System Archetypes Analysis: Hospital Performance Improvement Report

This report examines system archetypes within a hospital setting, specifically addressing the issue of prolonged patient waiting times in the emergency department. It begins by defining system archetypes and their impact on hospital performance, including an overview of reinforcing and balanc...Read More

REPORT WRITING

EXECUTIVE SUMMARY
This report has been emphasized on system archetypes that is provide changes in
behaviour pattern in system that is used in hospital. Report will include analysis of system
archetypes that prevent performance of hospital from changes that have been made in the future.
System Archetypes refers to the term that include changes that have been made in the company
for assessing different behaviour patterns in business. As changes are necessary in providing
different perspective for the future. Reinforcing will be depended on growth as it is going in
ascending or descending order according to this growth is settled down. In this report problem
arises related to waiting time for patient that is very high and becoming problem for them to wait
for longer time in the hospital. Report will include analysis of system archetypes that help in
preventing performance in the hospital. It also includes state value stream map of emergency
department that is based upon system Archetypes. Furthermore, it emphasized on consequences
that lead to modified system that is used in premises.

TABLE OF CONTENTS
EXECUTIVE SUMMARY ............................................................................................................1
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
Identifying and analyzing system Archetypes that help in improving performance .................3
Analysis of the current State Value Stream Map of the emergency department based on
System Archetypes......................................................................................................................4
Recommendation for new State Value Stream Map with desired reduction in patient
turnaround time...........................................................................................................................5
Discussions on intended and unintended consequences of the modified system........................6
CONCLUSION................................................................................................................................6
RECOMMENDATIONS.................................................................................................................7
REFERENCES................................................................................................................................8

INTRODUCTION
These changes help in utilizing different perspective that will help in satisfying needs of
patients in hospital. In this there are two types of feedback that is associated with changes that
have been made such as reinforcing and balancing feedback (Guo, Yiu & González, 2015). On
the other hand, balancing help in reducing distance between current and desired state for the
future. Flow diagram help in determining archetypes that mainly emphasize on different
segments in business. In this every activity is linked with each other so that effective work is
performed while providing services in the hospital.
MAIN BODY
Identifying and analysing system Archetypes that help in improving performance
System Archetypes is the approach that is being used for determining changing behaviour
of employees due to changes in working operations of the hospital. It comprises of eight types
such as fixes that fail, shifting the burden, limits to success, drifting goals, growth and
underinvestment, success to the successful, escalation and tragedy of the commons. All these
elements help in solving problem of patients in public hospital. As in this burden is not remain
on one person so it will be shifted to others. As patients have to wait for long time so by applying
value stream map its operations will be improved so that they do not have wait for longer time.
Changes will be provided into public hospital as time that is required for coming and going of
patients will be reduced that help in solving their problem (Brzezina & et. al., 2017). Through
value stream map it can be analysed that every activity is connected with each other so changes
will be made accordingly so that it help in improving waiting time for patients. By providing
them proper value chain to patients that help in improving operations of hospital and waiting
time can be reduced. Changes made in providing treatment also help in enhancing medical
services to patients. Therefore, waiting time can be improved by providing them appointment so
that they do not have to wait for longer time and easily assessed services to patients(Walsh. & et.
al., 2016).
Analysis of the current State Value Stream Map of the emergency department based on System
Archetypes
Value steam mapping is a management technique which is used to examine the current
state and make a prototype for possible future events. This process analysis the product or the

services from its very beginning to the consumption of the product with minimum wastage
comparative from the existing value stream map. The Value steam is that methods which helps to
identify all the areas and activities of the organizations which increase the value of the product.
The value steam model of emergency department is too complicated and the focus of these map
is following process according to the system, this value steam map is more system oriented not
patient oriented. In this model the patient have to wait in after every stage. This process of
emergency department consume lot of time as well as there are some extra stages in these Value
steam map which can be eliminated(Sharif, & Irani, 2016).
Figure 1: Current State Value Stream Map
These map of emergency room is classified into two parts, which are information flow
and material flow. In Information flow, the data of the patient is transfer to one department to
another such as the information of treatment of patient is transferred from the hospital records to
the insurance company which include the cost of treatment, type of treatment and other detail
related to the treatment of the patient. The informant of patient before the treatment and after the
treatment of patient is recorded and kept in the hospital records however in material flow patient
is transferred to different stages.
The material flow in the Value stream map of emergency room is a very long process
which consume lot of time of the patient as well as the patient need to wait a lot before
transferring of entering the new stage the patient is transferred to different stages. In this first the

registration of the patient is done then the patient is goes to the waiting room after that the patient
is taken to ER room then the nurse and the doctors examines the patient separately(Mutingi,
Mbohwa, & Kommula, 2017). . After the examination nurse bring the medical supplier and then
the doctor treats the patient. Once the treatment is done the patient is given the introduction
about departing and finally the patient is discharged from the hospital. The patient has to wait
after every stage in material flow. The Information flow and Material flow works closely
together in this existing map of Emergency room.
Recommendation for new State Value Stream Map with desired reduction in patient turnaround
time
The existing Value chain model of very complicated and consumer lot of time of the
patient moreover the patient need to wait before being transferred to the next stage. This map
was system base. If the Emergency room need to improve their the waiting time and enhance the
quality of their structure then hospital need to apply these changes. The company should
redesign their value stream model to reduce the patient turnover time. The hospital need to
redesign their material flow as well as the information flow of in the value stream model as well
the emergency room need to make sure that both of department are working in their most
effectively way, and they are working closely together(Mutingi, Mbohwa & Dube, (2017).
Firstly the information flow of Emergency room should be more effective like the doctors and
the nurses should keep the reports of the patient near to the patient which will save time at the
time of observation of the patient moreover the records should be updated after the patient is
being treated and before he/she has been discharged. The information flow has to work closely
together with the material flow to decrease the turnover time.

Figure 2: New Value Stream Map
Some unnecessary stages in the material flow should be eliminated which will helps the
hospital room to decrease the waiting time and the turnover time. The stages in the new Value
Stream map should be the like these the first the registration of patients should be done and the
availability of room should be checked at the same time by the registration staff this will
eliminated one stage and the patient is directly transferred to the ER after registration. The nurses
and the doctors should examine together, this will eliminate one more stage from the existing
Value chain model. Medical supplier should be keeps as close as possible to the Emergency
room then the doctors should start the treatment of the patient. After the treatment of the patients
the patient should provide the departure instruction and finally the patient goes home. The
Emergency room should always be prepared for the next step. In case of emergency case the
hospital should direct start treating the patient while the friends and family of the patients
focuses on registration process(Mohammadi, Tavakolan & Khosravi 2018).. This will minimize
the waiting time. This value chain map will definitely help the Emergency room to treat more
patient in less time.

Discussions on intended and unintended consequences of the modified system
The Intended consequences are those consequences which are arises because of direct
impact of the system. In the modified system of Emergency room the intended consequences are
the hospital can treat more customers in the same time then the existing Value Stream Map. This
will increase the workload on the doctors, nurses and the staff of the hospital moreover it will
directly impact the revenue and purchase of medical suppliers of the Emergency room. However,
the unintended consequences are those consequences which arise due to indirect impact on the
modified system. The unintended consequences of the new value stream map of the emergency
room are it can increase the employees turnover ratio of the hospital due to high workload
furthermore it can increase the need of new recruitment and selection process in the Emergency
room. This can also decrease the quality of the treatment of the hospital(Guo, Yiu & González.
(2015). .
CONCLUSION
From the above study it can be concluded that system archetypes is help in determining
behaviour pattern of a system that is implemented into the company. This is providing different
aspects to patients in providing services to them in the future. This system comprises of different
components that help in improving waiting time of patients in the hospital. Transformation is
made for providing effective services to patients so that they do not have to face any problem
while coming to hospital. There are various changes that is being made in facilitating services to
patients. On the other hand, feedback is provided by patients for improving services based on
growth of patients in hospital. Value stream map is used for determining flow of information
from one person to other in hospital. This map is providing different perspective to patients as
help in reducing waiting time for patients. Therefore, it is observed that this system bring
changes in operations in business.
RECOMMENDATIONS
The company should focus on some things to effectively implementation of modified Value
Steam map(Freire & et. al., (2017). . The company should organize training and developing
programs for their nurses doctors and staff regarding the time management in the hospital
business. These will helps the emergency room and their staff to treat the patient with less
wastage of time. The company can recruit and select professional or the employees with proper
reputations and skills this will helps the company to decrease the wastage of time as well as it

will decline the work load from the existing employees. The company should hire a quality
manager and a support team that make sure at all the practices in the emergency room are
practiced with proper quality as well they should also work on enhancing the quality of the
Emergency room. The hospital should also focus on their existing employees and provide them
promotion changes or increase their salary this will decrease the employee turnover ratio. All
these things will help the Emergency room to successful implementation of modifed Value
Steam Map with minimizing the intended and unintended consequences of the modified
system(Clancy, 2018).

REFERENCES
Books and Journals
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care system through archetypes and reinforced use of medical coding. International Journal of
Integrated Care (IJIC), 16.
Brzezina, N. & et. al., (2017). Development of organic farming in Europe at the crossroads:
looking for the way forward through system archetypes lenses. Sustainability.9(5). 821.
Clancy, T. (2018). Systems thinking: Three system archetypes every manager should know.
IEEE Engineering Management Review.46(2).32-41.
Freire, S. M. & et. al., (2017). Archetypes for representing data about the Brazilian public
hospital information system and outpatient high complexity procedures system. arXiv preprint
arXiv:1711.09731.
Guo, B. H., Yiu, T. W., & González, V. A. (2015). Identifying behaviour patterns of construction
safety using system archetypes. Accident Analysis & Prevention.80.125-141.
Mohammadi, A., Tavakolan, M., & Khosravi, Y. (2018). Developing safety archetypes of
construction industry at project level using system dynamics. Journal of safety research. 67. 17-
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Mutingi, M., Mbohwa, C., & Dube, P. (2017). System dynamics archetypes for capacity
management of energy systems. Energy Procedia. 141.199-205.
Mutingi, M., Mbohwa, C., & Kommula, V. P. (2017). System dynamics approaches to energy
policy modelling and simulation. Energy Procedia. 141. 532-539.
Sharif, A. M., & Irani, Z. (2016). People, process and policy perspectives on food security: an
exploration using systems archetypes. Transforming Government: People, Process and
Policy.10(3).359-367.
Walsh, C. & et. al., (2016). New kid on the block: a strategic archetypes approach to
understanding the Blockchain.