What is the analogy of the iceberg when referring to systems thinking?
Right Ans - - only 10% of the structure is visible
- enables us to use different lenses to view the system and expand our
perspectives to include various patterns, structures, or events that may cause
a critical event to occur
What are the four components of the iceberg analogy? Right Ans - 1. the
events level/observable variables: (how we perceive the world/situations)
2. the patterns of behaviour level: noticing patterns/trends - similar events
taking place over time -> forecast and forestall events
3. the structure level: whats causing the pattern? what are the
interrelationships? (e.g. structures, physical things, organizations, policies,
rituals, or habitual behaviours
4. the mental model level: assumptions, attitudes, beliefs, expectations, values,
etc. that shape an individual’s perception. Learned over time, often
subconsciously
What are systems thinking? Right Ans - - understanding systems by
examining the linkages and interactions between the elements that compose
the entirety of the system
- enables you to recognize the full context within which patients exist
What is the general systems theory? Right Ans - - created by Bertalanffy in
1968
- as system is a set of interrelated interacting parts within a boundary
- a system has a purpose, structure and function
- as a result of the interrelationships, a system is more than the sum of its
parts
What is the study of complexity science? Right Ans - - the study of complex
systems
- the patterns of relationships within them, how they are sustained, how they
self-organize, and how outcomes emerge
What is systems thinking in healthcare? Right Ans - - healthcare is full of
complex challenges, often their origins are not in a single cause or problem
but rather in multiple causes across a system
,- an approach to tackling healthcare problems to achieve better outcomes,
reduce complexities, minimize errors and variations in practice
- provides science, theory, knowledge and skills needed to see
interrelationships, patterns of change, structures, and processes underlying
patient scenarios
- provides strategies and tools to help: recognize different perspectives,
identify structural and functional relationships, drivers of change, change
processes, recognize the impact of environmental and social factors on
patients
why is healthcare considered a complex system? Right Ans - - due to the
interconnections between and among systems
- multiple actors, agents, stakeholders including: professionals, healthcare
teams, patients + families, technologies, suppliers, etc.
- all contribute to the complexity
what are the 12 social determinants of health? Right Ans - 1. income and
social status
2. employment and working conditions
3. education and literacy
4. childhood experiences
5. physical environments
6. social supports and coping skills
7. healthy behaviours
8. access to health services
9. biology and genetic endowment
10. gender
11. culture
12. race / racism
Why is healthcare considered a complex ADAPTIVE system? Right Ans - -
characterized by uncertainty and complexity
- delivering and receiving healthcare are not always predictable and tend to
change both due to changes within and outside their environment
- all agents in this system learn and change because of their experiences
- human behaviour
- a great variety of system design which has a strong influence on human
behaviour
, recognizing the full context in healthcare means what? Right Ans - - engage
effectively in interacting with the healthcare system on multiple levels
- see and anticipate interrelationships between and among systems
- understand how interactions and our decisions impact organizational and
patient health outcomes (i.e. quality, efficiency, cost)
- reinforces nurses roles in safety and quality improvement
- promote patient centred care and evidence-based practice
overall how does systems thinking improve leadership in healthcare? Right
Ans - - helps individuals understand complexity science and employing a
systems thinking approach to provide system-based practice as opposed to
treating individual patients or diseases
what does micro refer to in systems thinking? Right Ans - - specific patients
and care teams
what does meso refer to in systems thinking? Right Ans - - the organization
where care takes place
what does macro refer to in systems thinking? Right Ans - - the healthcare
systems and the broader societal issues
what does systems thinking require? Right Ans - - curiosity, intentionality,
and the ability to question
examples of how systems thinkers would think Right Ans - - are concerned
with the whole
- are concerned with the process
- are concerned with the underlying dynamics
- try to identify patterns
- try to find patterns amid the chaos
- care about content but are more attentive to interactions and patterns of
communication
- believe organizations are unpredictable in a chaotic environment
how is systems thinking exemplified in healthcare providers? Right Ans - -
the changing role of healthcare providers
- work in different practice settings and effectively work in interprofessional
teams to coordinate care delivery