Retiring Carayon leaves legacy of healthcare systems engineering research, mentorship

Pascale Carayon, who holds the Leon and Elizabeth Janssen Professorship in the College of Engineering, talks in a breakout session at the inaugural Wisconsin Institute for Healthcare Systems Engineering conference in 2017. Carayon launched the institute, which brings together researchers and practitioners in healthcare and engineering, as its founding director.
Pascale Carayon, who holds the Leon and Elizabeth Janssen Professorship in the College of Engineering, talks in a breakout session at the inaugural Wisconsin Institute for Healthcare Systems Engineering conference in 2017. Carayon launched the institute, which brings together researchers and practitioners in healthcare and engineering, as its founding director.

Pascale Carayon’s curriculum vitae is 72 pages long, detailing the litany of awards, publications and lectures the widely respected human factors engineering scholar has accumulated over the course of her more than 30-year career.

What it doesn’t list are the numerous times she’s set aside any zeal for personal accomplishment to include a junior faculty member on a major research grant, connect young researchers from different sides of the University of Wisconsin-Madison campus and beyond, or quietly put forward a current or former PhD student for an opportunity.

“She does a lot of work behind the scenes that she doesn’t even tell you she’s doing,” says former advisee Abigail Wooldridge (MSIE ’13, PhDIE ’18), who’s now an assistant professor at the University of Illinois. “Things would just kind of materialize for you.”

Or, as Michelle Rogers (MSIE ’98, PhDIE ’02), now an associate professor at Drexel University, puts it: “She has definitely spoken up for me when I wasn’t in the room.”

Carayon with former student Nana Khunlertkit (PhD ’11).
Carayon with former student Nana Khunlertkit (PhD ’11).

Carayon will retire from the UW-Madison Department of Industrial and Systems Engineering in August 2021, capping a remarkable tenure in which she established herself as one of the world’s foremost experts in applying human factors and industrial engineering approaches to the healthcare system. But she’s also forged a reputation as an uncommonly devoted mentor, particularly for women in engineering.

“Pascale has been so dedicated to supporting and shaping the future of the field,” says Nicole Werner, the Harvey D. Spangler Assistant Professor of industrial and systems engineering at UW-Madison and a beneficiary of that mentoring. “The scope of her influence as a mentor definitely rivals the scope of her influence as a researcher. The two are intertwined.”

And Carayon’s research influence on the field of healthcare systems engineering has been substantial. Werner was an intern at The Johns Hopkins Hospital as an undergraduate student at George Mason University when the resident human factors engineer shared Carayon’s 2006 paper detailing the Systems Engineering Initiative for Patient Safety (SEIPS) model, a framework for analyzing and improving healthcare systems and safeguarding patients.

The SEIPS model, which Carayon has subsequently updated twice, became a foundational piece of her work in healthcare. As director of the interdisciplinary Center for Quality and Productivity Improvement (CQPI) at UW-Madison, she shared the model with clinicians, healthcare leaders and other professionals through SEIPS short courses. She also founded and directed the Wisconsin Institute for Healthcare Systems Engineering (WIHSE) to better connect healthcare and engineering researchers and practitioners.

SEIPS grew out of research that began two decades earlier when Carayon was a PhD student with Professor Michael J. Smith, one of the longtime faculty members who helped establish UW-Madison as a leader in the then-burgeoning human factors engineering field. Together, Carayon and Smith developed a model for improving job design by balancing stressful requirements, which they published in 1989.

Carayon receives the 2015 John M. Eisenberg Patient Safety and Quality Award, given by The Joint Commission and the National Quality Forum.
Carayon receives the 2015 John M. Eisenberg Patient Safety and Quality Award, given by The Joint Commission and the National Quality Forum.

Carayon’s work on job design (the topic that drew her to UW-Madison in 1985 after graduating from the French engineering school Ecole Centrale de Paris) gradually shifted into healthcare settings, as did her early research on the impact of computer technology on workers and processes.

She’s studied the implementation of electronic health records systems, designed and evaluated various health information technologies such as clinical decision support for diagnosing pulmonary embolism and an integrated display to aid teamwork in pediatric trauma care transitions, and, through the SEIPS model, developed ways to improve patient safety and clinician well-being. She co-chaired a National Academies of Sciences, Engineering, and Medicine committee that examined clinician burnout and, in 2020, the National Academies named her a National Associate, a lifetime title. It’s one of the many national and international awards she’s collected over the years.

Carayon says she learned early on the importance of getting out into real workplaces and talking to the workers whose jobs would be affected by her research. Smith sent all of his PhD students to different settings; Carayon spent part of the spring 1987 semester embedded in the intensive care unit at UW Hospital, spotting opportunities for improvement in the unit’s physical layout and workflow.

“My lab is not a physical space in the Engineering Centers Building. My lab is going out and talking to people and observing them—being in the real environment. And I really, really enjoyed that,” says Carayon, who brought those observations into the classroom through her ISyE 653: Organization and Job Design course. “Sometimes it was talking to people, sometimes it was observing them, sometimes it was convincing them to do a survey and to collect data from them. So there was always that connection to people in their real environment that I liked. That gave me a sense that what I was doing was important.”

When Carayon finished her PhD in 1988, the then-Department of Industrial Engineering took the unusual step of hiring one of its own, first as a visiting professor for a year and then into a tenure-track position a year later. She set to work pursuing projects that combined the quantitative skill that drew her to engineering in the first place with her interests in the larger, organizational aspects of human factors engineering and the people-centered nature of the social and behavioral sciences.

Now, more than 30 years later, she’s returned to her native France, along with her longtime partner and research collaborator, CQPI Associate Director of Research Peter Hoonakker. Carayon says she plans to remain involved in WIHSE’s patient safety learning laboratory, and writing a book on SEIPS has been on her mind for years. But even when she and Hoonakker are more focused on hiking trips—they’re hoping to continue the Camino de Santiago pilgrimage network in the coming years—and spending more time with their families in France and the Netherlands, her influence on her field will persist through the likes of Wooldridge, Rogers, Werner and many more.

“Hopefully I’m helping all of them—students, mentees, decision-makers, leaders,” she says. “Hopefully I’ve changed some of their perspectives of how to do things, so we do things better for patients and healthcare workers.”

Author: Tom Ziemer