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In response to a 2007 request from the U.S. Army Medical Research and Materiel Command (USAMRMC), the National Academy of Engineering and the Institute of Medicine conducted a two-day invitation-only workshop in Washington, D.C., June 11–12, 2008 to help the Department of Defense identify promising areas for near-, medium-, and long-term applications of operational systems engineering (OSE) tools and information technologies for modeling, analyzing, designing, and improving the care and management of patients with traumatic brain injury (TBI) throughout the military health care continuum—from battlefield to field hospital to U.S.-based military health care facilities to TRICARE networks and U.S. Department of Veterans Affairs (VA) facilities.
During the planning phase of the workshop, a steering committee of experts in TBI, military and veterans health care delivery, and OSE, supported by NAE and IOM professional staff, compiled a list of issues raised by stakeholders in the MHS community related to the care of mild, moderate, and severe TBI cases. From that list, they identified issues that could potentially benefit from OSE approaches and categorized them into five major challenge areas for TBI care:
the capacity, organization, and resource allocations of the TBI care system
The committee then condensed the major stakeholder issues in each of these categories into two or three issues for OSE analysis, that is, analytical challenges that could be met through the application of OSE approaches and that could lead to improvements in the delivery of TBI care.
The resulting summary of the workshop discussion includes an introduction the reviews the potential of OSE for improving the quality of health care and places the challenge of TBI care in the context of the broader issues of the quality of, and cost challenges to MHS health care. Chapters 2 through 5 provide individually authored summaries of the workshop presentations and discussions. These included background on the medical aspects of TBI and major clinical and logistical challenges in TBI care, as well as examples illustrating relevant applications of OSE tools and methods, and a case study of a shift by a major unit in an academic health system from expert-based medical practice to expert-managed system-supported practice. And the final chapter 6 includes the charges to the five working groups that were asked to address the five major challenge areas for TBI care and describes the results of their deliberations.