New horizons in systems engineering and thinking to improve health and social care for older people.

IF 6 2区 医学 Q1 GERIATRICS & GERONTOLOGY Age and ageing Pub Date : 2024-10-01 DOI:10.1093/ageing/afae238
Navneet Aujla, Tricia Tooman, Stella Arakelyan, Tim Kerby, Louise Hartley, Amy O'Donnell, Bruce Guthrie, Ian Underwood, Julie A Jacko, Atul Anand
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Abstract

Existing models for the safe, timely and effective delivery of health and social care are challenged by an ageing population. Services and care pathways are often optimised for single-disease management, while many older people are presenting with multiple long-term conditions and frailty. Systems engineering describes a holistic, interdisciplinary approach to change that is focused on people, system understanding, design and risk management. These principles are the basis of many established quality improvement (QI) tools in health and social care, but implementation has often been limited to single services or condition areas. Newer engineering techniques may help reshape more complex systems. Systems thinking is an essential component of this mindset to understand the underlying relationships and characteristics of a working system. It promotes the use of tools that map, measure and interrogate the dynamics of complex systems. In this New Horizons piece, we describe the evolution of systems approaches while noting the challenges of small-scale QI efforts that fail to address whole-system problems. The opportunities for novel soft-systems approaches are described, along with a recent update to the Systems Engineering Initiative for Patient Safety model, which includes human-centred design. Systems modelling and simulation techniques harness routine data to understand the functioning of complex health and social care systems. These tools could support better-informed system change by allowing comparison of simulated approaches before implementation, but better effectiveness evidence is required. Modern systems engineering and systems thinking techniques have potential to inform the redesign of services appropriate for the complex needs of older people.

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系统工程和思维的新视野,以改善老年人的健康和社会护理。
安全、及时、有效地提供医疗和社会护理服务的现有模式受到了人口老龄化的挑战。服务和护理路径往往是针对单一疾病管理而优化的,而许多老年人却患有多种长期疾病,身体虚弱。系统工程描述了一种以人为本、系统理解、设计和风险管理的跨学科整体变革方法。这些原则是医疗和社会护理领域许多成熟的质量改进(QI)工具的基础,但其实施往往局限于单一的服务或条件领域。新的工程技术可以帮助重塑更复杂的系统。系统思维是这一思维方式的重要组成部分,它可以理解一个工作系统的内在关系和特征。它提倡使用各种工具来绘制、测量和分析复杂系统的动态。在这篇 "新视野 "文章中,我们介绍了系统方法的演变过程,同时指出了小规模质量改进工作所面临的挑战,即无法解决整个系统的问题。文章介绍了新型软系统方法的机遇,以及最近对患者安全系统工程倡议模型的更新,其中包括以人为本的设计。系统建模和模拟技术利用常规数据来了解复杂的医疗和社会护理系统的运作。这些工具可以在实施前对模拟方法进行比较,从而支持更明智的系统变革,但还需要更好的有效性证据。现代系统工程和系统思维技术有可能为重新设计适合老年人复杂需求的服务提供信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Age and ageing
Age and ageing 医学-老年医学
CiteScore
9.20
自引率
6.00%
发文量
796
审稿时长
4-8 weeks
期刊介绍: Age and Ageing is an international journal publishing refereed original articles and commissioned reviews on geriatric medicine and gerontology. Its range includes research on ageing and clinical, epidemiological, and psychological aspects of later life.
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