Introduction
Various internal and external systems influence the delivery of health care in hospitals. Any action or activity in one system can significantly impact other systems within a healthcare organization in intended or unintended ways. Indeed, the systems depend on each at some point in their effectiveness in delivering services. Health organization leaders must understand the systems’ interactions to optimize service delivery processes. Applying systems theory and systems thinking is a helpful approach for leaders.
Systems Theory Definition
Systems theory is a perspective that holds that several subsystems compose organizations. These subsystems may or may not be related to one another, but they work together to ensure the effectiveness of a whole system in achieving a common goal. According to Lai and Lin (2017), two pairs of concepts, control, communication, and emergence and hierarchy, are the foundation of systems theory. The pair of concepts considers open and dynamic systems as a set of interrelated subsystems where control and feedback loops of information keep in a state of dynamic equilibrium. The second pair views hierarchical organizational levels as the best way of expressing complex systems.
Systems Theory’s Application to Health Care Organizations
Healthcare organizations or hospitals are open systems that interact with the environment to accomplish their goals. One can define hospitals as institutions with organized and professional personnel and equipment for inpatient and outpatient health services such as diagnosis and surgical procedures. As open and complex systems, healthcare organizations have subsystems comprised of different departments such as nursing services, laboratory, laundry, radiology, and food services. These subsystems work together toward providing quality and safe healthcare services and guarantee improved patient outcomes. Based on the foundational concepts of systems theory, healthcare organizations have hierarchical levels such as managers and departmental leaders (Klier et al., 2022). Additionally, they have rules, policies, and procedures that regulate the interrelation of the subsystems, set standards, and stimulate behavior for acceptable safety and quality in care delivery. Constant feedback between the subsystems and their components is vital to ensuring that each well and the health care organization achieve their goals.
The Role of Systems Thinking in Managing Organizational Change and Quality Improvements
System thinking helps organizations manage changes and improve quality through holistic and interdisciplinary approaches. According to Westover (2020), six themes define system thinking: interconnectedness, synthesis, emergence, feedback loops, causality, and systems mapping. Interconnectedness and synthesis involve analyzing the dynamic relationships between various units or subsystems of an organization and the processes of obtaining collaboration among the latter. The analysis is vital to understanding change triggers and devising appropriate strategies to manage them. The concept of emergence concerns the outcomes of the identified organizational elements’ collaborations as a result of nonlinear interaction (McNab et al., 2020). These outcomes in organizational change can be in the form of push and pull due to competing priorities (Westover, 2020). System thinking allows leaders to view emergence as a significant opportunity for enhancing relationships and innovation, effectively managing change, and improving quality.
System thinking further facilitates a better understanding of feedback loops for the organization as a whole and every subsystem. Leaders use system thinking to balance and reinforce the feedback loops, guiding them to make appropriate adjustments and learn more and the interconnectedness of the organization’s units and their outcomes (Westover, 2020). More information acquired from the connection between subsystems and operations modifications allows leaders to manage organizational changes and improve the quality of services. The causality concept refers to the way influence flows between related units of organizations. This theme of system thinking is vital to developing an enhanced perspective on essential parts of organizations, their relationships, and feedback loops (Hassan et al., 2020). Lastly, systems mapping focuses on identifying and visualizing the interrelated elements of the organizations that changes can impact. Systems mapping allows leaders to develop policy decisions and interventions for managing changes and improving quality.
How Nurse Leaders Can Use Systems Theory to Understand Influences
Nurse leaders can use systems theory to understand various organizational factors influencing patient outcomes, such as culture, staffing, and interdisciplinary teamwork. According to the systems theory, healthcare institutions have various interrelated units that work together to provide quality medical services (Klier et al., 2022). These units or subsystems have common elements, including inputs, processes, and outputs. Employees are one of the essential inputs in hospitals that influence patient outcomes. For instance, the quality and effectiveness of care services depend on skills, experience, and the number of healthcare staff.
Equally, nurse leaders can use the concept of control and communication to understand how the culture of quality and safety impacts outcomes. Further, the leaders can evaluate how the level of collaboration among staff from different units influences the quality and safety of services. Understanding these effects can help nurse leaders to create appropriate strategies to manage outcomes.
How Nurse Leaders Can Use Systems Theory to Create Strategies to Manage Outcomes
Nurse leaders can apply systems theory to manage outcomes by advocating for appropriate and adequate staffing, creating a safety and quality culture, and promoting interdisciplinary collaboration. Staff shortage in healthcare facilities is dangerous for patients due to increased workloads, elevating risks of making medical errors (Witczak et al., 2021). A real-world example is when nurse leaders evaluate staff and equipment needed by different units for effective operations. Subsequently, they hire an adequate number of skilled staff to lower the nurse-to-patient ratios and purchase appropriate equipment as a strategy for managing outcomes. Moreover, leaders use training programs to sensitize staff about standards, policies, and procedures and eliminate cross-department communication barriers to create a safe and quality culture. Equally, nurse leaders set cross-functional care teams to promote collaboration and more coordinated care services to minimize the possibility of making errors and improve patient outcomes.
Potential System Impacts on Patient Outcomes
The health care system comprises institutions (hospitals), care teams, and resources such as medicine and equipment that facilitate delivering services that meet patients’ health needs. The elements can significantly impact patient outcomes, including functional status, satisfaction, and safety positively or negatively. The system’s potential impacts on patient outcomes are improved or maintained functional status, increased, reduced, or sustained satisfaction, and unharmed.
Conclusion
Healthcare institutions are complex systems with subsystems that influence patient outcomes. The systems’ units are interrelated and have common elements such as resources and care teams. The institution’s environment is one of the factors that can impact patient outcomes. For instance, the regulatory and policy framework defines the standard of care and a culture that hospitals instill in their staff. The set standards and the culture of safety and quality can impact patients’ functional status, safety, and satisfaction. Care teams comprise nurses, doctors, and other medical specialists collaborating to deliver health services. Their skills, experience, and level of collaboration can significantly impact patient outcomes. For example, skilled and experienced healthcare professionals are likely to provide more safe and satisfying care services to patients than those who lack such competencies.
Equally, collaborative interdisciplinary care teams alleviate possibilities for medical errors and enhance patients’ satisfaction. The type and quality of medical equipment used in different system units is another factor that impacts patient outcomes. For example, if a healthcare facility has malfunctioning laboratory equipment, patients may be misdiagnosed, jeopardizing their safety. The facility’s environment is imperative since it influences how the care team and other resources function to impact patient outcomes.
References
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Klier, S., Nawrotzki, R., Salas-Rodríguez, N., Harten, S., Keating, C., & Katina, P. (2022). Grounding evaluation capacity development in systems theory. Evaluation, 28(2), 231-251. Web.
Lai, C., & Lin, S. (2017). Systems theory. In C. Scott & L. Lewis, The international encyclopedia of organizational communication (pp. 2354-2368). John Wiley & Sons, Inc.
McNab, D., McKay, J., Shorrock, S., Luty, S., & Bowie, P. (2020). Development and application of ‘systems thinking’ principles for quality improvement. BMJ Open Quality, 9(1), 1-10. Web.
Westover, J. (2020). Council Post: The role of systems thinking in organizational change and development. Forbes. Web.
Witczak, I., Rypicz, Ł., Karniej, P., Młynarska, A., Kubielas, G., & Uchmanowicz, I. (2021). Rationing of Nursing Care and Patient Safety. Frontiers in Psychology, 12, 1-12. Web.