Sample MGT603 Systems Thinking Report

MGT603 Systems Thinking Report Sample

Context:

There are two approaches towards improving systems, short-term approaches that normally addresses the symptoms and rarely help understand and address the cause of the problem, and Long-term approaches, which allow managers to address the real cause(s) of the problem. In this assessment, students will try to solve a practical problem by using Systems Thinking tools called System Archetypes combined with value stream mapping.

Instructions:

Assessment 3 is about uncovering the complexities in operations management generally, identifying key themes, intended and unintended consequences and proposing a holistic solution to the problem using a Systems Thinking lens.

The following scenario study provides you with a brief overview of a hypothetical problem. Be aware that the scenario provided may not cover every detail that you will need to address in the Written Report, in which case, you will need to conduct additional research, including further research on how emergency departments function in any hospital.

ScenarioMGT603 Systems Thinking Assignment Report

Context:

There are two approaches towards improving systems, short-term approaches that normally addresses the symptoms and rarely help understand and address the cause of the problem, and Long-term approaches, which allow managers to address the real cause(s) of the problem. In this assessment, students will try to solve a practical problem by using Systems Thinking tools called System Archetypes combined with value stream mapping.

Instructions:

Assessment 3 is about uncovering the complexities in operations management generally, identifying key themes, intended and unintended consequences and proposing a holistic solution to the problem using a Systems Thinking lens.

The following scenario study provides you with a brief overview of a hypothetical problem. Be aware that the scenario provided may not cover every detail that you will need to address in the Written Report, in which case, you will need to conduct additional research, including further research on how emergency departments function in any hospital.

Scenario

Overview:

Consider yourself as part of a team responsible for managing the operations of an emergency department of a public hospital. The emergency department has received feedback from patients suggesting that the patient wait times need to be improved. The value stream map of the current operations is shown in the attached diagram.

The Value Stream Map is can be Found via the Assessment Link

You have been tasked with improving patient turnaround time by reducing the current time to half. To complete the task you are required to identify the various System Archetypes that affect the operations of the hospital and the emergency department itself and based on the archetypes, develop a future State Value Stream Map of the emergency department.

It is recommended that you identify and critically analyses intended and unintended consequences, recommending holistic solutions that will optimize the operations of the emergency department without compromising the performance of other functions of the hospital.

Suggested format: Your Written Report should include the following sections and sub-sections.
Cover Page (Subject Name & Code, Assessment No., Student Name and Surname, Student Number, Lecturer, Year and Trimester)

Executive Summary

Table of Contents

1. Introduction/Background

2. Main Discussion
2.1. Identification and analysis of the System Archetypes that may impede performance
2.2. Analysis of the current State Value Stream Map of the emergency department based on System Archetypes
2.3. Recommended new State Value Stream Map with desired reduction in patient turnaround time
2.4. Discussion on Intended and unintended consequences of the modified system

3. Conclusion
4. Recommendations
5. References
6. Appendices (Appendix A, Appendix B,)

Solution

Introduction

The case study provided, relates to a hypothetical hospital and in particular to the sub process of the Emergency room in which turnaround time of the patients are clogged up with several barriers and obstructions in place. As a result, individuals are subjected to a series of lengthy waits, which may in turn aggravate their current emergency conditions. For Assignment Help, The medical system must be inventive and technically sophisticated if that is to ensure that people receive the healthcare services they require without being backed up. Patients must be treated for in an appropriate amount of time in the event of an emergency.

Figure 1 - Existing VSM

As per the existing streams, the hospital has essentially over-complicated the entire process and the bulk of the burden falls on the patients. To the hospitals credit, one must accept that reordering items in this procedure might not have been feasible to rules and OH&S standards due to the obvious tight processes in place to protect the health and safety of said patients.

However, this does not rule out the possibility of enhancing and improving some aspects and dynamics by looking at both inherent input requirements as well as the techniques and tools available at our disposal. The tools and techniques therefore being utilized is the System Thinking approach (Narke&Jayadeva, 2020). In order to deal with the complexity of its internal systems, especially emergency rooms, hospitals should use a system strategy. As a result of these system-wide methods, healthcare stakeholders may work together to discover new solutions to a variety of challenges. Healthcare systems may use value stream mapping to visualise various processes and workflows in the accident and emergency department as well as other operational flows. Basically, it's a visual depiction of the complete procedure (Rajesh et al., 2019).

Main Discussion

Identification and analysis of Archetypes which impedes performance

According to System Archetypes, there are several methods to obtain a clearer grasp of the situation. These are the diagnostic tools as well as the high-leverage interventions that would make a substantial difference. Using archetypes and important concerns as a framework, they assist in examining the same scenario from a variety of perspectives. The following are some examples of system archetypes which might impair performance:

Fixes that fail Archetype

An issue that has to be addressed is a problem indicator. Adopting a technique to alleviate the symptoms To make matters worse, most treatments are only meant to be transient fixes. This may occur as a result of the applied patch having unexpected repercussions that become apparent over time, or could be the result of the repeated application of a short cure that builds up over time (Riezebos& Huisman, 2020).

Such system archetype may be present there in case study if one assumes the following:

1. The unintended effect of implementing new protocols to meet insurance standards is that patients must now fill complete written forms as well as other protocols, which causes them to be put on hold for longer periods of time throughout their surgery.

2. Moreover, nurses were taught to conduct pre-examinations upon patients, and the results of these examinations are entered into the patient ’s medical record. In order to safeguard patients, a new mechanism has been put in place that acknowledges records of prior health difficulties. Nevertheless, this has created a new waiting time for the patient to endure.

Limits to growth archetype:

This model illustrates how a preliminary rate of growth can be restricted over time by a limiting factor. As the Archetype begins, every action is meant to expand the consequence that produces the same kind of behaviour, which in turn causes more activity. Limiting factors slow down activity, and this affects the results. If we look at the Hospital as an example, this Archetype appears to be in effect (Riezebos& Huisman, 2020).

• Limiting Factor - There is a limit to how many patients the staff, facilities, and supplies can care for in a particular period of time.

• Slowing Actions - Overwhelmed staff, confusion over cases and protocols, and patient congestion all contribute to a sluggish operation.
Because of the unregulated needs of the industry, removing or lowering the influence of the bottleneck seems to be challenging in so many dimensions. For example, a steady flow can be caused by a variety of factors, such as riots, natural disasters, and rapid outbreaks of disease. This is unlike other companies, in which the flow of customers may be predicted or forecasted in advance.

There is a limit to how many patients can be served at a given time because of the high cost of human resources, emergency aid, and physical infrastructure, which necessitates a compromise on throughput (Russkikh et al., 2019).

Tragedy of commons

All of it boils down to the relationship between the individual acts and the collective outcome. It is founded on the belief that people may have a substantial impact on the system. When it comes to health care, if doctors stop undertaking unnecessary treatments and tests, it would benefit the overall system as well as save time for other people, who might otherwise have to wait longer for treatment. Telehealth has also been commercialised, which may be utilised to treat patients with far less critical conditions.

Analysis of the current State Value Stream Map of the emergency department based on System Archetypes.

As previously indicated, in this hospital's ER, three system archetypes are in play: growth limits, tragedy of the commons, and fixes that fail. One can tell from the VSM that several aspects of the workflow need to be improved. As a first step, any patient who enters the emergency department was made to go through up to seven phases before they may be seen by a specialist (Schoeman et al., 2020).

The first step in the procedure involves registration, which requires individuals to provide their medical information rather than an identifying number. Which is why patient’s complained that the emergency department's processing times really ought to improve, due to this particular circumstance. Both healthcare protocols as well as hospital bureaucracy have contributed to this situation. As a consequence of this discrepancy in hospital services demand and supply, the emergency room congestion was shown to be caused by patients who would no longer need acute or critical care, but are nevertheless occupying beds in the hospital. Hospital operations suffer from a lack of weekend discharges as well, which makes them less successful. On weekends, patients may be allowed to go home, which will free up the hospital ED and reduce wait times even further (Barnthouse et al., 2017).

According on the situations of both the patient as well as the hospital, the bottleneck in this procedure might be different from one to the next. When a result-limiting variable appears, the whole experience of consumers and employees engaged is jeopardised. Businesses will inevitably suffer as a result (Hoffmann et al., 2018). It's possible that a patient has complained about incorrect diagnosis, the absence of important historical information like food allergy, or unpleasant healthcare insurance concerns wherein patients were required to file additional claims and schedule appointments with one‘s insurance providers in order to recover emergency-related expenses. As a result, the discharge procedure takes a very long time due to the nurses' instruction routines and other insurance & hospital paperwork.

Management of operations would be required to re-evaluate current activities and determine whether or not a better course of action is available.

Recommend new VSM with desired reduction in patient turnaround time

Figure 2 - Redesign VSM

The aforementioned redesigned value stream map can be utilised by the hospital's administration to lower waiting times and offer high quality services within that shortest possible period of time, if necessary. There is no waiting on the updated value stream map except in the areas where it might be impossible to prevent it.

• Registration - This map illustrates that patients will be provided a consultation prior to their arrival at the hospital this is done via pre-registration by the patient on Call or via App or Website. The admin department will ensure that there is no lag time between both the scheduled appointments allotted to individual patients.

• Nurse Examination - The next step is to have the patient be examined by a nurse. Following registration, nurses conduct a thorough review of each patient's medical history using electronic health records, and the patients must submit their medical records immediately to the hospital for future support and treatment. The nurse updates the Electronic Health records of the patient, which in turn reflects to the insurance company.

• Physician’s Examination - Doctors should be extremely cautious whenever treating patients and therefore must deliver the finest possible treatment as promptly as feasible. Doctors following the nurse’s preliminary report in EHR, consults the patients, treats them if necessary and updates EHR.

• Electronic Health Records – EHR information flow is bi-directionwith Nurse and Doctors and also between the Insurance providers. The integrated and bi-directional nature as well as it being the central part of the entire information flow, has cut down on the processing times of the patient

• Patient’s Discharge– Overall improvement in the redesign VSM significantly increases the patient’s discharge process and by also adding an option for weekend discharges, it further reduces the ERD’s burden.

Discussion on Intended and unintended consequences of the modified system

As a result of the new and updated stream map, this very same hospital will be capable of minimizing waiting lists while also improving the quality of its service. The institution will be able to accommodate more patients under the new strategy, given the available slots.

Intended Consequences

• Patients' queues are expected to be considerably reduced as a result.

• On a given day, every unit might have a clear idea about how many patients it could handle.

• This information could then be used by the administration to prepare and plan for the expected volume of patients.

• In terms of manpower and other facilities, this hospital has a well-structured and highly managed system.

The unintended consequences could be:

1. It's not always possible to avoid long waits in some situations.

2. When appointments are booked, only a specific number of individuals could be seen per day.

3. At some time, the administration will have to deal with a random patient.

4. The system is being re-designed for a limited number of patients only. If the influx increases drastically, then the redesigned system would need to evaluated, perhaps redesigned again.

Conclusion

This assessment concludes that, in order to improve the performance of organisations by using system thinking as well as its modelling tools and approaches (Barnthouse et al., 2017). In this research, the existing VSM model among hospitals has already been reviewed critically. Unintended repercussions have been observed as well. A revised VSM model is proposed as a consequence, and it is expected to enhance the hospital's operating procedure. With the redesigned VSM model, obstacles and gaps that inhibit patient success may be successfully reduced, while maintaining the level of service already the hospital was famous for.

Recommendations

• When the hospital's process evolves, the value stream map that was redesigned should be updated again (Hoffmann et al., 2018).

• A hospital's facilities and personnel must be utilised as efficiently as feasible.

• It is important for patients to understand that the length of their wait is based on the seriousness of their situation, and not from the number of appointments they have already booked.

• The proposed map may have unintended consequences, in which case hospital administrators should be ready to adjust the system

References