Faced with a performance gap the two most obvious responses are to work harder or work smarter. There are trade offs associated with each, some obvious, some not so obvious.
WIP based on Emery Roe's 2013 book. See also Dynamics in Action IM-3239 for more on behavior and The Art of the State IM-11962 for more on Grid-Group Cultural Theory
This map is a WIP derived from the MIT D-memo 4641 presentation by Nelson Repenning 1996 and the paper "Nobody Ever Gets Credit for Fixing Problems that Never Happened: Creating and Sustaining Process Improvement" by Nelson P. Repenning and John D Sterman. http://bit.ly/jCXGKL See Insight 9781 for a simulation of this model. This map adds additional features mentioned in the article to the bare bones simulation in IM-9781
WIP Simplified Patient Flow map of features in a SD simulation model of performance of a City Hospital over 5 years. Built after a Regional 20 year planning model IM-10290 The simulation is a large ithink model built by Mark Heffernan
WIP Patient Flow improvement strategies for a City Hospital with 3 years historical data and two year planning horizon. Built after a Generic Teaching Hospital Model IM-10346 A simplified stock flow map is at IM-399
From PLOS One Article April 2012 Worni, M et al System Dynamics to Model the Unintended Consequences of Denying Payment for Venous Thromboembolism after Total Knee Arthroplasty
Grid-Group Culture applied to Public Management WIP based on Christopher Hood's 1998 book. plus excerpts from Schwartz and Thompson's 1990 Book Divided we stand. See also Managing Mess IM-11581 and FourCultures Blog and Wikipedia Cultural Theory of Risk
Regulation of resource allocation to service in response to service quality. A non-price-mediated resource allocation system. From Sterman JD Business Dynamics p172 Fig 5-27
From FIg.2 Past the Tipping Point:THe Persistence of Firefighting in Product Development by Nelson Repenning, Paulo Goncalves and Laura Black. Calif. Mgt. Review 43(4) p44-63 (2001). Also From William E. Novak and Linda Levine CMU SEI Sept 2010 Success in Acquisition: Using Archetypes to Beat the Odds paper and see webpage
Incorporating organizational factors into Probabilistic Risk Assessment(PRA) of complex socio-technical systems: A hybrid technique formalization Zahra Mohaghegh, Reza Kazemi, Ali Mosleh Reliability Engineering and System Safety (2009) 94 5 p1000–1018 http://www.sciencedirect.com/science/article/pii/S095183200800269X. More detailed part of Insight 1074
Jenny W. Rudolph Nelson P.Repenning Disaster Dynamics: Understanding the Role of Quantity in Organizational Collapse Administrative Science Quarterly,47(2002):1-30 paper
Incorporating organizational factors into Probabilistic Risk Assessment(PRA) of complex socio-technical systems: A hybrid technique formalization Zahra Mohaghegh, Reza Kazemi, Ali Mosleh Reliability Engineering and System Safety (2009) 94 5 p1000–1018 http://www.sciencedirect.com/science/article/pii/S095183200800269X. THis overview has a more detailed area in Insight 1077
Based on diagrams in the NAP 2015 Report Improving diagnosis in health care process Compare with IM-885 Clinical judgment to provide context and and Decision Ladder IM-689 to provide decision process task detail
Adapted from Systems approaches to public health by Alan Shiell and Penny Hawe See also Health System Efficiency IM and specific health outcome logic diagram example IM
From NAP Toward Quality Measures for Population Health and the Leading Health Indicators Report with detailed Maternal Infant and Child Health Example Fig.3-5. Compare with WHO NCD Framework picture and IHI Whole system measures 2.0 (Added Nov 2016) See CLD conversion insight
Rich picture version of causal loop diagram for medication errors, showing the importance of reporting, analyzing and fixing knowledge and process errors. Medication errors will tend to grow due to the use of more medications in more complex patients. This is exacerbated by the loss of staff knowledge by turnover and goal erosion in places with harmful errors.
