This paper compares systems theory with diffusion of innovation theory and specifically applies them to the healthcare environment and the nursing process. It also contains some personal reflection of how the nurse uses them in her workplaces. It then concludes with an analysis of how the author of the paper complied research on the topics and various search strategies used.
Systems Theory
Discuss relationship systems theory healthcare deliver U.S. - What current concepts healthcare explained helped a system theory approach? - What system theory? - How researchers (Ludwig von Bertalanffy Everett M.
Systems theory and diffusion of innovation theory
Systems theory
Systems theory was not specifically designed to cope with the challenges of the U.S. healthcare system, although it has been frequently applied to some of its issues. Systems theory was originally coined by the scientist Ludwig von Bertalanffy to sum up his idea that the 'whole' of systems -- both biological and otherwise -- were larger than the sum of their parts. According to von Bertalanffy, "in the past, science tried to explain observable phenomena by reducing them to an interplay of elementary units investigable independently of each other, conceptions appear in contemporary science that are concerned with what is somewhat vaguely termed 'wholeness', i.e. problems of organization, phenomena not resolvable into local events, dynamic interactions manifest in difference of behaviour of parts when isolated or in a higher configuration" (Von Bertalanffy 1968). This can be seen in the human body, where organs cannot be treated in isolation but must be viewed as part of the larger human 'system.'
Diffusion of innovation theory
Diffusion of innovation theory similarly underlines how outside data can stimulate change, specifically how information flows through a network. As defined by E.M. Rogers, "innovation is communicated through certain channels over a period of time among the members of a social system…An innovation is an idea, practice, or object that is perceived to be new by an individual or other unit of adoption [and] communication is a process in which participants create and share information with one another to reach a mutual understanding" (Diffusion of innovation theory, 2013, University of Twente). Innovation is a four-stage process, beginning with the generation of the invention, the diffusion (or communication) of the innovation "through the social system," time (the time it takes for the innovation to be tested and to take root) and "consequences" (Diffusion of innovation theory, 2013, University of Twente). For example, within the healthcare system, when a 'new' idea is introduced (such as the vaccine for chicken pox or a new drug to treat depression), at first, a handful of cutting-edge practitioners avail themselves of the treatment, but gradually it becomes more and more mainstream and adopted by more and more practitioners until it becomes the 'norm.' Eventually some treatments and protocols become so accepted that it is considered abnormal, even malpractice, not to offer them.
Systems theory and the nursing process
Some criticisms have been leveled against the healthcare system given its tendency to treat 'parts' of human health and wellness in isolation (such as having certain practitioners focus upon heart disease and others on diet rather than drawing interconnections between the two), and thus failing to exhibit sufficient appreciation for the biological 'system' of human beings. Human beings themselves and systems which treat the needs of human beings like the healthcare system are 'open' systems and receptive to changes in the environment.
From a nurse's perspective, systems theory is useful in that nursing views the patient as an open system, subjected to changes in terms of the input derived from biological, psychological, social, and spiritual influences. The nurse can help influence the system of the individual patient in a positive way because of this openness, but the openness and interconnectedness of the human makes him or her unpredictable and vulnerable to outside influences. For example, when treating a client who must lose weight, the nurse may recognize that in addition to the biological 'nutritional' systems of intake and outtake, there are social and familial systems which impact the individual and make it difficult for him or her to lose weight. By seeking to alter these systems (for example, urging the client to seek more support from friends and altering his or her routine as well as eating different foods), the nurse can help enact more proactive changes. Systems theory can be helpful to nurses in highlighting what different patient 'systems' must be changed to improve health in a holistic fashion, rather than focusing on individual systems or singular components of the illness.
Diffusion of innovation theory and the nursing process
According to Rogers' diffusion of innovation theory, there are "five categories of adopters of an innovation: innovators, early adopters, early majority, late majority, and laggards. Sometimes, a sixth group is added: non-adopters" (Kaminski 2011). I have seen this in my workplace on many occasions. When a new change, such as a new form of technology is introduced, some nurses will embrace it as a way of making their lives easier or enhancing the care they are able to give to patients. It is more typical that there will be some who 'grouse' about this idea, as gradually the use of the technology permeates the workplace. There are always a few 'laggards' who resist and may need to be spoken to, to ensure they perform their duties properly.
Similarly, within the field of healthcare as a whole, I have witnessed diffusion of innovation theory as certain ideas gain more and more traction. For example, many years ago, a very low-fat diet was considered optimal for patients to lose weight. Gradually, people have grown more open to the idea of 'good fats,' however, and the need to be more selective about the types of fats one consumes and their sources is emphasized, rather than cutting out fat calories altogether or using many 'fake fat' ingredients. But it is still not unusual (although much more rare) to find a nurse practitioner suggest 'fat free is better' to an obese patient or a patient with high cholesterol. Diffusion of innovation theory is helpful in weighing what options are the best for various patients -- when considering a new treatment, the nurse is often forced to ask if this idea is 'tested' enough and valid, and if it is sufficiently accepted within the medical community to warrant being recommended to a patient under his or her specific circumstances.
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