Health Care Systems Engineering - MasterClasses
Many believe that safety risks, long waits, poor quality, and rising costs are inevitable in modern health care systems. In reality, they are the predictable consequences of the system design. So, to avoid these unwanted outcomes it is necessary to learn how to diagnose the causes of these issues, and to learn how to design and deliver sustainable solutions to them. This the purpose of the HCSE program.
These Practical Skills Workshops are an essential component of the path to developing "diagnose, design and deliver" skills. After completing an online course or a practical skills workshop, a participant can immediately apply their new knowledge and demonstrate significant improvements in their part of their health care system. |
A Sample of Published HCSE Case Studies
© Wright L. Diagnosis and Treatment of CT Constraints.
Journal of Improvement Science 2023; 102: 1-31.
"A detailed summary of the successful outcome of a 2-year HCSE project to improve delivery times for diagnostic imaging (computed tomography) in four trusts across Kent and Medway."
© Lane M, Murphy J. A Return to Morriston Pre-Operative Assessment Clinic.
Journal of Improvement Science 2023; 100: 1-20.
"The second part of how the productivity of a POAC clinic was doubled by desigining the sequence and schedule in sympathy with the work done."
© Hothi S, Brown E. Developing a Vitals Chart Dashboard for Urgent Suspected Cencer Referrals.
Journal of Improvement Science 2022; 95: 1-19.
"The story of how a validated, Excel-based prototype of a diagnostic vitals chart (DVC) was collaboratively reverse-engineered into a Power BI dashboard."
© Hothi S. Understanding the Causes of Long Waits and Poor Patient Flow in an Urgent Suspected Breast Cancer One-Stop Clinic.
Journal of Improvement Science 2022; 89: 1-19.
"This project describes a systems engineering approach to understanding the complex flows in an urgent suspected cancer clinic and diagnosing the causes of the queues and delays."
© Flood R, Wright L. Reducing Lead Times for CT Colonoscopy Patients by Changing the Booking Policies.
Journal of Improvement Science 2022; 88: 1-26.
"This full diagnose-design-deliver project used the HCSE approach to identify the primary cause of queues and delays - the booking policies - and improved flow and waiting times
by just changing the bottleneck policy."
© MacDonald A, Silvester K. Applying Systems Engineering to Design an Urgent Primary Care Drive Through Facility: Part 1.
Journal of Improvement Science 2021; 85: 1-18.
"The COVID pandemic created the necessity for innovation as demonstrated by this ground-breaking project to design and deliver a high volume, zero wait, COVID-safe, drive-thru facility."
© Kidd P, Gallagher D. Using Systems Engineering to Create Resilience in COVID-19 Swabbing Capacity at University Hospital Galway.
Journal of Improvement Science 2021; 82: 1-20.
"All parts of the global healthcare system were affected by the COVID pandemic. This project from Galway in Ireland used the HCSE diagnose-design-deliver approach to dramatically
increase the flow of their safety-critical COVID swabbing service."
© Chong Y, et al. Planning Ophthalmology Workflow in Response to the COVID-19 Pandemic: A Systems Engineering Approach.
Journal of Improvement Science 2020; 69: 1-10.
"This project describes a systems engineering approach undertaken by ophthalmology registrars, with little prior knowledge in health care systems engineering (HCSE),
to help analyse current clinic workflow patterns."
© Dodds S, Bradley D. An Acute Hospital Demand Surge Planning Model for the COVID-19 Epidemic using Stock-and-Flow Simulation in Excel: Part 1.
Journal of Improvement Science 2020; 68: 1-20.
"This essay describes the science underpinning epidemiological modelling and demonstrates that a basic system dynamic (or stock-and-flow) model of an epidemic
can be implemented using widely available spreadsheet software such as Excel."
© Talbot L. Visualizing the Referral to Treatment Time (RTT) Waiting List for Ophthalmology Patients.
Journal of Improvement Science 2020; 66: 1-16.
"The purpose of the project was to create a visualization of those patients waiting for surgery in Ophthalmology as a means of helping the staff gain a better understanding of their service. The Vitals Chart® was chosen as this shows how changes in demand and activity affect the waiting list over time."
© Jones C. Improving the Delivery Model for Chemotherapy.
Journal of Improvement Science 2019; 60: 1-19.
"This case study describes the use of the innovative eleGANTT® technology for measuring and visualising a complex, chaotic microsystem in real-time to support the use of an advanced HCSE technique called diagnostic modelling."
© Dowdall M. 6M Design® in Our Hands - Improving Paediatric Ophthalmology In-Clinic Flow.
Journal of Improvement Science 2018; 53: 1-17.
"This essay describes the learning process experienced by the author, as a novice, in diagnosing and improving the problems affecting a chaotic paediatric ophthalmology clinic using the 6M Design® method."
© Wright L. Diagnosing Long Waits in Radiology.
Journal of Improvement Science 2017; 50: 1-8.
"The common assumption is that long waits are due to the service 'demand' being greater than the 'capacity' but this is not necessarily true. Making the diagnosis of the constraint is critical and requires managers to understand the flow through their service."
© Fullerton K. Theory of Constraints and 6M Design® Applied to a Virtual Scenario.
Journal of Improvement Science 2017; 41: 1-26.
"Eli Goldratt's Theory of Constraints (TOC) and SAASoft's 6M Design® approaches were applied to the worked example of a fracture clinic in the HCSE-1 training programme. The two approaches were found to work synergistically in understanding the flow through the clinic and addressing the problem of long waiting times for patients.."
© Bradley D. Investigating Fractured Flow from Orthopaedics to Rehabilitation.
Journal of Improvement Science 2016; 28: 1-16.
"We investigated the flow of patients through a trauma and orthopaedics unit using the 6M Design® framework and Vitals Charts® in order to investigate concerns about delayed repatriation. We found that, because only a small proportion of patients require repatriation, expediting the repatriation process by one day for each patient would only reduce WIP by an average of 1.6 patients."
© Debenham P. Improving Clinical Team Briefing Using 6M Design®
Journal of Improvement Science 2015; 25: 1-18.
"Despite modelling the anticipated benefits of re-designing the Team Brief Process, I was struck by both a sense of wonder and pride at the scale of impact I experienced on implementation of the re-designed process."
© Silvester K. Learning with the Labs.
Journal of Improvement Science 2015; 22: 1-30.
"This paper reviews the learning gained from the Lean A3 scientific problem solving process used at the time with process design skills acquired later from the FISH (Foundations of Improvement Science in Healthcare) and ISP (Improvement Science Practitioner) courses."
The Flow Workshop - CPD Certified (6 hours)
This one-day practical skills workshop is the recommended starting point for individuals and teams who want to see the diagnose-design-deliver techniques working in practice before progressing to HCSE-1 training and real-world improvement projects. We use a realistic, relevant, real-world simulated scenario to develop awareness of the core concepts and principles underpinning queue-free, delay-free, chaos-free, distress-free, efficient, effective and productive planned services.
Time | Activity |
---|---|
09:00 | Introductions and Expectations |
09:15 | The Dystopia One-Stop Clinic |
10:00 | 6M Design® - Map |
10:45 | Refreshments |
11:00 | 6M Design® - Measure |
12:00 | 6M Design® - Model - Diagnosis |
12:30 | Buffet Lunch |
13:15 | 6M Design® - Model - Design and Prognosis |
14:15 | 6M Design® - Model - Decide |
14:30 | 6M Design® - Modify |
15:00 | Refreshments |
15:15 | 6M Design® - Monitor - Review and Reflect |
16:00 | 6M Design® - Maintain - Next Steps |
16:30 | Reflections |
The TTBaCO Workshop
This Level-1, practical skills, one-day workshop is specifically designed to demonstrate the diagnose-design-deliver techniques applied to the most endemic causes of queues and delays - time-traps, batching and carveout.
We use a realistic, relevant, real-world simulated scenario to develop awareness of the core concepts and principles underpinning the diagnosis and treatment of these policy ailments.
Time | Activity |
---|---|
09:00 | Introductions and Expectations |
09:30 | The Carveout Game |
10:45 | Refreshments |
11:00 | Anatomy, Physiology and Pathology of the TTBaCO policy addiction |
12:30 | Buffet Lunch |
13:30 | Diagnosis of TTBaCO policies |
14:15 | Treatment of TTBaCO policies |
15:00 | Refreshments |
15:15 | The Carveout Game - revisited |
16:30 | General Discussion |
17:00 | Close |
The Resilience Workshop
This one-day workshop is designed to complement the Flow and Carveout workshops and is for anyone working in the unscheduled care system such as GPs, GPOOH, ED, Acute Care Clinicians, Service Managers and Commissioners who want to improve safety, on-time delivery, quality and affordability of unscheduled care by eliminating queues, chaos and associated stress.
The workshop is a learn-by-doing, seeing-is-believing experience that demonstrates how health care systems engineering (HCSE) theory, techniques and tools are employed to improve unscheduled care pathways.
Time | Activity |
---|---|
09:00 | Introductions, Expectations and Context |
09:30 | The Productive Clinic Revisited |
10:45 | Refreshments |
11:00 | Design for Resilience |
12:15 | Storyboard Review and Next Steps |
12:30 | Buffet Lunch |
13:15 | The Common Causes of Chronic Chaos |
14:00 | Diagnosis and Design |
15:00 | Refreshments |
15:15 | Restoration of Calm |
16:30 | Summary, Reflections and Feedback |
17:00 | Close |
Masterclasses
The HCSE Masterclasses are designed to develop deeper understanding of specific areas of health care system design. They are for those on the HCSE Programme, can be done in any order and are designed to complement each other. Each Masterclasse is a pragmatic, hands-on, immersive, learn-by-doing experience that is both fun and informative. A list of some of the themes covered to date is shown below. |
Masterclass | Masterclass Description |
---|---|
Scheduling Design | How to match load and resource-time capacity at the microsystem level. |
System Behaviour Charts | How to use time-series charts for diagnosis, design, and delivery. |
Synchronisation Design | How to design data flows to support chaos-free, autoregulating processes. |
Stream Design | How to assemble mesosystems from microsystem components. |
Agile Projects | How to design and manage an efficient and effective improvement project. |
Creative Design | How to amplify and accelerate team creativity. |
System Dynamics | How to create and use mesosystem and macrosystem stock and flow models. |
Causology | How to diagnose the counter-intuitive causes of chaos, queues and delays. |
Resilient Design | How to improve efficiency and on-time delivery without compromising safety and quality. |
Safety and Prosperity | How to ensure a system design delivers sustained success for all stakeholders. |
HCSE Masterclass Designer
Simon Dodds studied medicine and digital systems engineering before following a career in general and vascular surgery.
During his training he researched the problem of modelling blood flow in networks of diseased arteries and used computer
simulations to develop more accurate non-invasive tests for arterial disease.
In 1999, after appointment as a consultant surgeon in the West Midlands, he applied his skills as a systems engineer
and as a clinician in the redesign of the vascular surgery clinic and the leg ulcer service.
The project was awarded a national innovation award for service improvement in 2004 and the story is told in the book
Three Wins: Service Improvement Using Value Stream Design. See on Amazon.
This experience led to the creation of www.chcse.uk which is a web portal for the development and dissemination of the theory, techniques,
tools and training of Health Care Systems Engineering (HCSE). His current NHS role is a part-time consultant general surgeon. |
The Calendar
Date | Venue | Workshop Type | Flyer | Available | Action |
---|---|---|---|---|---|
Tues, 12th Nov 2024 09:00-17:00 | St. Marys Campus, Cork (Private) | Flow Workshop | N/A | No Places | |
Thurs, 23rd Jan 2025 09:00-17:00 | Moor Hall Hotel (Private) | HCSE Masterclass | N/A | >4 Places | |
Weds, 19th Feb 2025 09:00-17:00 | Cork, Ireland (Private) | TBC | N/A | >4 Places | |
Thurs, 25th Mar 2025 09:00-17:00 | Moor Hall Hotel (Private) | HCSE Masterclass | N/A | >4 Places | |
Weds, 16th Apr 2025 09:00-17:00 | Cork, Ireland (Private) | TBC | N/A | ? Places | |
Thurs, 15th May 2025 09:00-17:00 | Moor Hall Hotel (Private) | HCSE Masterclass | N/A | ? Places | |
Weds, 18th Jun 2025 09:00-17:00 | Cork, Ireland (Private) | TBC | N/A | ? Places | |
Thurs, 10th July 2025 09:00-17:00 | Moor Hall Hotel (Private) | HCSE Masterclass | N/A | ? Places | |
Weds, 13th Aug 2025 09:00-17:00 | Cork, Ireland (Private) | TBC | N/A | ? Places | |
Thurs, 18th Sept 2025 09:00-17:00 | Moor Hall Hotel (Private) | HCSE Masterclass | N/A | ? Places | |
Weds, 15th Oct 2025 09:00-17:00 | Cork, Ireland (Private) | TBC | N/A | ? Places |
The Reservation
?Note: There is no additional cost for delegates with an active HCSE Subscription on the date of the event.
The Payment
If you did not select "Invoice" please complete the on-line payment to secure your booking.
The standard cost of each One Day Workshop or Masterclass is £250.00 (ex VAT).
Included in all Workshops:
- One-day of Interactive, Learning-by-Doing, Practical Exercises and Facilitated Discussion.
- All-day Refreshments and Buffet Lunch.
- Printed Handout.
- Access to the FISH, CHIPs and JOIS online resources.
Please use the secure on-line payment below and be sure to include a valid email address.
If you require a VAT receipt please email us here.
No Payment
This is a funded workshop and there is no additional delegate fee for attending.
Included in the Workshop:
- On-line access to pre-workshop material (varies with specific workshop).
- Interactive, Learning-by-Doing, Practical Exercises and Facilitated Conversations.
- Printed Handout.
There are two dimensions of improvement by design:
1. Safety and Quality
2. Flow and Productivity
Safety comes first.
A high-quality experience for patients and staff requires a calm environment.
And a productive system is both effective and uses resources efficiently.
HCSE teaches how to design a health care system to be fit-for-purpose from all four perspectives.
Enquiries contact email