Field studies of psychological health delivery systems in the U.S. Military

Thesis (S.M. in Technology and Policy)-- Massachusetts Institute of Technology, Engineering Systems Division, Technology and Policy Program, 2012.Cataloged from PDF version of thesis.Includes bibliographical references (p. 97-102).Large-scale health enterprises comprise multiple organizations that provide programs and services for patients. Despite the interconnectedness of these systems there is a lack of empirical research documenting how these organizations work collectively - or integrate - and how this integration impacts enterprise performance measured through quality, efficiency, and access. In the case of psychological healthcare, patients often require a number of services that span multiple departments and programs within an enterprise, increasing the complexity of maintaining a continuum of care for these patients. This paper, which is part of a larger effort to examine psychological healthcare in the U.S. Military Health System, presents a series of qualitative observations and analyses of the integration of psychological health-related organizations at two large health enterprises within the military. These qualitative inquiries take a multilevel approach for examining integration within these enterprises and address the following areas of interest: 1) the mechanisms for integration; 2) the objects of integration; 3) the dimensions of integration; 4) the contextual factors that influence integration; and 5) the impacts of integration on enterprise performance. Using semi-structured interviews, qualitative data was collected and then examined using content analysis to identify the most frequent themes for each area of interest. This data was used to validate and refine a comprehensive framework for integration that was developed to pull together multiple, distinct strands of the integration literature. This data was also used to demonstrate the relationship between different dimensions of enterprise performance and to identify areas where, in the process of optimizing enterprise performance, there is a trade-off between these dimensions. The preliminary, qualitative results of this research are intended to provide a conceptual foundation and framework for future analytic studies.by Cody M. Kamin.S.M.in Technology and Polic

Psychological Health in the United States Military: Making Sense of What We Know

Hundreds of thousands of United States military service members are suffering from PTSD and other psychological health conditions as a result of their wartime service. A myriad of possible system interventions and resource allocation schemas have been researched and proposed, but finite budgets and manpower dictate a careful allocation of resources to optimize outcomes. We describe a stock-and-flow model of psychological health treatment tailored to the unique context of the military’s healthcare system. Our model, implemented as a “Management Flight Simulator”, reports the impact of system interventions on areas of stakeholder concern and is designed to communicate complex systemic behaviors to those without domain specific knowledge

A Survey of Systems and Improvement Approaches for Psychological Healthcare

This paper reviews the literature to date that uses industrial and systems engineering and operations management methods to improve psychological healthcare in the military setting as well as in the civilian sector. The study findings are categorized using an Enterprise Architecture framework; the categorization highlights the enterprise architecting views that have been more thoroughly studied and those areas that have not been addressed as extensively by the present research. The review also found that methods based in industrial and systems engineering and operations management concepts related to improvements in policy may be developed more holistically in the both the military and civilian sectors. In conclusion, methods used to improve psychological healthcare in both sectors may be transferable across sectors and should be considered for to the improvement of psychological health at large

Integration and the Performance of Large-scale Health Enterprises: Field Studies of Psychological Health Delivery Systems in the U.S. Military

Large-scale health enterprises comprise multiple organizations that provide programs and services for patients. Despite the interconnectedness of these systems there is a lack of empirical research documenting how these organizations work collectively - or integrate - and how this integration impacts enterprise performance measured through quality, efficiency, and access. In the case of psychological healthcare, patients often require a number of services that span multiple departments and programs within an enterprise, increasing the complexity of maintaining a continuum of care for these patients. This paper, which is part of a larger effort to examine psychological healthcare in the U.S. Military Health System, presents a series of qualitative observations and analyses of the integration of psychological health-related organizations at two large health enterprises within the military. These qualitative inquiries take a multilevel approach for examining integration within these enterprises and address the following areas of interest: 1) the mechanisms for integration; 2) the objects of integration; 3) the dimensions of integration; 4) the contextual factors that influence integration; and 5) the impacts of integration on enterprise performance. Using semi-structured interviews, qualitative data was collected and then examined using content analysis to identify the most frequent themes for each area of interest. This data was used to validate and refine a comprehensive framework for integration that was developed to pull together multiple, distinct strands of the integration literature. This data was also used to demonstrate the relationship between different dimensions of enterprise performance and to identify areas where, in the process of optimizing enterprise performance, there is a trade-off between these dimensions. The preliminary, qualitative results of this research are intended to provide a conceptual foundation and framework for future analytic studies