Healthcare Quality at the Organization and Microsystem Level

Systems Thinking

“…A view of reality that emphasizes the relationships and interactions of each part of the system to all the other parts” (McLaughlin & Olson 2012, 23).

 

 

 

 

McLaughlin, D.B., & J.R. Olson. 2012. Healthcare Operations Management, 2nd ed. Chicago, Health Administration Press.

 

A systems thinking approach to quality management

The interconnected system model

The three core process model

The Baldrige performance excellence program framework

Socioecological framework

 

Interconnected system level

Divided into four levels:

Environment level

Organization level: is a critical level of change in the health care system because it can provide an overall climate and culture for change.

Microsystem level

Patient level

 

Three core process model

Clinical, Medical, and Technical process: are critical process because they are the main reason why clients seek health care assistance.

Operational or patient flow process (registering patient, scheduling): enable clients to gain access.

Administrative process (decision making, communication, resource allocation, and performance evaluation)

The improvement in any one of these process has the potential to increase the value of the service provided.

 

Three Core Process Model

Outcomes

Clinical outcomes

Cost

Satisfaction

Functional status

 

Clinical/Medical/Technical Processes

Operational/Patient & Client Flow Processes

Administrative Decision-Making Processes

Administrative Decision-Making Processes

 

 

 

Source: Kelly, D. L. 2017. Applying Quality Management in Healthcare, 4th Edition. Chicago: Health Administration Press.

Baldrige Performance Excellence Program Framework (BPEP)

The model describes essential elements of organizational effectiveness

The model shows the importance of alignment in the organization

www.nist.gov/baldrige

 

 

 

Source: www.baldrige.gov.

Socioecological Framework

A transdisciplinary systems perspective on promoting health and wellness that uses and reflects theory from multiple fields; medicine, public health, behavior and social science.

Emphasis on multilevel and recognition of the complexity of human environment

Provide a more expansive view of the nature of health and wellness

Help to understand interventions designed to improve the quality and safety of services.

Maybe used to better understand smoking behavior and drinking

 

 

Socioecological Framework: Determinants, Interventions, Evaluation

https://www.cdc.gov/cancer/crccp/sem.htm

Systems Models: Lessons for Managers