McGrath Susan P, Wells Emily, McGovern Krystal M, Perreard Irina, Stewart Kathleen, McGrath Dennis, Blike George
Adv Health Care Manag. 2019 Oct 24;18. doi: 10.1108/S1474-823120190000018006.
Although it is widely acknowledged that health care delivery systems are complex adaptive systems, there are gaps in understanding the application of systems engineering approaches to systems analysis and redesign in the health care domain. Commonly employed methods, such as statistical analysis of risk factors and outcomes, are simply not adequate to robustly characterize all system requirements and facilitate reliable design of complex care delivery systems. This is especially apparent in institutional-level systems, such as patient safety programs that must mitigate the risk of infections and other complications that can occur in virtually any setting providing direct and indirect patient care. The case example presented here illustrates the application of various system engineering methods to identify requirements and intervention candidates for a critical patient safety problem known as failure to rescue. Detailed descriptions of the analysis methods and their application are presented along with specific analysis artifacts related to the failure to rescue case study. Given the prevalence of complex systems in health care, this practical and effective approach provides an important example of how systems engineering methods can effectively address the shortcomings in current health care analysis and design, where complex systems are increasingly prevalent.
尽管人们普遍认识到医疗保健提供系统是复杂适应系统，但在理解系统工程方法在医疗保健领域的系统分析和重新设计中的应用方面仍存在差距。常用的方法，如对风险因素和结果进行统计分析，根本不足以全面描述所有系统要求并促进复杂护理提供系统的可靠设计。这在机构层面的系统中尤为明显，例如患者安全计划，该计划必须降低感染风险以及在几乎任何提供直接和间接患者护理的环境中都可能发生的其他并发症的风险。此处给出的案例示例说明了各种系统工程方法在识别一个被称为未能及时抢救的关键患者安全问题的要求和干预候选方案方面的应用。文中介绍了分析方法及其应用的详细描述，以及与未能及时抢救案例研究相关的具体分析工件。鉴于复杂系统在医疗保健中的普遍性，这种实用且有效的方法提供了一个重要示例，展示了系统工程方法如何有效解决当前医疗保健分析和设计中的不足，因为复杂系统在该领域越来越普遍。
