The System Safety Group and Safer Healthcare, LLC
Examples of past roles, projects:
•Patient Care Ombudsman: for communities served by Calais Regional Hospital (CRH), a Maine Critical Access Hospital (CAH) on Maine’s eastern border with Canada. This was a position appointed by the United States Trustee, U.S. Department of Justice, per order of the Federal Bankruptcy Court, District of Maine. Our role entailed monitoring the safety and quality of care provided by the hospital between 09 April 2020 and 15 October 2020, following a patient safety event in the hospital’s emergency department. CRH was subsequently liquidated, and it assets acquired by the remaining Critical Access Hospital in Washington County, Maine.
•The Schmidt Institute, Bangor, Maine: Assessment of key structural and process attributes of the Penobscot Community Health Care Controlled Substance Stewardship (CSS) program. 2018
•The Maine Primary Care Association (MPCA) Patient Safety Organization. Developed and listed an Agency for Healthcare Research and Quality (AHRQ) designated Patient Safety Organization (PSO), Augusta Maine. Established on behalf of MPCA while serving as Director of Continuous Quality Improvement in support of Maine’s Federally Qualified Health Centers, 2015-2018
•Massachusetts Health Policy Commission: A project with Safe and Reliable Healthcare, LLC that collected interview and safety culture survey data from personnel serving in roles that ranged from housekeeping to senior leadership across 28 community hospitals. Interview data was analyzed to characterize the current state of care coordination, integration, and delivery transformations within each organization and with primary care services. These data supported the development of requirements for a grant program supporting community hospitals in anticipation of their transition to an accountable care environment, 2014.
•Federal Aviation Administration Research and Development Human Factors Laboratory. Senior Human Factors Contractor and Technical Task Lead. Management of a research team with projects supporting identification and mitigation of risks associated with integrating remotely piloted aircraft into the National Airspace System, and development NextGen air traffic control technologies. William J. Hughes Technical Center, Atlantic City International Airport, New Jersey. A collaborative intiative with TG O’Brien and Associates, a human factors engineering firm under contract with the Federal Aviation Administration in partnership with Applied Research Associates Transportation Division, 2011-2013.
•University of Kansas College of Medicine: An evaluation of diagnostic methods for understanding social process factors in significantly reduced morbidity and mortality in the post-surgical care of open heart surgery patients. Wesley Medical Center, Wichita, Kansas. An interdisciplinary research initiative. 2009-2011
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The U.S. Naval Expeditionary Combat Command (NECC): A study to develop design requirements for a new command and control interface for Riverine and Maritime Expeditionary Security Force forward operating units. With Applied Research Associates, 2010-2011
The U.S. Naval Expeditionary Combat Command (NECC): A study to develop design requirements for a new command and control interface for Riverine and Maritime Expeditionary Security Force forward operating units. With Applied Research Associates, 2010-2011•Patient Safety Solutions Center, Department of Defense Patient Safety Program: A Knowledge Audit of TeamSTEPPS Coaching Practices in Military Treatment Facilities. With Health Care Team Training, LLC, 2010-2011
•Children’s Hospital of Los Angles: A study to identify and mitigate the risk associated with the transition of a Pediatric Intensive Care Unit and Cardiothoracic Intensive Care Unit to a new building. With Applied Research Associates, 2010-2011
•Fatigue and Vigilance Decrement in Border Security and Public Safety: A study to identify and mitigate factors in vigilance decrement associated with fatigue and stress among homeland security and public safety personnel for a Southeast Asian government. With Applied Research Associates, 2008-2009
•University of Wisconsin Department of General Surgery, Madison, Wisconsin. Analysis of communication and decision making challenges among patients, nursing professionals, and medical personnel for the University of Wisconsin Department Of General Surgery. With Applied Research Associates, 2008-2009
COMPLETED HEALTHCARE RESEARCH SUPPORT
Right Care, Right Place, Right Time in Maine, 2020-2021 Co-developer and co-principal investigator with Susan Haas, MD, MSc for a qualitative study to identify systemic risk to provider and patient safety stemming from the erosion of rural healthcare infrastructure in Washington County, Maine. Findings represent frontline provider and patient understanding of leverage points for risk mitigation and improvement of health and healthcare. Funded by the Maine Health Access Foundation, (https://mehaf.org ) this was a joint research initiative of the Schmidt Institute, Bangor, Maine and Ariadne Labs, Boston, Massachusetts. The full report and journal publication describing findings are found on the Services page of this website.
Cooperative Communication System for the Advancement of Safe, Effective, and Efficient Patient Care W81XWH-12-C-0126 8/15/2012 – 11/29/2016
8/15/2012 – 11/29/2016United States Army Institute of Surgical Research (USAIR),
Principal Investigator LTC Jeremy Pamplin, MC HRPO Log Number A-17058.
Phase One (2013-2015). The goal of this research was to utilize cognitive systems engineering methods to develop design requirements for an interprofessional clinical decision aid. Project was undertaken on the Burn Intensive Care Unit (BICU) at San Antonio Military Medical Center, San Antonio, Texas. Role: Senior team member for observational study and cognitive work analysis.
Human Factors Evaluation of a Smart Intravenous Infusion Pump System Implementation
Prime Grant Number W81XWH-08-1-0-389
United States Army Telemedicine and Advanced Technology Research Center Program
06/02/2008-12/02/2009
This research assessed the implementation of the Sigma Spectrum Smart Intravenous Pump (SIVP) Infusion System at Memorial Medical Center, Springfield, Illinois. The study utilized quantitative and qualitative methods to evaluate user adoption of the SIVP and the impact of the SIVP system on medication errors. Role: researcher and project manager for a cognitive task analysis study to identify both intended and unintended effects on individual and team performance and patient care during and following implementation of the SIVP.
AHRQ Health Information Technology Program
UC1 HS15270
09/30/2004-09/29/2007
Improving Healthcare Quality via Information Technology, Southwestern Vermont Health, Bennington, Vermont. The goal of this initiative was to implement an integrated electronic patient medical record, electronic medication administration record, computerized physician order entry, and clinical decision support software. that will be accessible at all participating facilities which include an acute care hospital, home health care agency, ambulatory clinics, a rehab facility, and to patients/residents from home. Role: Consultant for improvement of technology supporting patient care transitions.
Computer Support of Collaborative Work
Partners Healthcare Information Systems Research Council
11/01/2004-12/31/2005
Care Process Innovation Laboratory, Massachusetts General Hospital, Boston, Massachusetts.
A study conducted for the Department of Biomedical Engineering's Care Process Innovation Laboratory. Collaborative care processes were studied by a multidisciplinary research team in simulated and real clinical settings to generate insight for the advancement of computer support of collaborative work. Role: Research Consultant conducting observation of, and interviews with, members of clinical teams to develop design requirements for computer support of collaborative practice.
Midcoast Maine Patient Safety with IT Integration
AHRQ Health Information Technology Program
P20 HS15170
9/30/2004-09/29/2005
Northeast Health Foundation, Rockland, Maine. The goal of this initiative was to develop “a high level of integration and cooperation in four significant areas: medication management, patient discharge, high-level integration of information, and the development of a new paradigm for evaluating, selecting, and implementing new technologies.” Role: Consultant for development of a new paradigm for evaluating, selecting, and implementing new technologies.
jbrown@systemsafetygroup.com 603-674-0687 (USA)