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The committee has adapted a four-level model by Ferlie and Shortell to clarify the structure and dynamics of the health care system, the rough divisions of labor and interdependencies among major elements of the system, and the levers for change.
A brief description of the model follows. Conceptual drawing of a four-level health care system. The Individual Patient We begin appropriately with the individual patient, whose needs and preferences should be the defining factors in a patient-centered health care system.
The availability of information, the establishment of private health care spending accounts, and other measures reflect an increasing expectation that patients will drive changes in the system for improved quality, efficiency, and effectiveness.
Overall, the role of the patient has changed from a passive recipient of care to a more active participant in care delivery.
Unfortunately, most people do not have access to the information, tools, and other resources they need to play this new role effectively.
The level of responsibility patients and their families assume differs from patient to patient. In either case, however, patients need a free exchange of information and communication with physician s and other members of the care team, as well as with the organizations that provide the supporting infrastructure for the care teams.
Information that supports evidence-based, effective, efficient care encompasses the patient's medical record, including real-time physiological data; the most up-to-date medical evidence base; and orders in process concerning the patient's care. From the patient's perspective, improving the timeliness, convenience, effectiveness, and efficiency of care will require that the patient be interconnected to the health care system.
Synchronous communication between patient and physician could improve the quality of care in a number of ways. For example, continuous, real-time communication of a patient's physiological data to care providers could accelerate the pace of diagnosis and treatment, thereby reducing complications and injuries that might result from delays.
Communication technologies also have the potential to change the nature of the relationship between patient and provider, making it easier for patients to develop and maintain trusting relationships with their clinicians. Asynchronous communication also has the potential to significantly improve quality of care.
The easy accessibility of the Internet and the World Wide Web should enable all but continuous inquiries and feedback between patients and the rest of the health care system IOM, The World Wide Web has already changed patients' ability to interact with the system and to self-manage aspects of their care.
One of the fastest growing uses of the these communication technologies is as a source of medical information from third parties, which has made the consumer i.
Some of the improvements just described are available today, some are under study, and some are as much as a decade away from realization.
Thus, research is still an essential component in transforming the current system. The Care Team The care team, the second level of the health care system, consists of the individual physician and a group of care providers, including health professionals, patients' family members, and others, whose collective efforts result in the delivery of care to a patient or population of patients.
In addition to the care team, a clinical microsystem includes a defined patient population; an information environment that supports the work of professional and family caregivers and patients; and support staff, equipment, and facilities Nelson et al.
Most health and medical services today, however, are not delivered by groups or teams. The role and needs of individual physicians have undergone changes parallel to those of individual patients.
The slow adaptation of individual clinicians to team-based health care has been influenced by several factors, including a lack of formal training in teamwork techniques, a persistent culture of professional autonomy in medicine, and the absence of tools, infrastructure, and incentives to facilitate the change.
To participate in, let alone lead and orchestrate, the work of a care team and maintain the trust of the patient, the physician must have on-demand access to critical clinical and administrative information, as well as information-management, communication, decision-support, and educational tools to synthesize, analyze, and make the best use of that information.
Moreover, to deliver patient-centered care i. At the present time, precious few care teams or clinical microsystems are the primary agents of patient-centered clinical care.
All of these can, and do, prevent systems thinking by clinicians, the diffusion of evidence-based medicine, and the clinical microsystems approach to care delivery.
Thus, tailoring evidence-based care to meet the needs and preferences of individual patients with complex health problems remains an elusive goal. For care teams to become truly patient-centered, the rules of engagement between care teams and patients must be changed.
Like individual care providers, the care team must become more responsive to the needs and preferences of patients and involve them and their families to the extent they desire in the design and implementation of care. Care teams must provide patients with continuous, convenient, timely access to quality care.
One member of the care team must be responsible for ensuring effective communication and coordination between the patient and other members of the care team.
The Organization The third level of the health care system is the organization e.Defining Corporate Social Responsibility: A Systems Approach For Socially Responsible Capitalism Abstract Although the concept of corporate social responsibility (CSR) has been advocated for .
An integrated management systems approach to corporate social responsibility Author links open overlay panel Muhammad Asif a b Cory Searcy c Ambika Zutshi d Olaf A.M. Fisscher e Show more.
BRIDGE PAPER™: Company Stakeholder Responsibility: A New Approach to CSR 5 In short, if you take a “creating value for stakeholders” approach to business, Capitalism is a system of social coop-eration—a system of working together to create value for each other, value which.
According to Open systems approach, outputs are the services or products produced and submitted to the environment. true The closed system is a self-contained entity in which the functioning of the component parts and their interrelationships are the primary objects of interest.
3. What does it mean to have an industry open-systems approach to social responsibility? What parties are involved? Who are the stakeholders? Stakeholders are anyone who has any form of investment in a company. This can range from money investors, to board members, and customers.
There are many parties involved beyond just Nike; this includes suppliers, customers, and even competitors within 50%(2). Nursing Services Delivery Theory: an open system approach. Keywords: nursing management, Nursing Services Delivery Theory, open system approach, organization structure, quality of care, staffing, In the systems approach, power is typically conceptualized as a resource.