Chester Chambers lives to simplify the complex all in pursuit of a better outcome. After all, you can’t fix what you don’t understand. In his recent book, “Improving Processes for Health Care Delivery: Lessons from Johns Hopkins Medicine,” Chambers takes on a particularly complex white whale: the United States health care system.
As a clinical professor in the Information Technology and Operations Management department at SMU Cox School of Business, Chambers instructs students to harness the full potential and impact of data and processes, equipping them with the tools and critical thinking skills to make waves in companies and industries worldwide that benefit all.
Chambers co-authored the book with two former Johns Hopkins colleagues: Maqbool Dada and Kayode Williams. The book, published in October, encompasses years of experience teaching at master’s levels, managing dozens of improvement projects and previous scholarly publications.
The trio had one main goal in mind: to provide current and future managers, consultants and analysts focused on health care delivery systems with tools to improve efficiency in delivering care.
“The classic problem in health care is that nobody knows what anything actually costs,” Chambers says. “Our real contribution […] was just sort of taking these very complex, convoluted things; boiling them down to their essence; and then figuring out how to use that to convey a fundamental understanding or a fundamental lesson about how these systems work.”
Data in Action
The book’s purpose was to compile Chambers’ readings, academic papers, book chapters and case studies. In a sense, it was his effort to publish his own “personal textbook.”
For about a decade, Chambers oversaw between 30 and 40 student projects while teaching courses about process improvement in the business of health. Chambers ended up with a massive amount of data from these different clinics, practices and offices, which ranged from neonatal ICUs to pain clinics to palliative care units.
For example, with this data, Chambers and his colleagues were able to offer process improvement strategies that often started with a small, but important, KPI: patient wait time. In addition to cost, the predominant patient complaints deal with how long they spend waiting and how much time they actually get with their doctor, Chambers says.
So, how does a clinic — or hospital — make tangible improvements?
In “Improving Processes for Health Care Delivery: Lessons from Johns Hopkins Medicine,” Chambers and his co-authors established a six-step “recipe” for process improvement:
1. Process map: Get an understanding of what’s going on — even if that means physically showing up and spending time in the space.
2. Collect data: Gather information and determine important nuances in the delivery system.
3. Create a virtual model of the system: Basic simulation software builds a model of the existing system.
4. Determine metrics: Establish measurements important to your organization or need.
5. Propose process changes: Experiment with the simulation to evaluate options for improvement.
6. Predict the impact: Leverage the virtual system to make predictions about how proposed changes will improve system performance.
Keep It Simple
Chambers reinforces the need for simplicity when working with busy health care professionals from varying backgrounds. A “fancy” model or algorithm, or even legislation, isn’t going to cut it. His six-step recipe is part of that quest for simplicity.
Chambers knows this firsthand from training medical residents. He’d show them the importance of operations research tools such as process mapping and queuing theory and explain how these tools could be applied to a clinic or medical practice. Presentations had to be concise because this audience has very little time to spare.
“The major takeaway is that […] simpler tools are almost always sufficient if you gain an understanding of the process before you apply them,” Chambers says, noting the need for simple charts and process maps.
In addition to keeping it simple, Chambers advocates for immersing yourself in the process to better understand the data and pain points that those you’re trying to help are experiencing. “People don’t care how much you know; they want to know how much you care,” Chambers says.
Chambers thinks this is the path to success, as you need a certain amount of buy-in from the stakeholders you’re trying to help. “They’re going to figure out a way to work around [it] if they really want to,” Chambers says. “But if you go in and invest the time and effort to learn what [they’re] actually doing and what their pain points actually are […], then you can make some improvement.”
An Expanding Audience
“Improving Processes for Health Care Delivery” is predominately geared toward MBA students, but there’s something for everyone at every level of the health care industry, from hospital administration to nursing staff to internal analysts at hospitals. Chambers believes the approaches outlined in his book could have a rippling effect when gradually applied to real-world scenarios.
This isn’t just a thought, either. Throughout the past decade, the data and analysis in Chambers’ book have been proactively applied to several clinic spaces.
“Health care is the largest industry in the United States, which means it’s the largest industry in the largest economy on earth,” Chambers says. “Everybody wants a piece.”
Chambers says it’s about conveying a basic message: Yes, America’s health care system can be improved. But it’s going to take an investment of time and patience — and it might be achieved one clinic, one operating room, one hospital at a time.
A Welcomed Return
Chambers rejoined the SMU Cox faculty in January 2022 after more than a decade at Johns Hopkins Carey Business School, where he helped create and cultivate that school’s enterprise risk management program. While there, Chambers also held appointments in anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine.
In some ways, returning to the Hilltop has been like coming home for Chambers. Chambers began his academic career at SMU Cox in 2001, shortly after earning his PhD in operations management from Duke University. Now, Chambers oversees the Cox School’s Master of Science in Business Analytics (MSBA)— a “hardcore analytics program” he sees as ahead of the curve.
Chambers notes the program’s lack of “fluff,” as students jump right into decision models, statistics, programming and business metrics within their first four classes. Throughout the MSBA program, students complete valuable internships and projects that enhance and apply what they’re learning in the classroom.
“That allows SMU Cox, in particular, to have a much better connection between the [analytics] program and the business community,” Chambers says. “What we’re teaching here, and what’s getting used by the companies in the DFW area, is more like what I think a business analytics program is supposed to be.”
Chester Chambers is a clinical professor in the Information Technology and Operations Management department at SMU Cox School of Business. His co-authored book “Improving Processes for Health Care Delivery: Lessons from Johns Hopkins Medicine,” was published in October 2022 and is on shelves now.