Describe a department or unit within a healthcare organization using systems theory
terminology. Include a description of input, throughput, output, cycles of events, and
negative feedback.
Describe the problem you identify within the department or unit using an open systems
approach, and state where the problem exists using the systems theory model (input,
throughput, output, cycle of events, or negative feedback).
Based on this information explain how you would address the problem as follows:
formulate a desired outcome, identify goals and objective that would facilitate the outcome.
Translate those goals and objectives into policies and procedures for the department and
unit. Describe relevant professional standards. Explain how your proposed resolution to
the problem would uphold the organizations mission and values and improve the culture
and climate.
Systems Theory in Healthcare Organizations
Introduction
The world we reside in is extremely complex and made up of subsystems. These
subsystems interact with each other and each has vividly coherent dynamics and defined
boundaries. Ludwig von Bertalanffy developed the systems theory in 19302 with an aim of
simplifying the world’s complexity and making it more comprehensible to human beings.
Basically, the theory aims at explaining how things function around us. The theory views the
world as constituting of smaller subsystems that humans utilize on a daily basis. For instance, a
hospital is a systems that has outputs, processes, and inputs. In itself, the hospital is part of a
bigger health care system. This paper aims at discussing the systems theory in a healthcare
organization.
A department in a healthcare organization that uses the systems theory
The surgical department is a good example of the application of systems theory in
healthcare organizations (Walshe & Rundall, 2001). In the department, there are bound to be
activities such as physiological monitoring, patient order entry, electronic documentation, and
medication administration. In the surgical department, systems theory can be used to ensure
professional autonomy, promote the staff’s participation in decision making, and create
supportive care environments.
In the light of this discussion, inputs comprise of the resources, energy, and raw materials
that processed within the department to enable production of outputs in the department (Begun,
Zimmerman & Dooley, 2003). Some of the inputs include funds, information, the efforts from
nurses and physicians, the time these professionals use, energy, fuel, individual effort, time, and
any other raw material.
Throughput involves the processes utilized by the system in converting energy or raw
materials acquired from the environment into services or products that can be used by the
environment or system itself. In the surgical department, throughput includes patient’s physical
examination, thinking, planning, diagnosing, writing prescriptions, decision-making, patient
operation, taking vital signs, sorting, constructing, making speeches, meeting in groups, sharing
information, and discussion.
Output is the service or product that results from a system’s throughput and processing of
human, financial, social, and technical input. Some of the examples include better health, health
SYSTEMS THEORY IN HEALTHCARE ORGANIZATIONS
services, documents, software programs, money, rules, laws, decisions, bills, clothing, cars, and
assistance (Begun, Zimmerman & Dooley, 2003).
Numerous cycles of events may be experienced in the surgical department. These cycles
repeat themselves as exports are used to gain more energy to export and reorganize. At times,
there are so many patients in the surgical ward such that there are no sufficient healthcare
professionals, time, and resources to care for them adequately. As a result, many patients may
end up dying as a result of inadequate care and complications. There periods may be followed by
stable times where there are adequate staff and resources to care for the few admitted patients.
During times when there are many patients to be care for; there is a need for collaboration and
assistance from other departments so as to prevent negative repercussions (Walshe & Rundall,
2001).
In the surgical department, the negative feedback includes the collaboration,
communication, feedback, and support from other departments and the management that are
aimed at promoting quality and the services offered. It is imperative to have mechanisms for
using and taking in negative feedback so as to ensure that the system does not end up taking in or
expensing too much energy, which would upset the system.
Open systems approach- problem identification
A surgical department comprises of an energic output- input system. The department
relies on the supporting environment for sustained inputs, which promotes the inputs’ processes
and sustainability through patterned and recurring interactions and activities of individuals to
produce the outputs (Glanz, Rimer & Viswanath, 2008). The surgical department is itself a social
system where the subsystems struggle to ensure a dynamic steady situation in which energy flow
regularities maintain the system’s character. On the same note, disturbances indicate system
adaptation.
One of the challenges that the surgical departments is likely to suffer is lack of
collaboration and proper coordination between the various professionals that are supposed to
care for patients in the department. A surgical department is extremely vulnerable to entropy, an
inevitable dissolution and disorder process that results from loss or inadequate inputs and the
incapability to transform energies (Walshe & Rundall, 2001). Considering that the healthcare
organization is an open system, there is a need for it to have negentropy or negative entropy that
can be achieved through some of storage capacity so as to promote its existence. To achieve this,
there is a need for inputs such as creating slack resources, storing energy, renewing inputs, and
increasing imported energy in relation to exported energy. The surgical department can also
counteract entropy through adapting system functioning in reaction to the environment’s
feedback and informational signals.
According to the open system theory, the surgical department has a hierarchical nature in
which every level has a subsystem consisting of interrelated parts. Each of these subsections has
an authority and collaboration between the various subsections is necessary to promote the
performance and quality of services offered by the department (Glanz, Rimer & Viswanath,
2008). The surgical department has numerous operations and energy transformation or
throughput is experienced in the production subsystems that promote labor division so as to
ensure that tasks are accomplished. However, the lack of proper coordination and collaboration
in the department is attributable to inequitable division of labor and failure of different
individuals to carry out their roles as required. The production system is tasked with
transforming energy so as to ensure that all tasks are performed as required as well as optimize
task accomplishment through technical proficiency.
SYSTEMS THEORY IN HEALTHCARE ORGANIZATIONS
It is worth noting that the principal mechanism is labor division and this determines the
work flow and structure as far as the production subsystem is concerned. Work subdivision
creates work flow breaks but this has continuously been identified as a challenge in the surgical
department.
Solving the problem
Desired outcome
Basically, the key desirable outcome is ensuring that all the subsystems in the surgical
department are able to collaborate and coordinate appropriately.
Goals
Promoting collaboration in the surgical department would improve patient outcome,
employee satisfaction, and performance of the entire department and entity. There is also a need
to concentrate on transformational leadership in the department. Another goal is redesigning care
so as to optimize on the specialist’s professional knowledge and expertise. the last goal is
ensuring that professionals who work in the surgical department are able to work with employees
from all other departments and they promote reliable and safe care (Glanz, Rimer & Viswanath,
2008).
Objective
One of the objectives that can guide the stated goal and desired outcome is the integration
of work procedures across subunits and roles through the use of coordination devices. With the
differentiation of the department, additional coordination and integration are necessary to ensure
unification of the system functioning (Begun, Zimmerman & Dooley, 2003). Therefore, the
coordination, complexity, and size require the organization to increase as the subsystems
specialize and multiply in function.
To ensure that there are transformational leaders in the surgical department, it will be
necessary to invest in leaders who can implement and create environments, products, and
programs to satisfy patient needs (Walshe & Rundall, 2001). In addition, there is a need to
empower and engage all professionals working in the department to perform as leaders who can
provide quality health care. Finally, providing departmental learning opportunities is imperative
for leadership teams and individual leaders to learn together as well as come up with tools that
can assist in meeting the desired goals and desired outcome.
Optimizing professional knowledge and expertise will be guided by a number of
objectives. First, it will be important to produce evidence which will drive the specialist’s
practice, legitimize, and recognize knowledge evolution in the environment that is changing
rapidly. Second, there will be a need to develop care systems and documentation for supporting
nurse workflow. This will help in optimizing patient and specialist interaction whenever it
occurs. The last goal will be guided by the desire to consistently exceed and achieve all the set
measure targets and compliance to all regulatory standards (Glanz, Rimer & Viswanath, 2008).
Policies and procedures
In regard to developing transformational leaders, the department will partner with various
bodies such as business schools to enable identification of a proper assessment tool through
which a gap analysis can be conducted in connection to the present knowledge state about patient
safety and quality (Walshe & Rundall, 2001). All professional who work in the surgical
department and from all levels will be trained in care process redesign and quality improvement
through the use of various programs including educational offerings and poster presentations,
shared governance programs, and E3 (Exploring Executive Excellence) mentoring program. On
SYSTEMS THEORY IN HEALTHCARE ORGANIZATIONS
the same note, it will be imperative to use unit boards and shared governance model as the
platform for involving nurses in leading patient safety and process improvement initiatives.
A literature review will be conducted in regard to highly reliable systems and
personalized health care. It will also be necessary for the surgical department to secure and
assess organizational synergy that will promote redesigning care as well as securing appropriate
resources (Walshe & Rundall, 2001). Moreover, there will be an analysis of patient experience
and care in several areas within the department. The professionals working in the department
will participate in the execution and development of focused initiatives that will be based on high
risk, high volume, and problem- prone events.
Relevant professional standards
The workers in the surgical department are supposed to comply with various professional
standards. First, they should maintain high levels of professional, personal, and academic
integrity and honesty. Second, they should respect confidentiality and privacy. Third, there is a
need to demonstrate empathy when interacting with everyone and treat everyone with dignity
and respect (Begun, Zimmerman & Dooley, 2003). There is also a need to be accountable for the
decisions made and adopt strategies for dealing with misjudgments and errors.
How the proposed resolution can uphold the values, mission, and improve climate and
culture at the organization
It is the desire of every institution to meet the set mission and values (Walshe & Rundall,
2001). The proposed resolution will assist in meeting these since there will be increased
collaboration and coordination within the department and institution and this will translated to
better patient outcome. In addition, the collaboration will make solving various issues easy and
this will in turn improve the culture and climate.
SYSTEMS THEORY IN HEALTHCARE ORGANIZATIONS
References
Begun, J. W., Zimmerman, B., & Dooley, K. (2003). Health care organizations as complex
adaptive systems. Advances in health care organization theory, 253, 288.
Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.). (2008). Health behavior and health education:
theory, research, and practice. John Wiley & Sons.
Walshe, K., & Rundall, T. G. (2001). Evidence‐based Management: From Theory to Practice in
Health Care. Milbank Quarterly, 79(3), 429-457.