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

Autor:	Aujla N; Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.; School of Psychology and Vision Sciences, College of Life Sciences, University of Leicester, Leicester, UK., Tooman T; Advanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, UK., Arakelyan S; Advanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, UK., Kerby T; Edinburgh Systems Ltd, Edinburgh, UK.; The Usher Institute, University of Edinburgh, Edinburgh, UK., Hartley L; Edinburgh Systems Ltd, Edinburgh, UK., O'Donnell A; Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK., Guthrie B; Edinburgh Systems Ltd, Edinburgh, UK., Underwood I; Advanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, UK.; School of Engineering, University of Edinburgh, Edinburgh, UK., Jacko JA; The Centre for Medical Informatics, The Usher Institute, University of Edinburgh, Edinburgh, UK., Anand A; Advanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, UK.; BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
Jazyk:	angličtina
Zdroj:	Age and ageing [Age Ageing] 2024 Oct 01; Vol. 53 (10).
DOI:	10.1093/ageing/afae238
Abstrakt:	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. (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Geriatrics Society.)
Databáze:	MEDLINE
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