Management in healthcare is continuously evolving. Systems thinking has been one of the approaches explored in several settings for different applications. Systems thinking has been identified to be associated with improved functionality through process examination, behaviour, and design adaptation.

This understanding led to the fragmentation of complex healthcare challenges that result in both positive and negative outcomes. Moreover, an outlook on quality improvement and assurance of persons’ safety within an action and reaction understanding will be sought.

In this day and age, the concept of safety in healthcare is becoming increasingly important. The scope of understanding the importance of safety is accounted from the understanding that the protection of patient, self, and others in healthcare remains the preamble of why people need healthcare services.

Re-design and understanding behaviours are crucial in systems thinking

Whilst a system is set through components towards a common goal, healthcare systems thinking gears towards the conditions of systems. The connotations of persons’ safety issues within the re-design of systems can lead to outcomes that would have differential impacts within a system. The effect of change, despite intentionally and primarily leading to immediate effect, is only the correction or resolvent of a symptom and not the cause.

Systems thinking objectives must focus on the bigger picture, and not be limited to the singularity which eventually leads to contrast with the behaviour and environment, through inputs, throughputs, and outputs.

What is safety?

The crucial aspect is to align the understanding of what constitutes a person/patient and what is the meaning of safety. Of course, this question is pertinent to healthcare. Thus, the idea of dealing with a person supersedes that of dealing with a patient.

Failures. Errors. Adverse events. All these have one common understanding in healthcare, that have a negative impact on service users. Systems thinking shifts the thought of blaming and guides individuals to focus on the external factors that lead individuals to harm patients. The scope of evaluation in systems thinking is to amplify the understanding of how systems can improve, and result in better healthcare outcomes. Improving processes away from a blame culture and subjective human error has a direct link with improved persons’ safety.

The basics revolve around the famous notion that ‘error is human’ whereby we should accept that all healthcare professionals are subject to error and acknowledge that the environment led to the construct of error. Above all, realizing that a human is a human, with strengths but limitations at the same time. We cannot accept that healthcare professionals are flawless or irreproachable. Why rather than who is very important, and through the application of systems thinking, this is fundamental. Re-thinking in systems design has major implications, and whilst root causes should be included in the implications for outcomes, component factors, methodologies and strategies must be adopted by organisations to learn and explore knowledge that can be translated into change. This needs to be consolidated in policy and practice revolving around persons’ safety.

Quality improvement

At the other end of the spectrum, we must remember that every person has the right to safe healthcare services, however, the complexity of healthcare makes this a very challenging factor but reducing harm in healthcare remains a primary objective.

Systems thinking with the capacity for change through knowledge leads to better organisations and safety cultures, which aim to limit error in the first place.

The importance of person safety in healthcare sets new horizons on how one can ensure that the principles and common objectives in healthcare are achieved by looking at individuals as persons, which after all is the very definition of persons’ safety in healthcare.

Noel Borg, Chief Operating Officer, CareMalta Group.