System Thinking Discussion 2022

Running head: SYSTEM THINKING
SYSTEM THINKING
Name of the Student
Name of the University
Author Note

1SYSTEM THINKING
Executive Summary
Hospital is a necessary residence for every individual in the world. There are numerous
subdivisions which are using for open facilities. There are outdoor organizations, indoor systems.
Operations theatre, Dangerous care unit, Intensive Coronary Care Unit. ICCU, CCU is the
emergency segments for any hospitals in this world. Every hospital's prosperity is very much
reliable on the patient response and the doctor’s accommodations. Let accept one of the public
hospital’s emergency department in the republic is not up to the mark for the amenities and
conveniences. The patients of this hospital give some negative response and want to improve the
hospital's emergency department. That is the main reason the hospital authority creates a
responsible management team. This team received the patients' feedback, report and suggestion.
Then the response team try to resolve this problem and enhance the emergency department of
this public hospital. I am one of the members of this accountable team. So my main job target is
to manage the whole operations and try to improve all sections, which are the main criteria of the
patients.

2SYSTEM THINKING
Table of Contents
Introduction:....................................................................................................................................3
Discussion:.......................................................................................................................................3
Identification of the System Archetypes that may impede performance:................................4
Analysis of the current state Value Stream Map of the emergency department based on
System Archetypes..................................................................................................................6
Recommended new State Value Stream Map with the desired reduction in patient
turnaround time:.......................................................................................................................7
Discussions on intended and unintended consequences of the modified system....................8
Conclusion:......................................................................................................................................9
Recommendation:..........................................................................................................................10
References:....................................................................................................................................11
Appendices:...................................................................................................................................14

3SYSTEM THINKING
Introduction:
Hospital is an essential place for every person in the world. There are many departments
which are using for public facilities. There are outdoor systems, indoor systems. Operations
theatre, Critical care unit, Intensive Coronary Care Unit. ICCU, CCU is the emergency sections
for any hospitals in this world. Every hospital's fortune is very much dependable on the patient
feedback and the doctor’s facilities. Let assume one of the public hospital’s emergency
department in the country is not up to the mark for the services and facilities (Feriver et al. ,
2019). The patients of this hospital give some negative feedback and want to improve the
hospital's emergency department. That is the main reason the hospital authority creates a
responsible management team. This team received the patients' feedback, report and suggestion.
Then the response team try to resolve this problem and enhance the emergency department of
this public hospital. I am one of the members of this responsible team. So my main job target is
to manage the whole operations and try to improve all sections, which are the main criteria of the
patients.
Discussion:
Systems thinking is a complete method to an investigation that concentrations on the way
that a system's essential parts interconnect and how schemes effort over time and inside the
context of more extensive arrangements (Shenk et al., 2019). The systems thinking method
contrasts with outmoded investigation, which revisions systems by contravention them down into
their discrete fundamentals. Systems thinking can be recycled in any area of the inquiry and has
been pragmatic to the study of medicinal, conservational, administrative, financial, human
possessions, and enlightening systems, among many others.

4SYSTEM THINKING
Identification of the System Archetypes that may impede performance:
The eight supreme collective arrangement standards are:
Fixes that fail:
The situation is an explanation is speedily executed to discourse the indications of a
crucial problem in this public hospital. These speedy repair arrangements hooked on sign
unintentional significances that are not obvious at chief but end up calculation to the indications.
Mainly the response team of this public hospital to find and problem and try to repair this failure
as soon as possible.
Shifting the burden:
An immediate and an ultimate solution talks a tricky indication. The short-range
explanation produces side possessions distressing the eventual solution. As this occurs, the
system’s consideration modifications to the quick declaration or the side effects .(Mutale et
al.,2016). As a member of this response team, the primary responsibility of mine to indicate the
immediate solutions and also removed the encumbrance, which is related to the hospital
emergency issues.
Limits to success:
A specified determination primarily produces an optimistic presentation. Conversely,
completed the confidence stretches a constriction that decelerates down the general enactment no
substance how much vitality is pragmatic. Achievement Restrictions is the one of the important
matter of this project because there are many departments combined in this public hospital. In
fact, the response team works only the emergency sections (Schiff et al., 2019). It is obvious to
create a positive enhance for the patient facilities. But other departments which are already there
in the hospitals working speed not up to the mark, it is one of fundamental limits of this case.

5SYSTEM THINKING
Drifting goals:
As a break between area and actual presentation is appreciated, the sensible choice is to
subordinate the aim (Iqbal et al., 2015). The consequence of this assessment is a continuing
deterioration in the system presentation. There is an enormous difference between the action plan
and executing the plan (Michelson et al., 2018). Patient safety and service facilities are very
much outstanding. So first of all, complete, the method of action is the main target of this system
thinking of hospital emergency services.
Growth and underinvestment Evolution methodologies a limit hypothetically preventable with
savings inability. However, a choice is completed not to capitalize ensuing in performance
deprivation, which outcomes in the failure in demand authenticating the pronouncement not to
participate if the hospital authority does not provide the sufficient money for this project, so it is
very much difficult to maintain the continuity of this project.
Success to the successful:
various efforts participate for the same predictable resources. The more effective effort
gets an excessively superior provision of the possessions to the impairment of the others (Lamkin
et al., 2019). It is crucial that the problems are correctly justified and fixed it. A good response
team does not overlook the minimal issues which are related to any project. So to makes a strong
impact, it is essential to identify the problem very prominently.
Escalation:
one of the most significant responsibilities of the response team is to improve the
communications between team and patients. The response team try to connect the patients and
identify the problem individually. If this public hospital enhances, then it is crucial to create a
good relationship between hospital and patients through Response team.

6SYSTEM THINKING
The tragedy of the commons:
If the project is doing very successfully then numerous festivities which are related to the
hospital relishing the assistances of a mutual resource do not recompense consideration to the
effects they are taking on the shared resource (Borich ,2019). Ultimately, this resource is pooped
occasioning in the shutdown of the happenings of all gatherings in the arrangement.
Analysis of the current state Value Stream Map of the emergency department based on
System Archetypes
The Value stream mapping progression agrees to you to generate a comprehensive
conception of all phases in your work progression. It is a demonstration of the stream of
belongings from contractor to consumer through someone association. The Current value stream
map is mainly categorizing in two different flow, like information flow and material flow. The
stream map is based primarily on the patient and hospital facilities (Lapoint et al., 2019). When
the patient admits in this public hospital, then nurse examines this patient primarily. After the
initial test, the physician supervises this patient. If the doctor believes that these patients suffered
from critical illness, then the doctor admits those emergency wise. Patient information is very
much important. Every public hospital should know the patient background after the initial
checkup. It is very much vital statistics to see the patient information. If this hospital does not
collect the patient record, it creates very much lousy impact on the hospital. Importantly this
record should be confidential. A hospital cannot enclose the patient's data. Responsibility of the
management team is to keep this data very securely. Hospital also saves the patient’s medical
information. If any patients covered by any medical schemes or medical insurance, so hospital
also keep this critical data for the security purpose (Leisman et al., 2019). Suppose a critically ill

7SYSTEM THINKING
patient admitted in the public hospital then they faced some steps as the hospital officials sent
them in a waiting area and the nurse or junior physician examined them then the authority taken
the patient to the emergency room. After that, the experienced doctor-supervised and trained
nurse checkup the patients regularly. As per the requirement, the doctor prescribed medicines
and continue the treatment. According to the doctor, the patient is cure then the patient are going
to the home and follows some primary instruction for their better health. The first part, which is
related to the patient background, medical history and diagnosis expenses, is naming as
information flow, another part is the internal part which is associated with the patient facilities
(Muhanuzi et al., 2019). These are called material flow. Treatment information is the
fundamental data for both hospital authority and patient parties. There is some intimate story
related to patient treatment, medical supply chain, medical scheme, insurance scheme, room
availability. When the patient ready to cure, then the hospital authority is connecting to the
doctor and nurse (Samuels et al., 2019). When the patient instructed for left before that patient
party need to fulfil all criteria which are given to the hospital. So it is the primary chain presently
connected to the hospital and patient.
Recommended new State Value Stream Map with the desired reduction in patient
turnaround time:
Current value stream mapping is not prominent in many cases. The response team try to
resolve this issue, which is related to patient feedback. First of all, an emergency patient cannot
wait in the waiting room, so no of the emergency centre must be increased and also upgraded the
infrastructure (Kin et al.,2019). There is some time-consuming incident in room availability,
diagnosis needs, treatment information, and patient background. So all issues are very much
practical for the patient. A responsible team must be concentrated on resolve these issues. The

8SYSTEM THINKING
vital statics storage strategy is the one problem because the patient provides some documents and
also provide some papers regarding the medical insurance scheme so the hospital authority must
keep this information very securely (Ray et al., 2019). Otherwise, this incident creates some
impact which is not suitable for this public hospital. As hospitals look to progress, complete
arrangements to decrease expenditures and improve the quantity, lean ideologies are being more
lengthily execute. These lean creativities instigated in developed, but have feast through other
portions of the economy, containing health care. The new arrangement can growth the capability
of the workplace without adding people or tackle, lower waiting times for individuals with
arranged activities, upsurge the occasion for patients without events to be seen at the last
miniature, and subordinate the pressure levels for the hospital's supervisor.
Discussions on intended and unintended consequences of the modified system.
First, the response team scrutinize whether therapeutic strategies, premeditated to
progress well-being care and decrease inequalities in experimental preparation, are
accomplishing their envisioned significances. Another, the responding team anticipate potential
accidental consequences of clinical strategies.(Zaman et al., 2019).Emergency Department
gathering is a thoughtful and global health care problem that seems to be impervious to most
well envisioned but often reductionist policy methods. In this study, the response team examine
Emergency Department assembling in public hospital from systems thinking standpoint using
key loop diagramming to envisage the complete structure essential this complex singularity
(Lieng et al., 2019). The building of the qualitative fundamental circle illustration is grounding
on discussions with Alternative Subdivision authorities, direct reflection, and the evaluation of
thorough work. For the determination of policy examination, a novel methodology, the path
examination, is pragmatic (Lange et al., 2019). The path investigation exposed that both the

9SYSTEM THINKING
outline of old alternative medication and the development of substitute prescription exercise may
be accompanying with objectionable significances underwriting to Emergency Department
problem (Weerahandi et al., 2019). In dissimilarity, enhancing primary care was originate to be
connected in plummeting Alternative Subdivision crowding; in a calculation, it has deceptively
no undesirable side effects, seeing the frontier of the model created (Arnold & wade, 2015).
Emergency department assembling is a health care offending noticeable in many fitness care
systems and reproduces a local appearance of a more significant universal sickness within a
health care arrangement. In this study, we move toward the problems using a systems thinking
tactic to interpretation for its multifaceted and general nature (Huang et al.,2018). Causal loop
diagramming was an influential tool for producing the universal construction of emergency
department problem, demonstrating the interrelations between its management and
consequences. Furthermore, the resulting response authority proved useful in assessing three
different strategies presently discussed by policy-makers in public hospital in specific
representative brightly, both intended and unintended consequences of policy proposals.
Conclusion:
In this thinking, members decided that whole organizational system vital and emergency
care permits for the project and execution of care distribution replicas that meet complication of
public healthcare needs, decrease repetition and discarded and progress healthcare consequences
and patient understandings. For this to be accomplishing, importance needs to be positioning on
sweeping changes in constructions, developments and decorations of the crucial and alternative
care system. Often discounted, decorations that drive the thoughtful and performance in the
office directly impact on staff enrollment and preservation and the overall efficiency of the

10SYSTEM THINKING
hospital. These also need to be appeared for transformational modification to be accomplished
and continued.
Recommendation:
Present value stream mapping is not noticeable in many circumstances. The reaction team
try to determine this question, which is associated with enduring feedback. First of all,
alternative enduring cannot wait in the waiting room, so no of the emergency centre must be
increased and also upgraded the infrastructure. There are some time incontrollable incident in-
room accessibility, diagnosis needs, treatment information, and patient background. So all issues
are very much practical for the patient. A responsible team must be concentrating on resolving
these issues. Otherwise, this occurrence generates some impact which is not suitable for this
public hospital. As hospitals look to progress, complete arrangements to decrease expenditures
and improve the quantity, lean ideologies are being more lengthily executing. These lean
imaginations prompted in established, but have feast perfect other portions of the economy,
containing health care. The new arrangement can growth the capability of the workplace without
adding people or tackle, lower waiting times for personalities with decided activities, upsurge the
occasion for patients without events to be seen at the last minuscule, and secondary the pressure
levels for the hospital's administrator.

11SYSTEM THINKING
References:
Arnold, R. D., & Wade, J. P. (2015). A definition of systems thinking: A systems approach.
Borich, G. D. (2019). Educational Psychology A Contemporary Approach.
Feriver, Ş., Olgan, R., Teksöz, G., & Barth, M. (2019). Systems Thinking Skills of Preschool
Children in Early Childhood Education Contexts from Turkey and Germany.
Sustainability, 11(5), 1478.
Huang, Y., Natale, J. E., Kissee, J. L., Dayal, P., Rosenthal, J., & Marcin, J. (2018). Association
Between Insurance and Transfer of Non-injured Children from Emergency Departments.
Kin, H. W., Yap, R. A. S., Guan, T. E., Hoong, L. Y., Lam, T. T., Seng, Q. K., ... & Dindyal, J.
(2019). Understanding the sustainability of a teaching innovation for problem solving: A
systems approach. In Mathematical Problem Solving (pp. 339-360). Springer, Cham.
Lamkin, L., Lindsey, S., Weant, K., Shoff, H., & Pinkston, C. (2019). Implications of the
presence of an emergency medicine pharmacist during critical care trauma patient
resuscitation. Journal of the American College of Clinical Pharmacy, 2(3), 251-256.
Lange, A., Manley, J., Baker, B., Dehning, M., Gardner, A., Holland, D., ... & Ruggiero, R. M.
(2019). Implementation of a Protocol for Bi-Level Positive Airway Pressure (BIPAP) to
Improve Transition from Emergency Department to Non-ICU Areas of a Safety Net
Hospital. In D44. CRITICAL CARE: AN ENCOUNTER-HOW WE MANAGE CRITICAL
CARE IN AND OUT OF THE ICU (pp. A6481-A6481). American Thoracic Society.

12SYSTEM THINKING
Lapoint, J., Meyer, S., Charles, K. Y., Koenig, K. L., Lev, R., Thihalolipavan, S., ... & Kahn, C.
A. (2018). Cannabinoid hyperemesis syndrome: public health implications and a novel
model treatment guideline. Western Journal of Emergency Medicine, 19(2), 380.
Leisman, D. E., Angel, C., Schneider, S. M., D'Amore, J. A., D'Angelo, J. K., & Doerfler, M. E.
(2019). Sepsis Presenting in Hospitals versus Emergency Departments: Demographic,
Resuscitation, and Outcome Patterns in a Multicenter Retrospective Cohort. Journal of
hospital medicine, 14, E1-E9.
Lieng, M., Rosenthal, J., Sigal, I., Dayal, P., Haynes, S., Mouzoon, J., ... & Marcin, J. (2019).
3455 Association between transfer of children from the emergency department and
pediatric readiness of the hospital. Journal of Clinical and Translational Science, 3(s1),
139-139.
Michelson, K. A., Hudgins, J. D., Monuteaux, M. C., Bachur, R. G., & Finkelstein, J. A. (2018).
Cardiac arrest survival in pediatric and general emergency departments. Pediatrics,
141(2), e20172741.
Muhanuzi, B., Sawe, H. R., Kilindimo, S. S., Mfinanga, J. A., & Weber, E. J. (2019).
Respiratory compromise in children presenting to an urban emergency department of a
tertiary hospital in Tanzania: a descriptive cohort study. BMC emergency medicine,
19(1), 21.
Mutale, W., Balabanova, D., Chintu, N., Mwanamwenge, M. T., & Ayles, H. (2016).
Application of system thinking concepts in health system strengthening in low‐income
settings: a proposed conceptual framework for the evaluation of a complex health system
intervention: the case of the BHOMA intervention in Z ambia. Journal of evaluation in
clinical practice, 22(1), 112-121.

13SYSTEM THINKING
Procedia Computer Science, 44, 669-678. Iqbal, A. M., Khan, A. S., Bashir, F., & Senin, A. A.
(2015). Evaluating national innovation system of malaysia based on university-industry
research collaboration: A system thinking approach. Asian Social Science, 11(13), 45.
Ray, K. N., Marin, J. R., Li, J., Davis, B. S., & Kahn, J. M. (2019). Referring hospital
characteristics associated with potentially avoidable emergency department transfers.
Academic Emergency Medicine, 26(2), 205-216.
Samuels-Kalow, M., Neuman, M. I., Rodean, J., Marin, J. R., Aronson, P. L., Hall, M., ... &
Shah, S. S. (2019). The Care of Adult Patients in Pediatric Emergency Departments.
Academic pediatrics.
Schiff, R. L., Ansell, D. A., Schlosser, J. E., Idris, A. H., Morrison, A., & Whitman, S. (2019).
Transfers to a public hospital. Community Health Equity: A Chicago Reader, 226.
Shenk, J. L., Vranas, K. C., Lin, A. L., Slatore, C. G., & Sullivan, D. R. (2019). POLST-
Discordant Care Among Patients Presenting to the Hospital: A Qualitative Analysis. In
A22. FACILITATING PALLIATIVE AND END-OF-LIFE CARE (pp. A1085-A1085).
American Thoracic Society.
Weerahandi, H., Wisnivesky, J. P., O’Conor, R., Wolf, M. S., & Federman, A. D. (2019). The
Relationship of Illness Beliefs with Hospital and Emergency Department Utilization in
Chronic Obstructive Pulmonary Disease. Journal of general internal medicine, 34(6),
923-928.
Zaman, K., Dodds, P., Xiang, N., & Barach, P. (2019). Impacts of noise on staff cognitive
performance in a hospital emergency department. The Journal of the Acoustical Society
of America, 145(3), 1658-1658.

14SYSTEM THINKING
Appendices: