Skip to 0 minutes and 6 secondsJOHN RASA: In your experience, how important have you found big-picture thinking or system thinking in terms of analysing the complexity of the environment that you're dealing with in the hospital and looking at all its various parts?

Skip to 0 minutes and 20 secondsDAMIAN ARMOUR: As a CEO, as a leader, a manager in the organisation, that's a fundamental part of your job-- is to, I suppose, take the helicopter view of what's going on in your organisation at various points and taking a step back, having data that-- so you will generally form certain theories as to why something's going right or wrong.

Skip to 0 minutes and 39 secondsAnd there's nothing like data to support or quash a particular theory and assist you in telling the story to your staff because if there's a certain process in your organisation that's not working properly, you can demonstrate the data that it is not working properly and tell a story to your team and, hopefully, engage them-- first of all, get them on board, get that guiding coalition, as many of the books tell us about, where they are then also participating in identifying the solutions.

Skip to 1 minute and 8 secondsJOHN RASA: You talked about some of the issues about hospital delays. But what smooths that patient flow through any parts of the hospital?

Skip to 1 minute and 16 secondsDAMIAN ARMOUR: What you do in terms of, I suppose, system-- systems thinking is to review the actual flow itself. Look at the data points at each of the various steps that's telling you whether the clogging might be occurring, the holdup, by involving the people in that process, many of whom have different roles in that process, being in the one room together. They talk about their role and what's happening in the process. And the person's hearing and listening to someone else involved in that process. That generates a conversation and ideas about, well, if I was to do this differently, that would help you in your role. Therefore, that starts the redesigning of that component of the process.

Skip to 1 minute and 54 secondsIt may not require the whole thing to be redesigned. But if there's certain parts of it that actually has, first of all, been identified as the problem, you focus on that. And that will typically-- the start and the end is better off as a result of fixing that bit in the middle.

Systems thinking in hospital operations

As clinicians, health service managers and leaders, we have a wide range of tools, techniques and frameworks available to help us improve the efficient operation of our hospital services.

Despite the challenges facing hospitals operations, there are many proven and researched approaches to assist hospital administrators develop more effective responses to address hospital delays, including those which assist us to:

  • diagnose issues, including root causes
  • devise process/procedural fixes and workarounds
  • monitor, manage and evaluate interventions.

While some specific approaches come in and out of fashion, many have stood the test of time and academic scrutiny.

One such approach is systems thinking.

An introduction to systems thinking

Systems thinking or theory is the trans-disciplinary study of the abstract organisation of phenomena, independent of their substance, type or spatial/temporal scale of existence in relation to one another.

Its objective is to identify patterns and use this to derive principles that can be distinguished from, and applied to, all levels and types of systems.

Systems thinking enables us to clearly understand the elements of a given system, identify how they interact and enable improvement of these systems in the same way engineers improve mechanical systems.

While traditional analysis involves separating or virtually breaking apart the object being studied, system thinking focuses on how components of a system interact with each other.

Systems thinking can be useful in resolving complex problems that require stakeholders to view the ‘big picture’, recurring problems that have had no resolution in the past, issues where there is a frequent interaction between constituent actors and challenges where solutions are not obvious.

For a short overview of how systems thinking can be applied to hospital settings and to evaluate and maximise program effectiveness, watch the video below.

Systems thinking and evaluation

This is an additional video, hosted on YouTube.

Other approaches, including queuing theory, total quality management (TQM) and Lean, will be explored more fully in other programs of the Graduate Certificate of Hospital Administration.

Your task

Watch the video to hear John discuss the application of systems thinking to hospital contexts with Damian Armour, CEO at Epworth Geelong Hospital.

When you’re done, consider (in relation to your professional context) what other departments, services and processes you interact with to deliver a particular service.

Which system connection or approach would make the biggest contribution to the more efficient operation of your organisation?

Use the comments to share and discuss your perspectives.

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This video is from the free online course:

Hospital Operations: Improving Patient Experience

Deakin University

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