Systems Thinking and Healthcare

Systems theory, now known as systems thinking, is a holistic approach of organizational analysis, examining the inputs, outputs, and processes of the organization [1]. Systems thinking has many prevalent theories and concepts based on those theories [1]. Within healthcare, the Donabedian model of health care systems quality analysis is based on soft systems thinking, a branch of systems thinking based on subjective analysis [2; 1]

The issue with the implementation of systems thinking within health care is that it is behind the current industrial thought [3]. For example Donabedian’s SPO model was published in 1980, based on theory from the 70s and 60s [3; 2]. Many of the base theories have been refined over the interceding 28 years, which leads to the belief that major revisions can happen via implementation of current theory [3].

Systems thinking is not without its drawbacks. The complexity of systems thinking is the highest drawback [1]. Much of hard systems thinking is based on mathematics and quantification, making it difficult to implement without significant training [1]. Conversely, soft systems thinking is subjective and based on qualitative analysis, requiring another set of skills [1]. Evolutionary systems thinking tries to tie these two branches together, which does an effective job, but makes for a discipline requiring significant and disparate skills [1]. However, they can give us a significant view into how health care organizations operate with just an investment of time and talent.

References

1. Jackson, M. C. (2003). Systems thinking: Creative holism for managers. West Sussex, England: John Wiley & Sons, Ltd.
2. Shi, L. & Singh, A. S. (2008). Delivering health care in America: A systems approach (4th ed.). Sudbury, MA: Jones and Bartlett Publishers
3. Komashie, A., Mousavi, A., & Gore, J. (2007). A review of historical developments of quality assessment in industry and healthcare. Proceedings of the 10th QMOD conferences, 2007, Sweden. Retrieved May 27, 2009, from http://hdl.handle.net/2438/1074