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An overview of engineering systems that describes the new challenges posed for twenty-first-century engineers by today's highly complex sociotechnical systems.
An argument that understanding healthcare delivery as a complex adaptive system will help us design a system that yields better health outcomes.Breakthroughs in medical science, innovations in medical technologies, and improvements in clinical practices occur today at an increasingly rapid rate. Yet because of a fragmented healthcare delivery system, many Americans are unable to benefit from these developments. How can we design a system that can provide high-quality, affordable healthcare for everyone? In this book, William Rouse and Nicoleta Serban introduce concepts, principles, models, and methods for understanding, and improving, healthcare delivery. Approaching the topic from the perspectives of engineering and statistics, they argue that understanding healthcare delivery as a complex adaptive system will help us design a system that is more efficient, effective, and equitable.The authors use multilevel simulation models as a quantitative tool for evaluating alternate ways of organizing healthcare delivery. They employ this approach, for example, in their discussions of affordability, a prevention and wellness program, chronic disease management, and primary care accessibility for children in the Medicaid program. They also consider possible benefits from a range of technologies, including electronic health records and telemedicine; data mining as an alternative to randomized trials; conceptual and analytical methodologies that address the complexity of the healthcare system; and how these principles, models, and methods can enable transformational change.
A guide to using the power of design flexibility to improve the performance of complex technological projects, for designers, managers, users, and analysts.Project teams can improve results by recognizing that the future is inevitably uncertain and that by creating flexible designs they can adapt to eventualities. This approach enables them to take advantage of new opportunities and avoid harmful losses. Designers of complex, long-lasting projects-such as communication networks, power plants, or hospitals-must learn to abandon fixed specifications and narrow forecasts. They need to avoid the "e;flaw of averages,"e; the conceptual pitfall that traps so many designs in underperformance. Failure to allow for changing circumstances risks leaving significant value untapped. This book is a guide for creating and implementing value-enhancing flexibility in design. It will be an essential resource for all participants in the development and operation of technological systems: designers, managers, financial analysts, investors, regulators, and academics.The book provides a high-level overview of why flexibility in design is needed to deliver significantly increased value. It describes in detail methods to identify, select, and implement useful flexibility. The book is unique in that it explicitly recognizes that future outcomes are uncertain. It thus presents forecasting, analysis, and evaluation tools especially suited to this reality. Appendixes provide expanded explanations of concepts and analytic tools.
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