A systems approach to healthcare: from thinking to -practice.
A systems approach to healthcare: from thinking to -practice.
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DOI：
10.7861/futurehosp.5-3-151
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发表时间：
2018-10-01
期刊：
影响因子：
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通讯作者：
Bashford, Tom
中科院分区：
文献类型：
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作者：
Clarkson, John;Dean, John;Bashford, Tom
医学越来越复杂，涉及一个由人员、资源、流程和机构组成的高度联系的系统。改善护理的尝试会破坏这一系统，可能产生广泛的积极和消极后果。尽管如此，许多改进方法在管理复杂性或风险方面装备不足——而是侧重于效果受到严格监测的离散干预措施。工程师们早就明白，复杂的问题需要一个系统的观点，而试图把事情做得更好本身就会给系统带来新的风险。鉴于此，工程系统方法可能对那些试图改善医疗保健的人具有重要价值。这种方法产生了两个基本问题：我们可以在哪些方面做得更好，哪些方面可能出错？本文描述了医疗保健系统方法的演变，并探讨了最近共同开发的框架，概述了基于医疗保健和工程之间协同作用的系统方法。
Medicine is increasingly complex, involving a highly connected system of people, resources, processes, and institutions. Attempts to improve care involve disruptions to this system, with the potential for wide-ranging consequences, both positive and negative. Despite this, many improvement methodologies are poorly equipped to manage either complexity or risk - instead focusing on discrete interventions whose effects are narrowly monitored. Engineers have long understood that complex problems require a systems view, and that attempts to make things better can themselves introduce new risk into a system. Given this, an engineering systems approach may be of significant value to those trying to improve healthcare. Two fundamental questions emerge from such an approach: what can we do better, and what could possibly go wrong? This paper describes the evolution of a systems approach to healthcare, and explores a recently co-developed framework outlining a systems approach based upon a synergy between healthcare and engineering.