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Activating a large foreign outpatient facility using a systems-based approach to dry runs
The value of dry runs as a tool to assess operational readiness when activating healthcare facilities is well documented. However, this paper analyses how the application of this tool is often limited to isolated teams or processes. The paper describes how, 2019, Mayo Clinic was engaged in a consulting capacity to activate a large healthcare facility in the Middle East. A short activation timeline and limited staff exposure to the new facility meant there was a need to conduct a systematic assessment of operational readiness. The systems-based approach to scenario development and dry run execution relied on the involvement of 28 outpatient specialties and 16 support functions. These teams collectively executed dry runs for 74 integrated scenarios and actively participated in the resolution of findings. Integrated scenarios served to validate operations at a systems level, while team-specific scenarios served as supplemental validation for isolated processes. Dry runs exposed a total of 231 findings. High, medium and low priority findings made up 36%, 42% and 22% of total findings, respectively. Prior to activation, 75% of findings were resolved, 9% were no longer applicable and 16% were prioritised as post-activation projects. During activation, no serious patient safety, regulatory or compliance issues were reported, and no major security events occurred. This is evidence that dry runs were successful in exposing latent gaps in workflows; training and education; and infrastructure, equipment, supplies and technology.
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Hugo Pariseau is a Health Systems Engineer in the Department of Management Engineering and Consulting (ME&C) at Mayo Clinic. He began his career with Mayo Clinic and ME&C in 2017 and has since worked on a variety of projects impacting multiple sites and functions. Originally an Associate in the Fellowship Program on the Arizona campus, Hugo gained early experience working on staffing-to-workload and surgery scheduling optimisation projects. Upon relocating to Rochester in 2018, Hugo became involved in revenue model innovation initiatives before joining the ME&C team supporting the activation of Sheikh Shakhbout Medical City (SSMC) in Abu Dhabi. Following the activation of SSMC, he remained engaged in international projects for both SSMC and Mayo Clinic Healthcare-London, where he partnered with executives on engagements ranging from strategy to execution. Hugo holds a Bachelor of Science degree in Biomedical Engineering from Texas A&M University and a Master of Science degree in Finance from Vanderbilt University.
Nahed Balalaa Dr Nahed Balalaa, MBBCh, EMHCA, is a Consultant Breast Surgeon at Sheikh Shakhbout Medical City (SSMC), where she serves as director of the outpatient department. She has extensive experience implementing strategies to improve and expand services while working to enhance customer access and satisfaction. Dr Balalaa has leadership experience in education and clinical practice and is actively involved in teaching, course design and research. She serves as a core faculty member in the General Surgery Residency Programme and as a member of several multidisciplinary subcommittees. During the activation of SSMC in 2019–2020, she was the physician lead for the activation of outpatient services. Dr Balalaa graduated from Dubai Medical College in the UAE and completed her MRCS with The Royal College of Physicians and Surgeons in Glasgow, UK. After completing her Arab Board and General Surgery Residency Programme, she was appointed the Administrative Chief Resident. She then completed her European Board of Surgery in Breast Surgery (EBSQ) in Belgium. Dr Balalaa obtained her Executive Masters in Health Care Administration (EMHCA) with distinction from Zayed University in partnership with University of Houston - Clear Lake and the University of North Carolina at Chapel Hill.
David M. O'Brien David M. O’Brien is a Senior Health Systems Engineer in the Department of Management Engineering and Consulting (ME&C) at Mayo Clinic. He has more than 5 years’ experience in leading clinical teams developing telehealth solutions and direct-to-consumer healthcare products and services, and he provides business and strategic consulting assistance to durable medical equipment providers. Before joining ME&C, David was a Laboratory Technologist Resource Coordinator at Mayo Clinic Laboratories, providing laboratory testing support and on-site workflow design and consulting services to over 70 referral laboratory clients. He has a master’s degree in Business Administration from St. Thomas University, St Paul, Minnesota.
Naser Ammash Dr Naser Ammash, MD, has been Professor of Medicine, Mayo Clinic College of Medicine, and Consultant in the Cardiovascular (CV) Department at Mayo Clinic, Rochester, since 1995. Dr Ammash is the current CEO of Sheikh Shakhbout Medical City (SSMC), a joint venture between Mayo Clinic and the Abu Dhabi health authority. He was one of the physician leaders responsible for the successful activation of SSMC. Dr Ammash is the immediate past Practice Chair of the CV Department at Mayo Clinic Rochester and served as Chair of the CV Clinical Practice Committee for Rochester and the Mayo Clinic enterprise (2014–2018). In that role, he oversaw and directly managed the restructuring of the inpatient and outpatient practice into an integrated patient-centric, disease-orientated, at times multispeciality, team-based service. Dr Ammash is board certified in cardiovascular diseases, with subspeciality certification in Adult Congenital Heart Disease and Echocardiography. He attended the American University of Beirut-Lebanon and moved to the United States in 1987. Dr Ammash currently serves on the American Board of Internal Medicine test approval committee for the cardiovascular board after being a member of the testing writing committee for the board certification examination until 2019. He has published more than 150 peer-reviewed articles and book chapters in addition to being an invited speaker at numerous national and international continuous medical education meetings, including many in the Middle East and Gulf regions.
Matthew Gettman Dr Matthew Gettman, MD, is the Erivan K. Haub Family Professor and Chief Medical Office at Sheikh Shakhbout Medical City. He also serves on the Clinical Practice Committee — International. Dr Gettman started the robotic surgery programme at Mayo Clinic in 2002. He has co-authored over 200 manuscripts and book chapters. He received the Smith Award from the Endourological Society in 2011 and the Platinum Award from the European Association of Urology in 2016. He serves on the editorial board for European Urology and Journal of Urology and is Section Editor of Mayo Clinic Proceedings. His current research interests include robotics, minimally invasive surgery, telemedicine, prostate cancer and regenerative medicine.
Muna Khan serves as the Director of Strategy and Planning Services at Sheikh Shakhbout Medical City (SSMC) in Abu Dhabi. He has been part of Mayo Clinic for over 21 years, where he has led several strategic initiatives for the organisation. Muna served as a voting member of the Electronic Health Record and Revenue Cycle Management Selection Committee. He also led the management consulting team that activated SSMC. Muna previously served as the President of the Health Information Management Systems Society, Minnesota Chapter. He has an MBA from the Carlson School of Management in Strategic Management and an MPH from Emory University.