREAkOuT gROuP DISCuSSIONS 1:00 Working group Reports and Discussion [Convene in Keck 201] moderator: Denis Cortese

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 APPENDix E SESSION Iv: PANEL DISCuSSION ISSuES, OPPORTuNITIES, AND POTENTIAL NExT STEPS Session Objective: To identify the most valuable analysis plans set forth by the working groups that would, if implemented, significantly im- prove the care of TBI in the military. Session moderator: Denis Cortese 3:30 Provider/Policy-Maker Perspectives on Working group Outcomes: Panel and Moderated Discussion michael S. jaffee, Col. (s), m.D., (uSAf) National Director, Defense and veterans Brain injury Center michael Dinneen, Director, office of Strategy management, military Health System 4:30 Concluding Summary Remarks and Adjournment Norman Augustine and Denis Cortese Planning Committee: Norman R. Augustine, M.S.E. (NAE/NAS), Co-Chair, Lockheed Mar- tin Corporation (ret.) Jerome H. Grossman, M.D. (IOM), Co-Chair (Noember 00 to April 00) Denis Cortese, M.D. (IOM), Co-Chair, Mayo Clinic (Beginning April 00) Seth Bonder, Ph.D. (NAE), The Bonder Group Patricia Flatley Brennan, Ph.D. (IOM), University of Wisconsin- Madison Thomas F. Budinger, M.D., Ph.D. (IOM/NAE), University of Califor- nia, Berkeley Barrett S. Caldwell, Ph.D., Purdue University Michael P. Dinneen, M.D., Ph.D., Military Health System Paul M. Horn, Ph.D. (NAE), New York University Michael S. Jaffee, COL (s), M.D., USAF, National Director, Defense and Veterans Brain Injury Center

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 SyStEmS ENgiNEEriNg to imProvE trAumAtiC BrAiN iNjury CArE William P. Nash, M.D., CAPT, Medical Corps, USN (ret.), USMC/ USN Liaison to the Defense Center of Excellence for Psychological Health and TBI Alexander K. Ommaya, Sc.D., Department of Veterans Affairs David T. Orman, M.D., COL (ret.), HQ, U.S. Army MEDCOM Ronald Poropatich, M.D., COL, Medical Corps, U.S. Army, Telemedi- cine and Advanced Technology Research Center (TATRC) William B. Rouse, Ph.D. (NAE), Georgia Institute of Technology Nina A. Sayer, Ph.D., LP, Department of Veterans Affairs Health Ser- vices Research & Development Center for Excellence This workshop is dedicated to Jerome H. grossman, M.D., a long-time member, friend, and leader in the work of the National Academies. By nature and profession, Jerry was a bridge builder. He was the liaison between the Institute of Medicine and the National Academy of Engineering and the primary motivator and intellectual compass for this workshop and its focus on harnessing systems engineering tools, techniques, and knowledge to improve the quality of traumatic brain injury care in the Military Health System. He passed away suddenly on April 1, 2008.