Comparison/ MHC6303 Week 2 Discussion
Systems Perspective

Whether US healthcare is a system is not only an academic question. Only under a systems view would one argue that there is benefit in improving interaction and coordination among healthcare organizations. Without the systems perspective, a manager would devote efforts to improvements within one area of the organization.

Even if US healthcare is viewed as a system, is it a good system? There are those that argue that the US health system is not effective in meeting the needs of all people and not always efficient in meeting the needs of patients. It is difficult to rationalize the goals of a system that invests in the most sophisticated and expensive services to save individuals while cutting back on the relatively inexpensive and effective services that would have prevented many poor outcomes in the first place.

As you read about systems models that can be applied to healthcare, try to relate them to situations you have observed. You will find that different models fit different situations. You may even have a preference for certain models. Remember, a model is a tool for viewing a system; it isn’t inherently right or wrong in itself. What matters is how well you use it to understand the system and, eventually, to improve it.

Reference:

Wiig, S., Robert, G., Anderson, J. E., Pietikainen, E., Reiman, T., Macchi, L., & Aase, K. (2014). Applying different quality and safety models in healthcare improvement work: Boundary objects and system thinking. Reliability Engineering & System Safety, 125, 134-144. doi:10.1016/j.ress.2014.01.008

Elton, J., & O’Riordan, A. (2016). Healthcare disrupted: Next generation business models and strategies (1st ed.). Hoboken, New Jersey: Wiley.

Chaos Theory

Chaos theory can also be used to describe how the US healthcare industry functions. Chaos theory explains that in large and complex systems, a small change in one condition can cause large and unpredictable changes in future conditions. Suppose a system comprises a large number of parts with many complex interrelationships among the parts. Even a small change in one part can lead to large changes in other parts or in the system as a whole. Where the interrelationships are not understood, the changes may be unpredictable.

In the past, every tinkering effort to address one of the three basic problems of the healthcare system—costs, quality, and access—has resulted in significant changes in one or both of the others. Others also suggest using chaos theory to study the healthcare industry. Perhaps systems theory is inadequate as the primary basis for curriculum design. The current health system may be equally well explained by chaos theory, which is based on the premise that the unfolding of the world over time is unknowable

References:

Richardson, M., & Schneller, E. S. (1998). Out of the box: Health management education in the 21st century. The Journal of Health Administration Education, 16(1), 87–97.

Baird, James,C.A.H.I., F.A.C.H.E. (2014). Leadership amidst chaos: How great managers transcend chaos, lean economic times, and lead their staff to success. Paper presented at the 99-103. Retrieved from https://search-proquest-com.southuniversity.libproxy.edmc.edu/docview/1639529639?accountid=87314.

Elton, J., & O’Riordan, A. (2016). Healthcare disrupted: Next generation business models and strategies (1st ed.). Hoboken, New Jersey: Wiley.

Measurement and Comparison

How would you determine which country provides better healthcare? This raises questions about the measurement of healthcare performance.

Would you compare an average hospital in Minneapolis to one in Winnipeg or Havana? Or should you include all hospitals in the country, as well as nursing homes and physicians? Or do population statistics, such as life expectancy and infant mortality, provide a better measure of performance?

There are organizations—public and private, not-for-profit and proprietary—that compare healthcare organizations and provide performance information to the public. You will read about such organizations this week. Pay particular attention to the performance measures they use.

Try viewing measurement questions from the perspective of a healthcare program or an organization manager and ask, “How would I like my program to be evaluated?” Use this perspective in your assignment on developing standards for measuring the performance of a specific healthcare service. After completing this exercise, you will be ready to start thinking about how to compare healthcare in Canada and in the United States.

This review of questions brings the manager to the realization that it is up to them to take the lead in defining quality for an organization. Read the following information for more information on these topics.

Resources:

Burstin, H., Leatherman, S., & Goldmann, D. (2016). The evolution of healthcare quality measurement in the united states. Journal of Internal Medicine, 279(2), 154-159. doi:10.1111/joim.12471

Polites, S. F., Habermann, E. B., Zarroug, A. E., Wagie, A. E., Cima, R. R., Wiskerchen, R., . . . Ishitani, M. B. (2015;2014;). A comparison of two quality measurement tools in pediatric surgery–the american college of surgeons national surgical quality improvement program-pediatric versus the agency for healthcare research and quality pediatric quality indicators. Journal of Pediatric Surgery, 50(4), 586. doi:10.1016/j.jpedsurg.2014.10.049