System Thinking

The report presents a scenario of an emergency department of a hospital, analyzes the existing Value Stream Map, recommends a new Value Stream Map for optimization, and explores the consequences and recommendations for improvement.

Running head: SYSTEM THINKING
System Thinking
[Name of the Student]
[Name of the University]
[Author note]

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Executive Summary:
The report is associated with presenting forward of a scenario of an emergency department of a
hospital by considering the archetype. Beside this in the report the existing Value Stream Map of
the hospital has been discussed along with recommending new Value Stream Map which would
not only be helping in reducing the time but would also be helping in optimization of the entire
operations of the Hospital emergency department. Besides this the report is also associated with
analysis of the consequences which are to be faced because of the optimized operations of the
emergency department. Lastly the report is also associated with presenting of recommendations
so as to make the processes become much better.

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Table of Contents
Introduction:....................................................................................................................................3
Background:.....................................................................................................................................3
Discussion:.......................................................................................................................................4
System Archetype identification and analysis:............................................................................4
Limits to growth:.....................................................................................................................4
Eroding goals:..........................................................................................................................5
Escalation:................................................................................................................................5
Current Value Stream Map Analysis:..........................................................................................5
New Value stream Map:..............................................................................................................7
Consequence of the New Value Stream Map:.............................................................................9
Conclusion:......................................................................................................................................9
Recommendation:..........................................................................................................................10

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Introduction:
Medical Emergency system is always seen to be associated with requiring immediate
attention and any kind of delays might lead to severe problems even might be responsible for the
death of the employees. The report has been associated with the identification and the analysis of
the System Archetype which is associated with impeding the performance (Hartel et al., 2018).
The existing value stream map of the emergency department has been analyzed in a proper way.
Followed by this the report has also been associated with designing of the new Value Stream
map which would be helping in increasing the efficiency of the entire department by means of
helping the hospital in decreasing the response time and optimization of all the operations. Lastly
the report has also been associated with putting forward of the recommendations which would be
helping in betterment of the entire process.
Background:
The emergency department is seen to be associated with receiving of feedback from the
patients which is associated including suggestions which states that the waiting time of the
patients is in need of making improvements in the waiting time. This is turn is initially seen to be
associated with making a patient wit for a longer time when they are in need of an emergency
medication. From the value stream map provided it is clear that the processes included in the
emergency department is seen to be very complicated and requires a lot of optimization (Guo,
Yiu & González, 2015). In this report an optimized value stream map has been provided.

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Discussion:
System Archetype identification and analysis:
This section of the report is associated with identification of the system archetype which
were responsible for obstructing the performance of the functional process, along with analyzing
them (Brzezina et al., 2017). The this system archetypes is mainly associated with including the
limits to the growth, eroding of the goals, tragedy of the commons, escalations, accidental
adversaries and the fixes and fails.
Limits to growth:
This is one of the major aspect of the system archetype which is associated with
including the fact that there is a need of proper examining of the various policies which has been
acting as one of the major reason lying behind the destruction of the resources (Bureš & Racz,
2016). There exists several challenges along with detractors in the theories and this particular
aspect is associated with taking into consideration the various aspects which are responsible for
managing the entire processes which are being performed in a poor manner. This also includes
the growth in the process of the business management which cannot be continued in a dynamic
manner on a regular basis. This archetype is associated with the usage of the dynamic theory and
the theory is mainly associated with enhancing of the balance processes which is required in the
process of managing the business. This in turn is associated with making sure of the fact that the
providing of similar effort the rate of return is highly reduced (Clancy 2018). The seven action
step should be associated with ensuring the proper identification of the growth engines and this
in turn would be helping in doubling of the performing time, another beneficial aspect is
associated with including the proper identification of the potential limits as well as the balancing
which are seen to be very beneficial. There is also a requirement of understanding the changes

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that are required so one of the beneficial aspect is the growth balancing and re-evaluation of the
entire strategy associated with growth.
Eroding goals:
This is considered to another aspect of system archetype which si seen to be rotating
around the functions related to the shifts taking place in the dynamic tension in between the
symptomatic aspects (Newell & Siri, 2016). This aspect is mainly associated with focusing upon
the dynamic behavior which would be entirely associated with resulting in proper forecasting of
the future which was determined in the past. One of the major aspect which has been taken into
consideration for this particular case is that because of the vivid circumstances which were set at
the initial stage of the project needs to be eroded, this in turn is associated with obstructing the
entire performance.
Escalation:
The functioning processes of the entire management of the hospital emergency
department is tested because it is associated with providing of improper service to the clients and
the waiting time of the patients is also seen to be longer. Escalation acts as one of the major
aspect associated with the lowering of the entire value of the organization for the customers
(Václavík et al., 2016). The processing of the action is associated with having a well
understanding of the dynamic theory of the escalation which is mainly related to a single party
and would in turn be associated with perceiving by the other parties and for this reason the threat
related to the hypothesis is performed in between the balancing so as to create the
reinforcements.

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Current Value Stream Map Analysis:
The Value Stream Map of the emergency department is seen to be dependent upon the
system archetype which is initially seen to be leading to the wastage of time as well as errors in
the operations of the organization (Akers et al., 2015). In addition to the customers have also
been associated with complaining about the fact that the waiting time for receiving the treatment
is seen to be longer (Freire et al., 2017). So this in turn has been associated with putting forward
of the need related to development of a new value stream map.
The existing value stream map is seen to be starting from the producing of the insurance
form by the patients which is to be followed by registration as an outpatient. Completion of the
registration is followed by taking of patients to the waiting area and in the meantime the internal
functioning processes would be associated with providing information related to the patient to
the nurse who would be further associated with providing assistance to the patient (Tripto,
Assaraf & Amit, 2018). Once this is done the nurse would be associated with the preparation of
the emergency room and this would also be requiring a lot of time and this would be leading to
an ample amount of time while waiting. Once the patient enters the emergency room the medical
history along with the vital statistics would be taken into consideration and checked by the
doctor. While doing this some of the internal activities which are seen to be included in the
process would be including the analysis of the vital statistics of the patients, preparation of the
medical equipment and providing of medical supply (Mjema, 2018). This phase is followed by
providing of treatment to the patient while treating the patients they are provided with several
tests and the reports of this tests are seen to be taking a lot to be generated which helps in
understanding the fact that in this transparent process the time required is very high. Once the
treatment gets initiated the associated nurse would be entirely responsible for the providing or

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conveying of any kind of details to the patients family. After completion of the treatment the
patient is released and this information is also conveyed by the nurse (Roychoudhury,
Shepardson & Hirsch, 2017). Once the treatment is completed and the patient leaves the hospital
then all the information related to the patient would be recorded into the records of the hospital
which is further forwarded to the insurance company. Entire process of treatment along with the
internal processes is seen to be running simultaneously.
New Value stream Map:
The new value stream map would be consisting of the archetype shifting of Burden. This
archetype is associated with helping the main concept of the new Value stream map which is
associated with including the fact that the entire change in the processes can be performed with
maximum flexibility and in the easiest way possible by having the least expenditure (Twisk et
al., 2015). This would be helping in better management of the emergency department and this in
turn would be helping in better understanding of the issues which are mainly being faced by the
emergency department because of the existing value stream map. Shifting of burden archetype
usage would be helping in planning of the long term based optimized process which in turn
would be helping in making a better plan of the processes (Eilam & Reisfeld, 2017). This is
considered to be one of the major aspect and the reason behind this is that it would be leading to
the functional processes of the symptomatic solutions along with helping in the implementation
of fundamental solutions in accordance to the problem resolving methods.

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Fig 1: New Value Stream Map
Source: Created by Author
The newly created value stream map would be helping in reducing the waiting time of the
patients, which would almost be reduced to half the waiting time of the existing value stream
map. The main issues identified as per the analysis is the issue related to the existence of the
common archetypes. This issue mainly aroused because of assigning a lot of tasks to the nurse.
The new value stream map would be including the shifting of the burden of work of the nurses to
the emergency treatment section of the emergency department (Monasterolo et al., 2016). By
usage of this archetype would be associated with introduction of a new entity in the process. The
implementation of the EHR would be helping in elimination of different kind of issues along

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with helping in management of different processes. The EHR would also be helping in
elimination of different manual processes due to automation.
Consequence of the New Value Stream Map:
The new value stream map would be having negative as well as positive effects upon the
operations of the emergency department. One of the major positive impact includes the
elimination of excess waiting time due to automation of the system. Excess time needed for
doing some of the manual works would be eliminated which in turn would be helping in
achieving the main goal that the creation of new value stream map is having.
The major negative impact of the new value stream map is the incurring of the increased
cost of the functional processes the reason behind this is the implementation of the EHR is costly
and this process includes addition of a new entity.
Conclusion:
The regular functioning of the hospitals have been associated with greater adaptation of
the system modelling. Data modeling tools are mainly used with an aim of enhancing the entire
functioning of the processes which in turn has been associated with making this one of the major
tool being used for achieving the objectives, in this case it is the optimization of the entire
process of the emergency department so as to reduce the waiting time. The system archetype
which has been used for the purpose of creating the new value stream map is the shifting of
burden which involves the distribution of tasks so as to reduce the burden on one specific entity.
In addition to this the EHR system is also included in the Value stream map which helps in
automation of different processes of the emergency department.

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Recommendation:
 The Data entry burden upon the HER system is to be decreased. New ways are to be
explored and included along with a care team in the process of documentation. Besides
this certain ways are to be identified which would be helping in automatic capturing of
the information.
 Data entry is to be separated from the data entering and patients along with the family
members and care team members should be allowed to enter the data which would be
helping in creation of customized reports.
 Reimbursement of the changes for driving the innovations in the EHRs should be
encouraged.

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References:
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