The world in which people live is a system that comprises subsystems that constantly interact with each other within coherent dynamics and clearly defined boundaries. The perception that the world has small systems that interact with each other is the central premise of the systems theory. The model proposes that systems are always a representation of life phenomena, which people use in their daily interactions. In its application to nursing and healthcare, the theory suggests that a hospital has a system that is made up of inputs, processes, and outputs. This paper contextualizes the systems theory in healthcare. Precisely, the paper analyzes the applicability of the theory at the John Hopkins Hospital, Baltimore by using theory’s terminology to describe the organization of the hospital and an identified patient care problem. The paper also identifies goals, outcomes, and standards that would be used to deal with the patient care problem identified according to the systems theory terminology before concluding with aligning the identified solution with the mission, vision, and values of the hospital.
Systems Theory
Inputs
Literature on the application of systems theory suggests that inputs include the resources, energy, and raw material that could be processed to lead to organizational outcomes (Hayajneh, 2007). The examples of inputs that the cited author gives include individual effort, fuel, energy, physician’s time, nurses’ effort, money, and information. At the John Hopkins Hospital, informational resources are among the most advanced forms of input. For instance, the healthcare organization has invested in research that would help to advance nursing and health care practice ( Johns Hopkins Medicine, based in Baltimore, Maryland, 2018 ). The nurses and physicians strive to share information with patients about practices that would improve their health outcomes. The nurses are always committed to ensure that they provide the best health care services to the patients, which is why the hospital was recently ranked among the best in the country for patient care ( Johns Hopkins Medicine, based in Baltimore, Maryland, 2018 ). Although it is not possible to quantity the amount of money invested in the projects at the hospital, one may conclude that the organization has a significant level of monetary resources invested to fund research, equipment, and other support services.
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Throughput
In systems theory terminology, refers to the processes utilized to covert the raw materials into services or products that are used by either the environment or by the system itself (Meyer & O’Brien ‐ Pallas, 2010). Examples that the cited author give for this terminology include, and which are also applicable for the case of the John Hopkins Hospital include the decision-making process , examination of the patients, treating the patients for their conditions, sharing information between the patients and the physicians, and critical thinking ( Johns Hopkins Medicine, based in Baltimore, Maryland, 2018 ).
Output
According to Alligood (2013), output refers to the results of the throughput, which could be equated to the health care services that the John Hopkins Hospital offers to the patients. The institution has always been striving to improve its standards of care for the patients, and its efforts have been recognized in the recent past when the hospital was ranked the third best in the country for patient care.
Cycle of Events
Cycle of events relates to the substances, parts, or things that constitute the entire system, and they include equipment, material, and humans. At the John Hopkins Hospital, human resources are integral for the provision of high-quality healthcare. For instance, because the hospital prioritizes professionalism, its professional team is highly trained, and it undergoes continuous training to ensure that it upholds the desired standards of care. Apart from human resources, the hospital has acquired state-of-the art facilities and technologies that promote patient safety and effective care ( Johns Hopkins Medicine, based in Baltimore, Maryland, 2018 ).
Feedback
Feedback is identified as the best approach to collecting information that would be used to improve the system. At the John Hopkins Hospital, nurses, and physicians alike invite patients to engage in patient satisfaction surveys that would be used to collect their views for improvement. Working on the comments of patients could be one of the reasons that the hospital has managed the high standards of care in the recent past.
Open Systems Approach to Patient Care Problem
As much as the hospital has the identified reputation, it is notable that some of the patients take longer than they expect to be seen by their physicians. Consequently, the number of patients who are seen by the doctors is not to the optimal standards of the institution. The system theory and its application to the healthcare context at John Hopkins Hospital indicate that the patient care problem falls in the category of throughput. At the institution, it is noted that the patients have an option of booking appointments with their physicians online, but the process is not as efficient as it should be since the number of patients booking overwhelms that of the physicians ( Johns Hopkins Medicine, based in Baltimore, Maryland, 2018 ). As much as it is not possible to have a 1:1 patient-physician ratio, it is possible to improve the throughput procedures to ensure that the system speeds up.
Goals, Outcomes, and Standards
The desired outcome of the system should be to increase the number of patients who are seen by physicians through reducing the time that they take before being attended to by their health care professionals. The objective, therefore, is to attend to 20000 patients during the first quarter of 2019. The standard of attaining the desired outcome for institution would be according to the nursing standards defined by ANA, American Nurses Association, especially the ADPIE nursing process (Butcher et al., 2018). The hospital should strive to eliminate any processes that delay service delivery, especially when the patients check in.
Alignment with Mission, Vision, and Values
The mission of the hospital is to improve the health of the community and the world by setting the standard of excellence in medical education, research and clinical care ( Johns Hopkins Medicine, based in Baltimore, Maryland, 2018 ). The institution has been involved in the provision of patient-centered care, which sets the standard for high-quality care that the institution is always dedicated to deliver. Furthermore, the corporate website of the hospital reports that the vision of the institution is Johns “ Hopkins Medicine pushes the boundaries of discovery, transforms health care, advances medical education and creates hope for humanity. Together, we will deliver the promise of medicine,” ( Johns Hopkins Medicine, based in Baltimore, Maryland, 2018 ). It is also important to note that the institution operates on a system of core values, which include respect and collegiality, diversity and inclusion, leadership and integrity, and excellence and discovery.
The desired and proposed solution to patient care issue identified suits the mission and vision statement of the institution in addition to upholding the core values. For instance, the mission statement suggests that the hospital strives to set the pace in the provision of health care in the US and around the world. Consequently reducing the time that the patients take before they see their physicians would ensure that the hospitals serves as many people as possible, and to spread the influence of high-quality medicine to the community and the world. Furthermore, while the solution does not address the vision of the institution directly, it should be understood that it might result in more patient satisfaction and feedback that would be used to improve the approach to care, and consequently transform its practices to deliver the promise of medicine—to improve the health standards of the patients under care. The proposal would also uphold the core values of the institution, especially through the development of an inclusive approach to the delivery of care—seeing as many patients as possible would mean that the physicians at the institution do not discriminate against some of the patients for any reasons.
Conclusion
The systems theory perceives the world as comprising of several subsystems that connect to form one large system. The system has several processes, which ensure the interconnection of the subsystems, which include the inputs, throughputs, cycle of events, and feedback that combine to produce the desired products and services. This paper has applied to theory to the healthcare context of the John Hopkins Hospital and described that way in which the institution’s levels of investment in human resources and modern equipment has committed the efforts of nurses and physicians towards the delivery of patient-centered care. The institution has earned the reputation of one of the best in the healthcare industry because of the objective of delivering the best standards of care in Maryland and the country. However, it has been identified that the hospitals progress could be hampered by a long waiting time for patients who would like to see their physicians. Applying the systems theory, it has been proposed that the management strive to meet the institution’s promise of delivering high-quality health care to community through working to lower the waiting time. If adopted, the hospital would be able to serve as many patients as possible, which is in line with its core values, mission, and vision statements.
References
Alligood, M. R. (2013). Nursing Theory-E-Book: Utilization & Application . Elsevier Health Sciences.
Butcher, H. K., Bulechek, G. M., Dochterman, J. M. M., & Wagner, C. (2018). Nursing Interventions classification (NIC)-E-Book . Elsevier Health Sciences.
Hayajneh, Y. (2007). Management for Health Care Professionals Series. Systems & Systems Theory , 1 , 1-5.
Johns Hopkins Medicine, based in Baltimore, Maryland . (2018). Hopkinsmedicine.org . Retrieved 10 December 2018, from https://www.hopkinsmedicine.org/
Meyer, R. M., & O’Brien ‐ Pallas, L. L. (2010). Nursing services delivery theory: an open system approach. Journal of Advanced Nursing , 66 (12), 2828-2838.
