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  • Pages
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01 Cover
02 Contents
03 Find out what's useful for you
04 Foreword
05 Executive summary
06 introduction
07 Section 1 - Healthcare as a ‘system of systems’
08 Section 2 – Approaches to improvement
09 Section 3 – Defining a systems approach
10 Section 4 – A framework for thinking
11 Section 5 – A framework for action
12 Annex 1 – Applications of the approach
13 Annex 1 - study of the Esther Model
14 Annex 1 - study of oral methotrexate
15 Annex 2 – Case studies
16 Annex 2 - explore the case studies
17 Case study 1 – The Esther model
18 Case study 2 – Oral methotrexate
19 Case study 3 – Michigan intensive care unit project
20 Case study 4 – St Aubyn Centre
21 Case study 5 – London Ambulance Service
22 Case study 6 – Arsenal’s Emirates Stadium
23 Case study 7 – Design Bugs Out
24 Case study 8 – Modelling and simulation saves lives
25 Case study 9 – The GlaxoSmithKline Diskus inhaler
26 Case study 10 – Coordinated care at end of life
27 Case study 11 – Daily inpatient schedules in Birmingham
28 Case study 12 – Barts Sustainability Strategy
29 Case study 13 – The Dyson Centre for Neonatal Care
30 Annex 3 – Elements of a systems approach
31 Annex 3 – people perspective
32 Annex 3 – systems perspective
33 Annex 3 – design perspective
34 Annex 3 – risk perspective
35 Annex 3 – Engineering systems
36 Annex 4 – Compilation of approaches
37 Annex 4 – Change model
38 Annex 4 – Model for improvement
39 Annex 4 - Quality improvement journey – NHS Scotland
40 Annex 4 - Leading large-scale change
41 Annex 4 - Human factors in healthcare
42 Annex 4 - Root cause analysis
43 Annex 4 - Systems thinking for health
44 Annex 4 - Experience-based co-design
45 Annex 4 - Lean in healthcare
46 Annex 4 - Risk assessment made easy
47 Annex 4 - Systems engineering
48 Annex 4 - Human-centered design
49 Annex 4 - Six sigma
50 Annex 4 - Inclusive design
51 Annex 4 - Risk management
52 Annex 4 - System safety assessment
53 Bibliography
54 About this project

Annex 1

Applications of the approach

The two studies that follow explore retrospectively how the questions from the spiral model of the systems approach could have been applied (Section 5: A framework for action) to the development and deployment of:

The Esther Model of care for elderly persons with complex care needs

— a multi-organisational collaboration between acute, primary and social care providers was created by Jönköping County Council to develop a model for the improvement of patient-centred care in the community, based on a fictitious patient known as Esther (see also Case study 1: Esther Model). 


Explore the Esther Model study >

Safer care for patients using oral methotrexate for the treatment of rheumatoid arthritis

— local and national stakeholders, led by the National Patient Safety Agency (NPSA), were engaged in making the design of methotrexate tablets and their prescription, delivery and monitoring safer for patients (see also Case study 2: Oral methotrexate). 


Explore the Oral Methotrexate study >

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Foreword

Executive summary

Introduction

Section 1

Healthcare as a ‘system of systems’

Section 2

Approaches to improvement

Section 3

Defining a systems approach

Section 4

A framework for thinking

Section 5

A framework for action

Annex 1

Applications of the approach

Annex 2

Case studies

Annex 3

Elements of a systems approach

Annex 4

Compilation of approaches

Bibliography

About the project