Summary
Complete summary cases (HPI4010)
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Day 1 – Eco-system thinkingWhat is a system?
A system is:
- Purposeful
- Collection of entities
- Relationships between entities (structure)
- Behaviour: dynamic interactions
o System as a negotiated order
- External environment (open systems):
o Boundaries allow exchange + relationships
- Input – transformation – output – feedback
- Process, flow
Banathy (1996) – Classification of systems
A system can be:
- Natural: e.g., subatomic, fauna, planets, universe
- Designed: created by humans.
In this course we focus on the designed systems, and especially on the Human activity
systems:
1. Fabricated physical systems (e.g., neighborhood)
2. Hybrid systems (combines nature and physical constructions, e.g., hydroelectric power
plant)
3. Designed conceptual systems (theories, philosophies)
4. Human activity systems
There are 5 types of human activity systems:
- Rigidly controlled – rather closed, limited degree of freedom, rather mechanistic
o Assembly-line work groups
- Deterministic – more open, some degree of freedom, less mechanistic
o Bureaucracies
- Purposive – somewhat open, more freedom, less mechanistic
o Corporations
, o Public service agencies
- Heuristic – necessarily open to changes, more freedom, not mechanistic
o New business ventures, R&D agencies, experimental educational programs
- Purpose-seeking – open, much freedom (define own policies/purposes), not
mechanistic
o Corporations seeking social service roles
o Communities that seek to establish comprehensive systems of learning and
human
o Societies/nations establishing integrated regional systems
Types of system becomes more open, more degrees of freedom and less machinelike.
So far, an organisation is a system, and departments are sub-systems. However, increasingly
we see interorganisational systems, i.e., systems of organisational systems:
- In which organisations are sub-systems of interorganisational systems.
This means, whether an entity is a system or subsystem depends on where you draw
the system boundary.
Integrated Care Ecosystems
What is integrated care?
Patient care, that is:
- Coordinated across professionals, facilities, and support systems
- Continuous over time and between visits
- Tailored to the patients and family members’ needs and preferences
- Based on shared responsibility between patient and caregivers for optimizing health.
Why is it important?
In healthcare there are great challenges:
- Greatest challenge: Meeting complex needs of patients with chronic illness or
impairment
- Chronic patients’ needs require multiple services
- Due to specialization + professionalisation needs cannot be addressed by 1
professional or organisation alone
,Integrated care requires
Processes and flow between/across professional groups and organisations.
Integrated care Ecosystems
Dynamic and co-evolving communities:
- Of sovereign and unique organizations, independent care providers, informal care
givers, care networks, patients and others
- Which co‐produce care or develop care innovations
- Related to a specific or to multiple patient population(s)
- With requisite levels of care process integration and coordination
- Within unique social, physical and systemic conditions
- Which are highly effective at achieving the aim
Integrated care is difficult to achieve. This has many causes, among others:
- Government policies and funding schemes
- Competition between providers
Notes:
, Because most human systems are open systems, it is difficult to draw straightforward
boundaries between parts and system.
Day 2 – Continuous Process Improvement (CPI)
Context Orientation:
1. What is the relationship between systems thinking and continuous improvement?
Systems:
This graph describes the essence of a system
within its boundaries. It contains actors,
relationships, and interactions.
Continuous improvement does address all three
components in its own way. You could say that
continuous improvement works on
improvements within the system – this
differentiates continuous improvement from STS. Particularly with regard to processes and
flow.
Continuous improvement happens inside the system!
Link between systems theory and continuous improvement
Deming has established a clear relationship between system thinking and continuous
improvement. He is a system thinker and one of the founding fathers of continuous
improvement.
Deming: what is a system (this is the link between Deming and System theory)
- Network of interdependent components that work together to try to accomplish the
aim of the system
- A system must have an aim. Without an aim, there is no system.
- Management of a system requires knowledge of the interrelations between all the
components within the system and of the people that work in it.
- A system must be managed. It will not manage itself.
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