Ziad Gellad, MD, MPH, assistant professor of medicine (Gastroenterology), has received a Veterans Affairs career development award for his research project, “Simulation Guided Systems Redesign in GI Endoscopy.”
With the award, Dr. Gellad will test a simulation-based intervention to expand the screening capacity of the Veterans Health Administration (VHA) through improved endoscopy unit efficiency.
Improved efficiency is a business mandate and a quality imperative for the VHA, and one valuable target for improving efficiency is the capacity to provide colorectal cancer screening, said Gellad.
Colorectal cancer ranks third in both incidence and mortality among veterans, and while effective screening tests are available, the capacity for the VHA to provide this screening is strained, he said.
Gellad will learn to use discrete event simulation, a computer-based modeling approach, to look for ways to improve patient flow and efficiency of clinic operations at the Durham VA Medical Center. One of his first steps has been to implement a time-tracking tool in the clinic in order to collect data for simulation.
Discrete event simulation is a systems engineering methodology that is not routinely used in VHA system redesign efforts.
"This VA career development award also will prepare me to conduct independent research on the broader dissemination of simulation-guided systems redesign within the VHA," said Gellad.
"Ziad's proposal to combine implementation science and systems engineering is a unique one for the CDA program," said David Simel, MD, vice chair for Veterans Affairs. "But it's also a really exciting line of research, and success is going to require the cooperation and collaboration of all Ziad's colleagues doing procedural GI at the Durham VA Medical Center."
The award will fund the project for five years, and allow Gellad to attend courses in implementation science and systems engineering at N.C. State University.
Dr. Gellad will collaborate with Javad Taheri, PhD, research associate professor at NCSU and a VA systems engineer. He will be mentored by Dawn Provenzale, MD, professor of medicine (Gastroenterology), George Jackson, PhD, associate professor of medicine (General Internal Medicine), Stephen Roberts, PhD, professor of industrial engineering at NCSU, and Melissa Partin, PhD, research career scientist at the Minneapolis VA Medical Center, will also mentor Gellad.
Gellad credited a pilot grant from the Duke Institute for Health Innovation that allowed him to gather preliminary data for his VA proposal. He believes that the lessons he learns doing this work at the Durham VA Medical Center will be applicable across the street at Duke University Medical Center, with potential high impact on care delivery in both places.