Application of Systems Theory
In health care settings understanding how staff influences patient outcomes remains
unmeasured, as a result vague information concerning the link between staff and patient
outcomes exist. Several theories have been established to explain the link between the nursing
profession, the work environment and the outcomes in different health care settings to inform the
management of the decision when allocating resources (Cowling et al, 2013). A system based
theory will be discussed to understand the nature of the emergency department and how certain
changes need to be implemented to promote quality care that can be measurable.
Description of System
An emergency department is a unit where patients go through registration within the
hospital. Within the emergency department, administrative intake processes occur with series of
diagnostic testing. This includes several therapeutic interventions being carried to determine if
patients can either be admitted to the hospital or discharged after treatment (Cowling et al, 2013).
At the emergency units, input data includes personal patient’s information which is fed
into the hospital information system. This includes their demographics or insurance information,
patient’s medical history and his current condition (Cowling et al, 2013).
At the emergency department services includes the triage nurse make an initial judgment
of the type of care one needs. The physician orders for series of specific diagnostic tests like an
electrocardiogram, x-rays or blood tests. The patient can be moved into other areas to enable
certain tests to be done especially radiology and other imaging tests. While other tests are being
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conducted, the nurse continues to monitor the patient and reevaluating his condition (Cowling et
Characteristics of Caregivers: The physician can at times be forced to contact other service
providers to obtain important information about the patient from his personal physician or get his
previous medical records. Depending on the emergency, the physician can recommend various
therapeutic interventions to be initiated as suggested by Cowling et al. (2013).
Characteristics of care receivers: depending on the information generated by monitoring the
current patient condition, the previous intervention can be modified. In emergency department
patient display many complicated social and psychological problem including their medical
problem that needs to be sorted out at the emergency department according to Cowling et al.
Cowling et al. (2013) states that at the emergency department decision can be made to either
admit the patient or discharge him, discharge means treatment has been administered and the
patient feels much better. In the output, there cannot be two paths within the emergency
department systems. The decision by nurses and physicians as to what need to be done for
patients are continuously being modified as time unfolds.
Every patient who goes through the emergency department comes with the complication
that can unfold over time leading to the more complex medical problem. Some patients who
experience severe pain can suddenly develop respiratory distress forcing the Emergency systems
to reprioritize their response causing the problem to the whole systems. Lack of coordination can
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affect the patient’s overall diagnosis hence affecting the patient health outcomes (Brennan-Cook
& Molloy, 2016).
The emergency department is the largest contributor of adverse patient health care
outcomes. For example, if there are no free beds for admitting a patient in the wards, the patient
might not be transferred from the emergency department to the ward. This forces patient to stay
in the waiting room when the flow of patients keeps coming and the patients are unable to be
moved out of the emergency rooms staffs will be forced to attend to patients along the corridors
until rooms are available (Brennan-Cook & Molloy, 2016).
Communication Problems in the emergency department
Complexity exists in the emergency department in different domains, mostly being timely
communication to enable nurses make timely decisions. Communication is one of the key
elements that can assist emergency nurses to exchange vital information about patients with the
physicians. according to Brennan-Cook & Molloy (2016), lack of coordinated information
affects the functions of the emergency department.
According to Meyer et al. (2014), open system theory requires one to be familiar with
each level of the organization and understand the subsystems that are interrelated. In large
organizations energy transformation needs to occur within these subsystems because labor is
divided within these systems to accomplish specific tasks. For Meyer et al. (2014) the foundation
of service is the division of labor which determines the structure and workflow within the
subsystems. It is important that the management establish adaptive and supportive systems
necessary for evaluation and completion of nursing work within the subsystems.
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The nursing internal production demands determine the nature of the work performed.
Negative feedback, in this case, is the long waiting period experienced at the emergency
departments. As an open system, the emergency department needs to adapt its functions to
respond to negative feedback by making an adjustment to enable the system to evolve as it
maintains its characteristics (Meyer et al, 2014).
Effective communication requires complete, accurate, timely information that needs
verification, verifying information is important to ensure that the meaning of the message sent is
mutually agreed upon .The entire emergency team needs to discuss patient plans in meetings to
limit negative feedbacks according to Press et al. (2015).
Goals and objective
Cowling et al. (2013) suggests that developing team based approach using the open
system will promote collaborative treatment plan for patients. Communication channels should
be open to enable other team members to be aware of the physical, spiritual, medical and
psychological needs of patients to deliver quality service. Patient outcomes can be measured by
reviewing shift staff reports and documentation; this approach success can be measured by the
quality services offered through positive health outcomes
Policies and Procedures
Some of the policies and procedures should enable nurses to form part of the care team to
discuss patient treatment decisions, activities, follow-up needs, and overall unit status especially
when changing shifts. These procedures will ensure that every staff within the emergency
department is updated on the patient health status .patients personal records need to be updated
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and well documented including the number of Emergency Department visits and patients
concerns (Meyer et al, 2014).
Within the health care setting, it is the responsibility of every health care worker to
document and reports specific changes noted to his coworkers; this requires open communication
to facilitate discussion on appropriate solutions. Promoting collaborative approach to patient care
can prevent negative patient outcomes (Meyer et al, 2014).
How Resolutions will uphold visions, values, and Mission
Developing a collaborative approach to care allows staff to develop open communication
hence improving their performance. Open communication also improves work relationships and
patient outcomes. By improving patient care through the emergency units, forms part of the
organizations’ values and mission. Health care organizations need to be committed to ensuring
continuous improvement to accomplish their vision by identifying their shortcoming and
improving their work process (Press et al, 2015). Therefore positive work relationships between
staff will enable them to embrace ethical behavior in managing patient’s health and improving
the quality care.
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Brennan-Cook, J., & Molloy, M. A. (2016). Utilizing Trigger Films to Enhance Communication
Skills of Home Care Clinicians. Home Healthcare Now, 34(7), 376-380.
Cowling, T. E., Cecil, E. V., Soljak, M. A., Lee, J. T., Millett, C., Majeed, A., & Harris, M. J.
(2013). Access to primary care and visits to emergency departments in England: a cross-
sectional, population-based study. PloS one, 8(6), e66699.
Meyer, R. M., O’Brien-Pallas, L., Doran, D., Streiner, D., Ferguson-Paré, M., & Duffield, C.
(2014). Boundary spanning by nurse managers: effects of managers’ characteristics and
scope of responsibility on teamwork. Nursing leadership (Toronto, Ont.), 27(2), 42-55.
Press, M. J., Gerber, L. M., Peng, T. R., Pesko, M. F., Feldman, P. H., Ouchida, K. & Casalino,
L. P. (2015). Postdischarge communication between Home health nurses and physicians:
measurement, quality, and outcomes. Journal of the American Geriatrics Society, 63(7),