Systems Thinking and Healthcare

This study explores the concept of systems thinking in healthcare and its impact on performance. It discusses the identification and analysis of system archetypes that impede performance, the current map of value stream in emergency departments, recommended state value stream maps, and the intended and unintended outcomes of system modifications. Recommendations for implementing a holistic approach and nurturing expert system thinkers are also provided.

Running head: SYSTEMS THINKING AND HEALTHCARE
Systems thinking and healthcare
Name of the student:
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Author Note

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Executive summary
The system thinking is a vital tool for analyzing the systems. It is helpful for any person to face
organizational systems. Further, the value stream mapping is an effective measure for team
management. In the following study, the assessment and identification of the system archetypes have
been impeding performances. Apart from this, the discussion includes the analysis of the current
map of value steam of different departments of emergency. This is based on different system
archetypes. Moreover, different types of value stream maps are suggested here. Lastly, an evaluation
is done on different types of intended and unintended results of the new systems.

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Table of Contents
1. Introduction:......................................................................................................................................3
2. Determination and analysis of the system archetypes impeding performances:...............................3
3. Discussing on the present map of value stream:................................................................................6
4. Illustrating recommended state value stream map:...........................................................................7
5. Demonstration on intended and unintended outcomes of the latest system modified:......................8
6. Conclusion:........................................................................................................................................9
7. Recommendations:............................................................................................................................9
8. References:......................................................................................................................................11

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1. Introduction:
System thinking is one of the important tools for system analysis. This is the method through
which an individual can face the systems. This is from the perspective of the board including the
fetching of overall structures. It also involves the cycles and patterns in systems instead of
witnessing the particular events in systems.
The value stream mapping is the tool for team management. It is helpful to see the phases
required for taking the product creation for delivering that to the customer at the end. Similar to
other methods of business process mapping, this is helpful for introspection along with process and
analysis development.
The following report includes the identification and assessment of the archetypes of systems
that have been impeding performance. This involves the assessment of the present map of the value
stream of various emergency departments based on system archetypes. Further, various latest state
value stream maps are recommended having the intended reduction of the turnaround of the patient.
At last, discussions are made on unintended and intended outcomes of the systems modified.
2. Determination and analysis of the system archetypes impeding performances:
In the present system, ten kinds of system archetypes are identified. These are commonly
seen to form the set of tools and displaying the patterns of behaviours in systems. Hence, to
determine and assess the system archetypes help impede the performance to get selected from the
following aspects.
Attractiveness Principle:

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This is the idea that is included in the fact that the type of business and product can never be
everything to every people. However, the organizations have been striving to follow the path (Stalter
et al., 2017). Here, one requires undertaking important decisions on the characteristics of the
product. This is because it can never be perfect for every dimension. The product can never go to be
successful due to the limited resources and natural constraints. This has been the reality of life that
considering the relationships among the elements of the systems one can influence, remove and
inhibit the limits. This can be done by making various expert modifications in the systems.
Accidental Adversaries:
Here, the archetypes have been demonstrating the patterns. Here, two subjects are decided to
function together. This is because they can bring the advantage of those alliances. Here, all the
activities have believed that they can bring advantage to others and as the cooperation works they
can bring benefit from that. Here, issues have been arising as all the subjects have required fixing the
local gap for performances. This is because of external pressure. They have initiated the fixing of the
gap and accidentally have been undermining the success of other people (Chung, Lim & Lee, 2016).
Here, the outcomes have been developing a sense of resentment between the subjects. This has also
been turning the subjects of the adversaries thus destroying the alliances.
Growth and Underinvestment:
It was comprised of the reinforcing loop that has been a kind of feedback loop. Here, the
positive rise of a specific variable is seen. Then, there is a balancing loop. This is a kind of feedback
loop that has fetched the positive rise of that variable due to the decline of the other one. This has
been in turn causing the positive rise in the initial variable (Best et al., 2016).
Fixes that Fail:

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It is the system archetypes under the system dynamic. This is used for demonstrating and
assessing any situation. Here, it is fixed effectively as per short-term duration. It generates side
effects for various long-term behaviours of the systems. This it has been resulting in the necessity of
more fixes (Fischer, 2015).
The tragedy of the commons:
Here, the tragedy of the common is the case that has been under shared-resource systems.
Here, distinct users have been acting independently as per the self-interest for behaving the contrary
to the common good for every user. This is through spoiling and depleting the resources with the
help of collective activities (Waring et al., 2016).
Success to the Successful:
It denotes a couple of reinforcing structures. This has been under delicate balance. It occurs
as one achieves the little benefits for the allocation for resources. They have been favouring the more
successful outcomes. Here, the result is quickly skewed in the direction to be more successful
(Ahluwalia, Gimpel & Varshney, 2015).
Escalation:
This is the probable kind of system behaviour. This is known as the system archetype. This
escalation kind has been common for various cases of non-cooperative games. Here every player can
make their individual decisions. This can lead to the outcome for the player.
Eroding Goals:
This is a changing the archetype of burden. Here, the present issues require to be controlled
as soon as the long-term aims constantly minimize. This can be avoided by getting stuck to the

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vision (Manley et al., 2016). For instance, this involves the sliding limits for environmental
pollution, balancing the debt of public.
Shifting the burden:
The structure is one of the vital remarks of the system thinking and system dynamics. These
are utilized for detecting the patterns of various behaviours of social systems that involve the
economies, states, communities and businesses. This is utilized as the diagnostic tool for the present
states and the tool for looking at the further development of the system (Phillips & Stalter, 2016).
This, as a diagnostic tool, has been helping the managers in gaining the view-points of the internal
structure of the system. This involves functioning and helping to gain a smarter concept of the
present state of the system. It as a prospective measurement is primarily utilized for the planning.
The managers have been formulating the goals of the future knowing the functioning of the business.
Thus they can determine the process better through which the aim can be attained (Carey et al.,
2015).
Limits to Growth:
Here, the initial step has been to use the limits of success archetype. This is to recognize the
rise in engines. Though the rise in the limits of success has been demonstrated under one reinforcing
loop, the loop has been represented as the number of process of reinforcing that has been fueling the
first time success (Parkin & Leveson, 2017).
3. Discussing on the present map of value stream:
The current map of the emergency department is found to be based on various system
archetypes. First of all. Various information has been flowing from outside. The information
includes the patient data, records of the hospital, attending nurses, attending the physicians and

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insurance companies. Here, a relationship between the treatments information is fund between
insurance companies and hospital records. Further, the data about the attending nurses has been
provided to the attending physician. Moreover, various material flow is indicated in the present map.
The various elements of the material flow has included the out patent registration, moving to the
waiting area, considering the ER Rooms, patients of nurse examines, patient examined by the
doctors (Saviano et al., 2018). Then, there are departing instructions and ultimately the patents
reaches home. The departing instructions has involved the treatment information of the hospital
records. The nurse bringing the medical supplies has been attending the physical data as the patient
is ready for treatment. The nurse examines the patient through the help of vital statistics of patient
history. The patient registration is done through the patent information. Them the patient has been
making the patent registration through the nature of inquiry (Hulme & Finch, 2015).
4. Illustrating recommended state value stream map:
This is designed through the intended time of patient turnaround.

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Figure 1: “New State Value Stream Map”
(Source: Created by Author)
5. Demonstration on intended and unintended outcomes of the latest system
modified:
It can easily be highlighted that the approach of the new system adds value. This is done by
decreasing the necessity for the plan and rework. In this way, it can optimize the margin of risk and
permitting the projects in fulfilling the objectives in time and budget. The intended outcomes include
that higher stakeholder engagement has been across the project. This can lead to a better analysis of
the issue. This also involves the proper solution and actual requirements (Riley et al., 2017). Further,
more comprehensive and effective risk mitigation and planning have been leading to the greatest
confidence for the ultimate schedule and costs. The coverage of every task having no missed
requirements and features has been enabling smarter and successful acceptance with the phase of

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handover. Moreover, the better progress and planning reporting of various multi-discipline has been
working to cope with various complicacies. This has been leading to becoming a much realistic
statement of the current status of the status (Whitehead, Scherer & Smith, 2015).
Nonetheless, the concept of the system has acted as the set of various parts. This, when
assimilated, have the qualities that have not been present in any parts in a productive manner. This is
to look for the portfolios, programs and projects. Here there are many parts and elements to the
system. This involves the services, transformations, organizations, information, processes and people
(Valentinov, Hielscher, & Pies, 2015). Besides, it can involve complex products along with
hardware and software. It can also be said that the modified value stream map has been regarding the
analysis of what programs and project have been trying to gain. This assures that the dependencies
and activities have never been falling between various cracks of the discipline silos and contractual
liabilities (Phillips et al., 2016).
6. Conclusion:
The above study on system thinking is helpful to assess, choose and deploy various tools of
system modelling. This is for integration, optimization and developing the business process for the
current healthcare organization. Next, this is useful for synthesizing the non-technological and
technological outcomes for the issues of the business. This is useful to promote the integration and
making optimization of the overall operations. It is also understood that the view of the system is the
manner of looking and positioning to the systematic and organizational issues. It is also analyzed
from the above study the system view is the manner of looking and positioning into the concerns of
systems and organizations. Here, the system boundaries are needed to be set. This is helpful to find
the elements within the system and the parts considered as the external scenario. Here, the scenario
has been affecting the capabilities of solving the issues. However, this has not been the part of the

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overall system. Moreover, the outcomes have been relying greatly on how the system has been
defined. This is because the system thinking has been investigating various relationships. It has been
occurring between different elements of the intended system and the outside environment. Under the
view of the system, the concentration has been spread on various directions as compared to the
traditional linear style to think.
7. Recommendations: Implementing a holistic approach to solving issues:
There must be effective identification of the systems, capturing of task dependencies and
outlining of the activities required to be synchronized, coordinated and sequenced. This has been
appearing to be an isolated issue under the healthcare business. This has can also be part of the
interconnected network of various related problems. The system thinking has been useful to identify
that to be dynamic.
 Defining purposeful approaches for understanding and evaluating the system-wide
effects:
The systems-thinking approach has been helpful to decode various complicacies under the
healthcare company. They are used for analyzing the evaluation and designing of the interventions.
This maximizes the patent safety and system performances. Under the systematic framework, there
is consideration of the probable untended and intended impacts. Its less obvious impacts of the
intervention have been missed the evaluation and designing stages. Moreover, the evaluation and
designing of the system-wide interventions have needed a comprehensive investigation of various
contextual factors. This can inform whether the intervention has been successful.
 Determination and nurturing the expert system thinkers:

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For smart development initiative, the people have been exhibiting strong leadership traits. This has
often been leading to changes under practice. Thus they can foster the adherence of the standards of
performances. Despite being under the job position providing the formal authority, the individuals
must challenge boundaries, share knowledge and develop the consensus.

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8. References:
Ahluwalia, P., Gimpel, G., & Varshney, U. (2015). ICT interventions impacting big societal
challenges: an electronic healthcare approach to homelessness. International Journal of
Electronic Healthcare, 8(2-4), 95-120.
Best, A., Berland, A., Herbert, C., Bitz, J., van Dijk, M. W., Krause, C., ... & Millar, J. (2016). Using
systems thinking to support clinical system transformation. Journal of health organization
and management, 30(3), 302-323.
Carey, G., Malbon, E., Carey, N., Joyce, A., Crammond, B., & Carey, A. (2015). Systems science
and systems thinking for public health: a systematic review of the field. BMJ open, 5(12),
e009002.
Chung, Y., Lim, J. M., & Lee, K. J. (2016). Systems thinking for the crisis and improvements of
healthcare delivery system. Korean System Dynamics Review, 17(1), 5-24.
Fischer, M. (2015). Fit for the Future? A new approach in the debate about what makes healthcare
systems really sustainable. Sustainability, 7(1), 294-312.
Hulme, A., & Finch, C. F. (2015). From monocausality to systems thinking: a complementary and
alternative conceptual approach for better understanding the development and prevention of
sports injury. Injury epidemiology, 2(1), 31.
Manley, K., Martin, A., Jackson, C., & Wright, T. (2016). Using systems thinking to identify
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Parkin, T., & Leveson, N. (2017). Conversations on a Systems Approach to Safety. In Influencing
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Phillips, J. M., & Stalter, A. M. (2016). Integrating systems thinking into nursing education. The
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Stalter, A. M., Phillips, J. M., Ruggiero, J. S., Scardaville, D. L., Merriam, D., Dolansky, M. A., ... &
Winegardner, S. (2017, October). A concept analysis of systems thinking. In Nursing forum
(Vol. 52, No. 4, pp. 323-330).
Valentinov, V., Hielscher, S., & Pies, I. (2015). Nonprofit organizations, institutional economics,
and systems thinking. Economic Systems, 39(3), 491-501.
Waring, J., Allen, D., Braithwaite, J., & Sandall, J. (2016). Healthcare quality and safety: a review of
policy, practice and research. Sociology of Health & Illness, 38(2), 198-215.
Whitehead, N. P., Scherer, W. T., & Smith, M. C. (2015). Systems thinking about systems thinking a
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