Systems

Read here for an overview of Systems. For a more detailed explanation, please go to the Education module for the full Systems chapter.

Understanding systems

A system is the ‘Central Law of Improvement.’ Systems contain a team of professionals, groups of items and processes that work together to achieve a clear defined purpose. It uses and the input-process-output (IPO) model in that there is an input (for example, patients entering the pre-assessment clinic), a process (for example, being pre-assessed) and an output (for example, achieving accurate and thorough pre-assessment). Process mapping within a system can identify waste and become a useful source of improvement using methodologies such as PDSA (plan-do-study-act) testing and lean. Systems evolve over time and change in response to the needs of the population they serve.

Systems thinking

Systems can be further divided into microsystems, meso-systems, macro-systems and macro-organisations. Microsystems form the building blocks of the healthcare system and stem from systems theory. It is the place where the patient interacts with a group of healthcare professionals who regularly work together to receive value based healthcare. A meso-system is a group of multiple microsystems that deliver care to a shared population of patients. A macro-system is the larger organisation in which the clinical microsystems exist providing resources, services and policies that allow the smooth running of the microsystems.

Ultimately everyone who interacts with a healthcare system wants the same thing. A system that works well provides excellent health outcomes, delivers peak operating performance, and develops and retains competent caring staff that remain committed to their job.