Analysing system failure

Exercise

Analysing failure with multiple cause diagrams

Imagine that as the manager of a hospital you have the problem that patients are spending an unacceptable time on trolleys in a corridor next to the admissions unit, sometimes hours or even days. The following have been identified as relevant factors:

• patients waiting in corridor
• too many people being admitted
• too many people are presenting at A&E
• too many accidents and incidents
• no beds are available in the wards
• there are insufficient beds for the population
• beds are blocked by elderly patients
• some patients have no carer at their home
• transport provision is unreliable and patients cannot be discharged
• there is no accommodation available in residential homes

(a) Arrange these factors into a multiple cause diagram

(b) Put pluses and minuses on your arrows to make a sign graph

You may have to adjust your multiple cause diagram to make it into a sign diagram. This reflects the usual evolutionary nature of systems thinking. The diagramming tools in these exercises often help and inform the process of reflection on a system and its behaviour.

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