Analysis and modeling of quality improvement on clinical fitness landscapes

TL;DRAbstract

Widespread unexplained variations in clinical practices and patient outcomes, together with rapidly growing availability of data, suggest major opportunities for improving the quality of medical care. One way that healthcare practitioners try to do that is by participating in organized healthcare quality improvement collaboratives (QICs). In QICs, teams of practitioners from different hospitals exchange information on clinical practices, with the aim of improving health outcomes at their own institutions. However, what works in one hospital may not work in others with different local contexts, due to non-linear interactions among various demographics, treatments, and practices. I.e., the clinical landscape is a complex socio-technical system that is difficult to search. In this dissertation we develop methods for analysis and modeling of complex systems, and apply them to the problem of healthcare improvement. Searching clinical landscapes is a multi-objective dynamic problem, as hospi

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