Open Versus Closed Systems Perspectives: Healthcare Processes
According to Zakus & Bhattacharyya (2007), one of the great paradoxes of modern healthcare is despite the “availability of many cures, treatments, and preventive measures” for both severe and mild ailments, there remains a failure to engage in effective delivery of treatment to patients (p. 278). One possible explanation to this conundrum is that while the actual technology and medical care may be of high quality, the systems which deliver such care are faulty. Systems theory suggests that many of these issues lie in the fact that healthcare organizations are closed rather than open systems. Closed systems are by their very nature impervious to outside influences and determined to maintain standard operating procedures. Although this can ensure consistency, given that healthcare is a field constantly in flux, it is not an effective approach for the long term (Zakus & Bhattacharyya 2007).
In contrast, open systems are receptive to input from the external environment. They are constantly “exchanging materials, energies, or information, and are influenced by or can influence this environment; they must adjust to the environment to survive over time” (Zakus & Bhattacharyya 2007, p.279). A good example of an inefficient closed system approach...
Medical errors are a serious problem for all healthcare institutions to varying degrees. But because my institution’s rate of errors is not significantly worse than the national average, there is not as much as pressure to go above and beyond to identify what processes could be improved to achieve a preferable rate of zero errors.
One reason to make improving medical errors that are the result of inefficient processes an important goal is that such a goal is a measurable target, and what is not measurable cannot be improved. Numerous systematic research studies have confirmed that the most common errors to result in serious harm to patients include: “drug to wrong patient, wrong dose of medication, drug overdose, omitted drug, wrong drug and wrong administration time” (Carayon, & Wood, 2010, par. 3). The causes of these errors are also well known, including “failure to follow checking procedures, written miscommunication, transcription errors, prescriptions misfiled and calculation errors” (Carayon, & Wood, 2010, par. 3).
A closed system approach usually involves simply inflicting disciplinary action towards such violators. An open systems approach, however, would attempt to discern…
