systems analysis

Systems Analysis Iris Thiele Isip Tan MD, MSc, FPCP, FPSEM

Associate Professor, UP College of MedicineChief, Medical Informatics Unit

28 May 2013Monday, May 27, 13

Systems are created to solve problems

The Systems Approach is an organized way of dealing with a problem

“Lego gears” by Sonny Abesamishttp://www.flickr.com/photos/enerva/4302079406/

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http://www.flickr.com/photos/enerva/4302079406/

http://www.flickr.com/photos/enerva/4302079406/

A system is a collection of components that work together

to realize some objectives.

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A health system consists of all organizations, people and actions whose primary intent is to

promote, restore or maintain health.- WHO

Sick patient

Department of Medicine

Well patient

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http://www2.fraserhealth.ca/media/how%20hazardous%20is%20healthcare%202.jpg

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Systems analysisHelp manage and reduce risks by identifying hazards

so they can be controlled through good design

Completely understand the system

- Karsh & AlperWork System Analysis: the Key to Understanding Health Care Systems

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Key systems terms

System element: anything that is part of a particular system Ex. Medication administration system - patients, medications, administering nurses, administration record, stock room, patient room, identification band

System attribute: perceived characteristics of the system Ex. error-free, time consuming, chaotic, high quality

System boundary: zones between one system and another (time, space, process or hierarchy)

System input: anything necessary to energize the system Ex. nurses who administer drugs, physician orders, pharmacy dispensing

Transformation: processes that turn inputs into outputs; actions in the system Ex.The action of administering medication to a patient is a transformation of an input (i.e medication) into an output (i.e. a medicated patient).

Outputs: results of transformation

Unit operation: simple input-transformation-output process that does not contain any other input-transformation-output processes

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Step 1Decide what system will be the subject of the analysis.


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Step 2Produce a preliminary work system map.

The purpose of this map is to identify inputs and outputs relevant to the system.


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Shinder et al. BMC Health Services Research 2012

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• What technology is used

• What policies and rules (internal to the unit and external to the organization) are involved in determining how, when, why or where a step is executed

• What supervision is involved in the step

• What environmental factors (e.g. lighting, noise, vibration) might affect the step or how it is executed

• What other people might influence the execution of this step or determine whether the step takes place

• What information is needed for the execution of this step

Work system map


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Step 3Use the preliminary work system map to determine

who should be represented on the team that will carry out the analysis.


Team membersCommunicate with frontline employees

Provide inputsReceive outputs

Assume responsibility for various parts of the processExpert in systems analysis to guide the process

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Step 4Conduct an initial scan of the system.

First, study the preliminary work system map and gauge accuracy.

Second, scan the horizon.


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• What other people take part in this system? Where do they come from: other units or temporary agencies? Are other people who provide information relevant to the system?

• What other technologies, tools or equipments are used in this process? Where do they come from? Who is responsible for maintaining them?

• What other policies or regulations are relevant to the steps in this process? Who develops them? Who enforces them?

• What other organizational variables, such as reward systems or communication systems, affect the performance of this process? Who is in charge of this?

Guide questions for initial scan


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• What other jobs or tasks affect the performance of the steps in the process? Who carries out these jobs? Who is responsible for them?

• What other environmental factors impact the system?

• What people, technologies, tools, equipment, processes and/or jobs are impacted by the process under study?

Guide questions for initial scan


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Scan the horizon ...Investigate any pending decisions, policies or

regulations, internal or external to the organization, that could impact the system.


Determine if any internal process changes are planned and if any new technologies

are scheduled for implementation.

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Step 5Put boundaries on the system under study.

process, hierarchical, temporal and spatial


Step 6Determine performance expectations

for each step in the system.safely, quickly, within 15 minutes

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Step 7Formal data collection

Revise and update the work system map.Gauge the current performance of the system.Determine baseline measures that will be used

to evaluate the effectiveness of redesign.


Step 8Analyze the collected data.

Identify weaknesses, variances, and any series of events that could cause the system to fail.

Prioritize the identified problems for redesign.

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Step 9Develop a hazard control matrix.


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Step 10Conduct a system analysis on the redesign hazard-

control ideas that the team develops.Once completed, pilot testing and implementation can begin.


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systems analysis

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