NEWS
Applying a Systems Thinking Model for Effective Staffing
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October 1, 2008
Kathy Douglas, RN, MHA, and Karlene Kerfoot, RN, PhD, CNAA, FAAN, Nurse Leader
As if the pressures of running modern health care organizations aren’t challenging enough, finding time to invest in uncovering new and sustainable solutions to staffing challenges can be just as daunting. It is, however, essential to our future. Determining how to achieve effective staffing while managing costs is not a new question for healthcare. On the other hand, never before have we faced this challenge with the convergence of so many variables that surround and influence the ability to successfully meet staffing demands.
However, we now have more research to apply to staffing methodologies. We have evidence that correlates staffing to patient-care outcomes, patient safety, and nurse safety. National initiatives such as the MAGNET Recognition Program, the Joint Commission, the demand for public reporting of quality outcomes, and paying for performance are “raising the bar” to shine the spotlight on the contribution that effective nurse staffing has on the success of these initiatives. In this environment, we can no longer rely on well intentioned and seemingly isolated staffing decisions without considering the down-stream consequences. On the bright side, it is often through seemingly impossible challenges that new solutions are discovered. As the pressure to find answers increases, the need for exploration grows, and this gives rise to new thinking and the uncovering of new possibilities.
Healthcare organizations across the country can benefit from taking a fresh look at staffing practices and their relationships to quality of care and financial viability. One of the tools that can help navigate through the discovery process and assure that we create well understood solutions with long term viability is a systems thinking model. To help in the difficult process of looking at things in new ways, we can draw upon the work of Martha E. Rogers, Peter Senge, and others to apply the principles of systems thinking.
THE ESSENCE OF SYSTEMS THINKING
Martha E. Rogers, a nurse scholar, advanced systems thinking in nursing at a major conference in 1978 with her presentation “Science of Unitary Human Beings”. It was based on an open-systems model with a focus on holistic and individualistic care.1 The concept of systems thinking was popularized by Peter Senge in his influential work The Fifth Discipline, which demonstrates how organizations may apply systems thinking for problem resolution.
How is “systems” thinking different from traditional thinking? The basic difference is that systems thinking encourages you to see the whole picture, the interaction between the parts rather than just its isolated parts. It recognizes the importance of understanding how the different segments of a system are interconnected.
Toward this end, the language of systems thinking is circular rather than linear. It focuses on closed interdependencies, where a influences b, b influences c, and c influences a. These interrelationships can result in actions with positive and negative ripple effects that can move quickly through the entire system.2 Organizations that work systemically begin by looking for the connections between the various parts of the system to ensure better coordination of organizational functions.
Systems thinking attempts to integrate the various parts of a system in a way that optimizes, rather than maximizes, the performance of each of its parts in order to achieve organizational effectiveness. This big picture approach recognizes that relationships and the context in which they function are just as important as the details.
Continued… Click here to view the full article (PDF)
However, we now have more research to apply to staffing methodologies. We have evidence that correlates staffing to patient-care outcomes, patient safety, and nurse safety. National initiatives such as the MAGNET Recognition Program, the Joint Commission, the demand for public reporting of quality outcomes, and paying for performance are “raising the bar” to shine the spotlight on the contribution that effective nurse staffing has on the success of these initiatives. In this environment, we can no longer rely on well intentioned and seemingly isolated staffing decisions without considering the down-stream consequences. On the bright side, it is often through seemingly impossible challenges that new solutions are discovered. As the pressure to find answers increases, the need for exploration grows, and this gives rise to new thinking and the uncovering of new possibilities.
Healthcare organizations across the country can benefit from taking a fresh look at staffing practices and their relationships to quality of care and financial viability. One of the tools that can help navigate through the discovery process and assure that we create well understood solutions with long term viability is a systems thinking model. To help in the difficult process of looking at things in new ways, we can draw upon the work of Martha E. Rogers, Peter Senge, and others to apply the principles of systems thinking.
THE ESSENCE OF SYSTEMS THINKING
Martha E. Rogers, a nurse scholar, advanced systems thinking in nursing at a major conference in 1978 with her presentation “Science of Unitary Human Beings”. It was based on an open-systems model with a focus on holistic and individualistic care.1 The concept of systems thinking was popularized by Peter Senge in his influential work The Fifth Discipline, which demonstrates how organizations may apply systems thinking for problem resolution.
How is “systems” thinking different from traditional thinking? The basic difference is that systems thinking encourages you to see the whole picture, the interaction between the parts rather than just its isolated parts. It recognizes the importance of understanding how the different segments of a system are interconnected.
Toward this end, the language of systems thinking is circular rather than linear. It focuses on closed interdependencies, where a influences b, b influences c, and c influences a. These interrelationships can result in actions with positive and negative ripple effects that can move quickly through the entire system.2 Organizations that work systemically begin by looking for the connections between the various parts of the system to ensure better coordination of organizational functions.
Systems thinking attempts to integrate the various parts of a system in a way that optimizes, rather than maximizes, the performance of each of its parts in order to achieve organizational effectiveness. This big picture approach recognizes that relationships and the context in which they function are just as important as the details.
Continued… Click here to view the full article (PDF)