Systems Thinking and Value Stream Map Analysis: Emergency Department

This report evaluates the application of systems thinking and value stream mapping within the context of a public hospital's emergency department. It begins by analyzing patient feedback regarding wait times and identifies relevant system archetypes impacting the department's performance. The report then presents a current value stream map, followed by a recommended new value stream map designed to improve efficiency and patient flow. A detailed discussion of the intended and unintended consequences of the modified system is provided, along with a conclusion that emphasizes the benefits of a systems-based approach to healthcare process optimization. The report highlights how the integration of technological and non-technological solutions can enhance overall operations and patient experience.

Running head: EVALUATION OF SYSTEMS THINKING AND VALUE STREAM MAP
Evaluation of systems thinking and value stream map
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Author Note

1EVALUATION OF SYSTEMS THINKING AND VALUE STREAM MAP
Executive summary
The system thinking denotes to the expansion of a broad range of opportunities that can resolve
various concerns. In this study, the case study of a public hospital is considered. It is seen that the
emergency department of the hospital has been getting different feedbacks coming from their
patients. At first, the system archetype of healthcare is found out and analyzed. Next, in this report a
discussion is made on the new value stream map that is needed to be implemented for the hospital.
After that, an evaluation is done on different intended and unintended results for the modified
framework.

2EVALUATION OF SYSTEMS THINKING AND VALUE STREAM MAP
Table of Contents
1. Introduction:......................................................................................................................................3
2. Background of the present study:......................................................................................................3
3. Discussion in the system archetypes:................................................................................................4
4. Demonstration of the present value stream map:..............................................................................7
5. Recommended new value stream map:.............................................................................................8
6. Understanding the intended and unintended results of the system modified:...................................8
7. Conclusion:........................................................................................................................................9
8. Recommendations:..........................................................................................................................10
9. References:......................................................................................................................................12

3EVALUATION OF SYSTEMS THINKING AND VALUE STREAM MAP
1. Introduction:
The system thinking has been expanding a wide range of scopes to resolve issues. This is
done by widening the thinking. It helps in articulating concern in distinct manners. On the other
hand, the value stream map helps the business to visualize how the various end-to-end measures
have been working. It helps in evidencing the real performances and determine the scopes regarding
process development.
In the following report, the system archetype of a public hospital is determined and assessed.
Then a new State Value Stream Map is illustrated. At last, discussions are made on intended and
unintended outcomes of the changed system.
2. Background of the present study:
The emergency department of a public hospital has been receiving feedback from various
patients. They have suggested that the wait times of patients is required to be developed. The patient
turnaround time is developed by decreasing the present time to half. For finishing the activity,
different System Archetypes are required to be determined. This has been impacting the various
controls of the hospital, the emergency department. Hence, there is a necessity to design a future
value stream map for the emergency department on the basis of the archetypes. Here, the different
expected and unexpected results are to be determined with a crucial analysis. Moreover, a holistic
solution is to be made that can optimize the activities of the emergency department. This can be done
despite compromising the performance of other types of activities at the hospital.

4EVALUATION OF SYSTEMS THINKING AND VALUE STREAM MAP
3. Discussion in the system archetypes:
At the current system, various archetypes are determined. They are seen mainly as the format
of a set of tools and highlight the system behaviors. For this reason, the assessing and determining o
system archetypes are helpfully impeding the performance from the following aspects.
Attractiveness Principle It is the concept to be involved in the fact that the kind of
product and business has been never been all the things for all
people. Nonetheless, the business has been striving in following
the path. At this place, one needs the undertaking of vital
decisions on the product characteristics. The reason is that it
has been never been suitable for all kinds of dimensions
(Clarkson et al. 2018). It can never move to be successful
because of natural constraints and restricted resources. This is
a reality of life to be considered as the relationship among
various elements where the systems can influence.
Accidental adversaries The archetypes are the patterns and a couple of subjects has been
decided to perform together. Two subjects are decided to function
together. Further, the activities have been believed that they are
useful to bring benefits and works of the cooperation as they are
able to bring advantages from that. The concerns have been arising
as every subject are needed to fix the performances of local gap
due to outside force (Kreitzer et al. 2019). They are found to
initiate the fixing and accidentally has been undermining the other
people’s success. Further, the results have been giving rise to the

5EVALUATION OF SYSTEMS THINKING AND VALUE STREAM MAP
sense of resentment taking place between various subjects.
Development and
underinvestment
It has consisted of the reinforcing loop. This is a type of feedback
loop. The positive advent of the particular variable is witnessed
here. Next, there is a balancing loop. It is a type of loop for
feedback. It has fetched the adverse rise of the variable because of
the minimizing of others (Grall & Nelson, 2017).
Fixes that Fail Here, the system archetypes has been within the system dynamic.
They are utilized for analyzing and demonstrating the situation.
This is fixed efficiently according to the short-term duration.
Tragedy of commons The tragedy of the common is the situation as there are shared-
resource systems. The distinct users have been acting in an
independent manner according to the self-interest to behave
contrary to the common welfare of all the users. It is done through
depleting and solving the resources through the collective tasks
(Bernard & Oster, 2016).
Success in becoming
successful
This refers to various reinforcing structures. It has been within
the delicate balances. This has been happening as one gain the
benefits to allocating the resources. It is seen that they have been
favoring more successful results. The outcomes have been skewed
quickly in the direction to become successful.
Escalation It is a possible type of system behavior. It is also referred to as the
system archetype. Here, this type of escalation is common for
different cases of games that are non-cooperative in nature. All the
layers are able to make distinct decisions (Norman & Stappers,

6EVALUATION OF SYSTEMS THINKING AND VALUE STREAM MAP
2015).
Eradicating the goals It is the changing of the archetype of burden. The current issues
have needed to be maintained. This takes place as soon as the aims
of the long-term have been minimized consistently. It can be
avoided by getting stuck the vision. Here, for example, it has
included the limits of limits regarding environmental pollution.
This balances the debt of public (Galsworth, 2017).
Shifting the burden It is an important remark of the system dynamic and system
thinking. It is used for finding the patterns of different behaviors
regarding social systems. This involves the business, communities,
states and economies. It is used as the diagnostic till for the current
states and tool for fetching the future development of the system.
It is a diagnostic tool helpful for the managers in achieving the
vie-points f systems internal structure. It has been involved the
helping and functioning in gaining the smarter idea of the current
state of the systems. Here, it is also seen that the managers have
been formulating the aims of the further known of business
functioning (Calancie et al., 2018). Further, the managers are fund
to be formulating the future to know the functioning of a business.
In this way they the process can be determined well, and this will
be helpful to attain the goals.
Limiting the growth The initial step has been used for limiting the archetypes of
success. It is to identify the rise of engines. With the help of the
rise, the success can be limited that can be discussed within the

7EVALUATION OF SYSTEMS THINKING AND VALUE STREAM MAP
reinforcing loop. This has represented as the process to reinforce
that has fueled the success for the first time (Shahamat et al.,
2018).
4. Demonstration of the present value stream map:
It is seen that the present map of the emergency department is been found on the basis of
different archetypes of systems. Here, the data has been illustrating the patient data, different
hospital records, attending of the nurses and then attending the insurances and physician
organizations. Further, the relationship taking place between the information treatments is seen to be
existing of hospital records and insurance organizations (Bradley, Taylor & Cuellar, 2015).
Moreover, the information is regarding the attending of nurses that are provided through visiting the
physicians. Besides, the different flow of materials is determined from the present map. Here,
different elements of the material flow have involved the registration of patients, accessing to the
waiting sectors and taking into consideration of the ER rooms. This also includes the patent
examined by doctors and the patients examined by the nurses (Salmon et al., 2017). Further, there
are departing of various instructions and then it is seen that ultimately the patients can reach home.
The instructions of departments have included information of treatment for the hospital records.
Here, the nurse has started to bring the medical supplies to attend the physical information as the
patient gets ready to get treatment (Pitt et al., 2016). Moreover, the nurse has been investigating the
patients with essential statics derived from the history of the patient. Apart from this, the registration
of the patients is performed through the information of patents. The patient can make the registration
of patents with the kind of inquiry.

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5. Recommended new value stream map:
Figure 1: “Modified value stream map”
(Source: Created by Author)
6. Understanding the intended and unintended results of the system modified:
The approach towards the latest system has been adding value. Thus one can optimize the
limits of the risks and permissions of the projects to fulfil the aims within a specific budget and time.
Here, the unexpected results has involved the greater engagement of stakeholders that has been
around the project. It has been leading to an effective analysis of the problems. Further, this has
included a suitable solution and real requirements (Mutale et al., 2017). Moreover, there must be
efficiency and comprehensive mitigation of risks. Here, the planning has been giving rise to utmost

9EVALUATION OF SYSTEMS THINKING AND VALUE STREAM MAP
costs and schedules. The coverage of all the activities has never missed requirements and features
and has been enabling successful and smarter acceptance having the phase of handover. Further,
there are better planning and progress that has been reporting different multi-discipline. This has
included working for coping with different complicacies. In this way, it has led to turn to be much
realistic statement of the present status (Khammarnia et al., 2017).
However, the idea of the system has acted as a set of different parts. It amalgamated possess
the qualities that have been present in various parts in a productive way. It has been looking for
projects, programs and portfolios. Here, there are various parts and the elements into the system. It
has included the information, processes, people, organizations, transformation and services. Apart
from this, it has included various complicated products with software and hardware (Iannuzzi et al.,
2015). Besides, it can be said that the modified map of value stream has been about the analysis of
what the projects and programs have been trying to achieve. It assures that the activities and
dependencies have been falling within different cracks of discipline silo with contractual
responsibilities (Loosemore & Cheung, 2015).
7. Conclusion:
It is seen from the analysis that system thinking is useful to analyze choose and implement
the tools of modelling of systems. It is for developing, optimization and integration the process of
business for preset healthcare. Apart from it has been helpful for synthesizing the technological and
non-technological results of the business concerns. Thus the study is beneficial in integrating and
optimizing the entire activities. Further, it is also evaluated that the system view is the way to
position and look for organizational and systematic issues. Thus, one can also assess from the report
that the system boundaries are required to be set. It is useful for setting the elements under the parts
and systems that are seen as the external scenario. Further, the scenario has been impacting the

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abilities to resolve the problems. Thus one can affect the abilities to resolve the concerns. In this
way, this has been the part of the entire system. Further, the results have been depending highly on
how the system can be defined. In this manner, the system thinking can examine different
relationships. This has occurred between various elements for the expected results and the external
environment. In the systematic view, the concentration is spread of different direction as a
comparison is made with a conventional linear way of thinking.
8. Recommendations: Deploying the holistic approach to resolve concerns:
Here, proper identification of systems, gaining of task dependencies and making an outline of
the tasks are needed to sequence, coordinated and synchronized. It has appeared as a distinct
problem within the business of healthcare. It can also take part in the interconnected network of
different relevant issues. Then, various system thinking is helpful for determining that to be
dynamic.
 Identifying the meaningful approaches to understand and analyze the effects that are system-
wide:
The approach of the system thinking is also useful for decoding different complicacies within
the healthcare company. Moreover, they can be used to analyze the designing and evaluation of
interventions. It has been maximizing the system performances and security of patients. Within this
systematic framework, the possible expected and unexpected effects are to be considered. This has
been the less obvious effect of an intervention that can be missed for designing and evaluation
stages. Hence, there are lesser effects of the interventions that are missed for designing evaluations
steps. Apart from this, the designing and evaluations of various system-wide interventions are

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required to undergo a comprehensive evaluation of different contextual factors. It denotes that the
intervention is successful.
 Finding and nurturing of the smart system thinkers:
Regarding smart development initiatives, the individuals have been exhibiting effective traits
of leadership. It has led to the changes within the practices. In this way, the adherence to standards
of performances can be fostered.