But not simpler... Technology, operations, management, and policy interfaces - engineering systems (not only) in healthcare
02:00pm to 04:00pm


In this talk we would like to introduce you to the problems and methods that we have worked with, in a domain at the intersection of engineering and other areas of knowledge, tentatively called Engineering Systems. We will provide a very brief introduction to Engineering Systems, and then present three pieces of research that we have carried out in this domain, one in forest fires, and two in healthcare.


Forest fire management to avoid unintended consequences: A case study of Portugal using system dynamics

Forest fires are a serious management challenge in many regions, complicating the appropriate allocation to suppression and prevention efforts. Using a System Dynamics (SD) model, we explore how interactions between physical and political systems in forest fire management impact the effectiveness of different allocations. A core issue is that apparently sound management can have unintended consequences. An instinctive management response to periods of worsening fire severity is to increase fire suppression capacity, an approach with immediate appeal as it directly treats the symptom of devastating fires and appeases the public. However, the SD analysis indicates that a policy emphasizing suppression can degrade the long-run effectiveness of forest fire management. By crowding out efforts to preventative fuel removal, it exacerbates fuel loads and leads to greater fires, which further balloon suppression budgets. The business management literature refers to this problem as the firefighting trap, wherein focus on fixing problems diverts attention from preventing them, and thus leads to inferior outcomes. We illustrate these phenomena through a case study of Portugal, showing that a balanced approach to suppression and prevention efforts can mitigate the self-reinforcing consequences of this trap, and better manage long-term fire damages. These insights can help policymakers and fire managers better appreciate the interconnected systems in which their authorities reside and the dynamics that may undermine seemingly rational management decisions.


A system dynamics based simulation of alternative supply chain strategies for hospital high volume, frequent and generalised use items

In a sector where traditionally changes are difficult to implement and sustain, and where multiple stakeholders are involved, the development of simple supply chain management process simulators can facilitate the observation and analysis of the effects of alternative decisions and the conciliation of the involved, often conflicting interests. In this work we focus on the internal hospital supply chain, with the development of several System Dynamics models, to simulate and analyse alternative supply chain operational processes. These processes involve: decentralised inventory control with no information sharing versus centralised inventory control and some information sharing; the possibility of emergency deliveries from the Distribution Centre (DC) in case of a stock-out at a ward; giving (or not) priority to the emergency room (ER) in the allocation of inventory when the inventory on hand at the DC is insufficient to meet all requests; and/or the existence of lateral transshipments from the other wards to the ER. Furthermore, the effects of some usual behavioural-based hospital management practices, namely the “just-in-case” approach to inventory control, are analysed.


Sequences of alignment between technologies and adopters: case research of implementations of a new health screening program

This work is motivated by the importance of technology implementation projects for networks of preventive healthcare providers to fully benefit from the technologies that they adopt. The focus of the research is on implementation processes, conceptualized as sequences of alignment between the technology and the adopter. The main goal of our work is to improve the current understanding about technology implementation projects, specifically by answering the following research question: “How do technology and its adopters align during its implementation in networks of organizations?” We use inductive multiple case research about implementations of a new health screening program in several networks of healthcare providers in the North of Portugal, to improve the understanding of the reasons, consequences, and management of sequences of alignment, namely non-linear and cascading sequences, which have been shown to be important mechanisms in implementations of technologies in networks.


Abílio Pereira Pacheco
INESC TEC, Faculdade de Engenharia da Universidade do Porto
João Claro
INESC TEC, Faculdade de Engenharia da Universidade do Porto
José Coelho Rodrigues
Nazaré Rego
EEG, Universidade do Minho