DHA 711 Week 7 Assignment: Application + Conclusion

Application: Opportunity for Improvement and Recommended Solutions

Systems thinking provides a roadmap toward understanding factors underlining healthcare operationalizations. As complex adaptive systems, healthcare organizations are intertwined in an intricate network where competing interests influence all aspects of care delivery. Through systems thinking, care administrators and other players within care organizations can understand the challenges and identify the mechanisms for addressing them. The Southwest Hospital, like other care organizations, can benefit from this approach: DHA 711 Week 7 Assignment: Application + Conclusion.

Problem or Innovation Opportunity

Implementing technologies within care organizations remains an opportunity for innovations for many care organizations. Foremost, technological advances have long been lauded for their roles in healthcare operations. Health information technologies, such as electronic medical records, clinical decision support systems, and wearable devices, are hallmark innovations that continue to define care operationalizations. Notwithstanding, implementing such technologies is not always smooth.

Kato et al. (2024) note that health information technologies sometimes produce a disruptive effect on the organization’s workflows when they are implemented. These disruptions can be attributed to poor buy-in and understanding of these technologies.

This was the case when implementing telehealth at Southwest Hospital. While there was a consensus on the effectiveness of telehealth in facilitating access to care, controversies existed on the ethicality, legality, and convenience among some patient and caregiver groups. This resulted in a back-and-forth tussle that dragged the implementation process.

Summary of the Setting

The healthcare setting under scrutiny is a hospital. It has a bed capacity of 170. The facility specializes in chronic care and has service lines in diabetic care, comprehensive stroke care, and cardiovascular illness centers, among others. While many patients are managed in inpatient care, the majority of the patients are under outpatient care.

Through outpatient care services, healthcare providers engage the patients in preventive care, disease monitoring, and follow-up, among other care continuum services. The vision of the organization is to expand its niche by providing high-quality care services and excellent patient experiences. However, the rising volume of services put considerable strain on the organizational workflows, impacting the efficiency of their services.

Implementing telehealth was seen as a viable solution to the increasing volume of patients within the facility. Leveraging telehealth would help in patient load management by curtailing hospital visitations accustomed to monitoring and follow-up services (Stoltzfus et al., 2023). This informed the move to integrate telehealth into the care continuum services of the hospital.

Stakeholders Necessary to Effect the Change

The change process at the hospital drew several stakeholders. These included healthcare providers, health administrators, departmental heads, the finance department, patients, and the Health Information Technology (HIT) department. Healthcare providers included nurses, physicians, pharmacists, and social workers. As part of the primary utilizers of the new system, they were tasked with piloting the telehealth software and providing feedback to the change managers.

Health administrators played a role in coordinating the project activities. They lobbied for financing through the financed department, mobilized departmental heads to buy into the telehealth idea, and organized educational forums on the change process. Patients were also involved in the process. They were expected to use the new systems and provide feedback to the change managers.

The HIT department was involved in implementing the system. They were part of the change committee and were involved in procuring and implementing the project. Departmental heads were tasked with communicating the change process to other staff members to help influence them toward the change process.

Recommended Solution in Complex Systems Thinking Terms

Healthcare organizations are complex adaptive systems. Complex adaptive systems are dynamic networks where each element interacts and influences each other in a non-linear fashion (Ahmad et al., 2024). Complex systems thinking requires a comprehensive analysis of healthcare organizations and systems by considering the influences an entity has over the other, as well as the interactions and ability to work with one another.

As a complex adaptive system, each player in the healthcare ecosystem exists as an independent entity. Notwithstanding, the represented entity must be able to relate with other entities, as their actions may influence others.

The problem emerging in the hospital case presented can be analyzed and addressed through complex systems thinking. The stakeholders, in this case, are the individual elements or entities interacting within the organizational ecosystem. To address the emergent problem, each involved stakeholder must understand the change process is a system-wide endeavor implemented at the organizational level rather than piecemeal (Uvhagen et al., 2024).

They should, therefore, recognize that they play a role in the process and are interconnected. This means that the success of the process is dependent on their input towards the change.

Several strategies can be utilized to ensure all stakeholders are in sync with the plan. These include stakeholder education on the benefits of telehealth, caregiver and patient education on the use of telehealth to facilitate patient-caregiver engagements, and information sharing across teams to enhance buy-in into projects. These communication-based strategies demonstrate non-linear relationships among the involved teams and help streamline the strategy component of the systems change model (Phillips & Klein, 2022). Consequently, it will promote the adoption of the change process, facilitating a smooth implementation.

Expected Outcomes and How They Will Be Measured

The proposed solution is expected to enhance awareness of the change process and ensure a greater buy-in into the project. By the end of the educational sessions, each stakeholder should verbalize telehealth and how they can leverage it to streamline patient workflows. Likewise, they are expected to know their responsibilities when using the system.

Stakeholders’ knowledge of telehealth can be measured formatively through quizzes interrogating aspects of telehealth, such as the technological devices involved and perceived benefits. Likewise, a summative evaluation of the project can provide insight into the level of adoption of the technology, as demonstrated by the number of active users and its effectiveness in bridging apparent gaps in accessing healthcare and inpatient monitoring and follow-up services.

The proposed solution aligns with the triple aims of improving individual experiences of care, population health, and reducing per capita cost of care. Through telehealth, persons can access care services in the comfort of their homes, thereby reducing the cost of care. Likewise, telehealth improves patients’ experiences and populations by ensuring individuals and communities receive high-quality care that is most cost-effective.

Theory Synthesis

The proposed solutions require stakeholder collaboration to address the emergent problem. This is aligned with the systems model of change and learning organizational theories. As per the systems model of change theoretical postulates, the paradigms of people, design, strategy, culture, task, and technology are intertwined. The stakeholders represent the people, while the change process is denoted by task.

Through a collective approach and understanding of the task, the organization can successfully implement the change process (Phillips & Klein, 2022). Likewise, the learning organizational theory advocates for capacity expansion and value addition through continuous learning (Suh, 2021). Educative approaches not only advance change processes but also contribute to capacity expansion.

The elements of team learning are affirmed through the collaborative approach fronted in the proposed solution. Similarly, personal mastery is fronted by the call for all stakeholders to be accountable in their roles for the success of the project.

Conclusion

Healthcare organizations operate in an ever-changing healthcare environment. Nevertheless, the resolve for quality elevation and safety enhancement continues to underline all healthcare operationalizations. With competing interests being apparent in the contemporary care system, it is important that all players within the healthcare environment understand their surroundings to curtail any apparent strains.

Theoretical frameworks continue to form the background of understanding the healthcare environment. They explain relationships between different concepts and factors underlining healthcare operationalizations. Learning organizational theory and the systems model of change are some of the theories that provide insights into the dynamics influencing healthcare operations.

The learning organizational model is based on systems learning. It places value in capacity expansion and sees healthcare organizations as learning systems where desirable outcomes can only be attained through innovation and new thinking patterns and where collective aspirations are welcomed. The theoretical postulates emerging from the theory, such as personal mastery, team learning, systems thinking, shared vision, and collaborative culture, point toward the interconnectedness of the individual elements within the systems and how they can be leveraged for the prosperity of the system. (Uvhagen et al., 2024).

The systems model of change provides a road map toward change processes in healthcare organizations. As per the model, change processes are system-wide endeavors that should be implemented at the organizational level rather than individually. The model demystifies individual excellence in the systems change process and points toward a collaborative approach, drawing all the individual elements to ensure a successful change process. It further identifies the six interconnected and interdependent variables of people, design, strategy, task, culture, and technology that play a role in organizational change processes (Phillips & Klein, 2022).

There is a consensual finding on the significance of system thinking in identifying and addressing apparent challenges in healthcare. Literature findings affirm the dynamicity and complexity of contemporary healthcare systems and emphasize the need for a better understanding of all variables influencing the system.

As per these findings, high innovations in highly complex healthcare units result from limited role autonomy for all stakeholders in the healthcare sector. This means that health innovations can only be driven in an environment with a shared vision and role objectives rather than where players can set rules. Performance orientation is another enabler of innovations and should thus be fostered across care organizations.

Systems thinking is also lauded as a tool for addressing any healthcare challenges. The key characteristics of systems thinking, such as identification and understanding of feedback, identification of leverage points, and recognition of systems structure, among others, form the frameworks for understanding various healthcare interventions. Such frameworks can be used to analyze the healthcare environment, identify apparent strains, and elucidate address measures. The system thinking framework can also be used to scrutinize various healthcare innovations, enabling the identification of organizational components that can drive growth.

As players within a complex care ecosystem, healthcare organizations maintain independence in their roles. As care processes shift toward value-based approaches, quality, and safety, collaborative paradigms integrating information sharing, open communications, and multi-sectoral consultations are necessitated. Systems thinking allows diverse players in a fast-paced care landscape to understand the complexity of the system.

This means they can understand their actions and influence on others, identify apparent barriers and possible address mechanisms, and enhance their operationalizations and workflows. As evident in the case hospital described above, system thinking allows the elucidation of strategies necessary for implementing the change process.

References

Ahmad, M. A., Baryannis, G., & Hill, R. (2024). Defining complex adaptive systems: An algorithmic approach. Systems, 12(2), 45. https://doi.org/10.3390/systems12020045

Kato, D., Lucas, J., & Sittig, D. F. (2024). Implementation of a health information technology safety classification system in the veterans health administration’s informatics patient safety office. Journal of the American Medical Informatics Association, 31(7), 1588–1595. https://doi.org/10.1093/jamia/ocae107

Phillips, J., & Klein, J. D. (2022). Change management: From theory to practice. TechTrends, 67(1), 189–197. https://doi.org/10.1007/s11528-022-00775-0

Stoltzfus, M., Kaur, A., Chawla, A., Gupta, V., Anamika, F. N., & Jain, R. (2023). The role of telemedicine in Healthcare: An overview and update. The Egyptian Journal of Internal Medicine, 35(1). https://doi.org/10.1186/s43162-023-00234-z

Suh, B. (2021). Workplace learning: How to build a culture of continuous employee development. The Learning Organization, 28(4), 457–459. https://doi.org/10.1108/tlo-05-2021-269

Uvhagen, H., Gärdegård, A., & Klinga, C. (2024). Through the lens of learning organization theory: Strategies used when introducing new work methods as described by practitioners and leaders in social services. Nordic Social Work Research, 1–17. https://doi.org/10.1080/2156857x.2024.2329945

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Upon completion of all three parts of the Integrative Paper, you will have brought together the systems theories, contemporary research, and your application of this work to a real-world opportunity for improvement. The result will be recommendations for change and innovation through the lens of systems thinking.

Read the Integrative Paper Guidelines to prepare for this final of three assignments during this course.

Review the results from your analysis of a problem or innovation opportunity conducted in Week 5.

Write the 1,050- to 1,225-word “Application” section of your integrative paper in which you do the following:

• State the specific problem or innovation opportunity.
• Summarize the setting within the health care organization where this problem/opportunity exists.
• Identify and describe the stakeholders involved and those who are essential to effecting change (and why).
• Describe the recommended solution in complex systems thinking terms.
• Specify the expected outcomes and how they will be measured, including (but not limited to) how results from this solution contribute to the organization’s pursuit of the Triple Aim.
• Present a synthesis of the specific theories, conceptual models, and research into complex systems thinking and innovation that support your recommended solution. Be persuasive by drawing on scholarly sources used in the “Breadth” and “Depth” sections.

Write a 350- to 700-word “Conclusion” section for the paper in which you do the following:

• Discuss how the solution will improve the performance of the health care organization.
• Contribute to the knowledge and understanding of the broader health care ecosystem and discuss how such problems or opportunities can be addressed in other organizations.