This document discusses health service management for medical laboratory students on the topic of health system thinking. It provides objectives for understanding systems thinking principles, WHO health system building blocks, and organizational culture in health care systems. It then defines systems thinking and common system characteristics. It describes the six WHO health system building blocks and organizational culture levels in health care delivery. Finally, it outlines several methods to measure organizational culture in systems thinking and discusses theories of systems thinking evolution.

1. COLLEGE OF MEDICINE AND HEALTH
SCIENCES
Health service management for
medical laboratory students
TITLE -HEALTH SYSTEM
THINKING

2. GROUP - SIX
GROUP MEMBER ID NUMBER
1. BELAY GEBRE ………………….BDU1201099
2. DESALEGN DEGU……………..BDU1201446
3. GETACHEW ALEMNEH…….BDU1201814
4. KALKIDAN JENBERU………..BDU1202106
5. MARSHET TEKALIGN………..BDU1202285
6. MELAT WORKNEH…………….BDU1202354
December 14,2015E.C
BAHIRDAR/ETHIOPIA

3. Objective
 Understand the principle of systems thinking and its scope of
application.
 Understand the key concepts of WHO health system building
block and its principal guidelines.
 To identify the organizational culture in health care system.
 To provide health care professionals with concrete example
of how system theory can be used in analyzing complicated
issues in health care.

4. System thinking
Systems thinking have its origins in the early 20th
century in fields as diverse as engineering, economics and
ecology.
 The health sector has started to adopt systems thinking to
tackle complex sectorial problems such as tobacco control,
obesity, and tuberculosis.
 Systems thinking are an approach to problem solving that
view "problems" as part of a wider dynamic system.
Systems thinking involves much more than a reaction to
present out comes or events. It demands a deeper
understanding of the linkages, relation- ships, interaction
and behaviors among the elements that characterize the
entire system.

5. System thinking cont…
The application of systems thinking in the health sector
is accelerating a more realistic understanding of what
works, for whom, and under what circumstances.
common system characteristics
• Self-organizing – No individual agent or element
determines the nature of the system.
• Constantly changing – systems adjust and readjust
at many interactive time scales.
• Tightly-linked – the high degree of connectivity
means that change in one sub-system affects the others.

6. Common system characteristics cont..
• History dependent – Time delays are under-
appreciated forces affecting systems.
• Resistant to change – seemingly obvious
solutions may fail or worsen the situation.
• Governed by feedback – Systems are controlled
by “feedback loops” that provide information flows
on the state of the system, moderating behavior as
elements react and “back-react” on each other.
• Non-linearity – relationships within a system
cannot be arranged along a simple input-output
line.

7. WHO health system building blocks
There are six WHO building blocks of health system.
Service delivery: a vital element of any health system,
including effective, safe, and quality personal and non-
personal health interventions that are provided to those in
need, when and where needed (including infrastructure), with
a minimal resources.
Any well-functioning health system have the following key
characteristics:- comprehensiveness, accessibility, coverage,
continuity, quality, accountability, coordination….
The health workforce: - all people engaged in actions
whose primary intent is to enhance health. These include
clinical staff, such as physicians, nurses, pharmacists and
laboratory technologist, as well as management and support
staff.

8. WHO health system cont….
 Health information system:- foundation of
decision-making across all health system building
blocks. It is essential for health system policy
development and implementation, governance and
regulation….
 Access to essential medicine :- health system
ensures equitable access to essential medical products,
vaccines and technologies of assured quality, safety,
efficacy and cost effectiveness.
Health system financing: - Health financing is
fundamental to the ability of health systems to maintain
and improve human welfare.

9. WHO health system cont….
 leader ship and governance: - ensuring that
strategic policy frameworks exist and are combined with
effective oversight, coalition-building, regulation,
attention to system design and accountability.

10. Organizational culture
Organizational culture is generally understood as all of
company beliefs, values and attitudes, and how these
influence the behavior of its employees.
Levels of organization of health care systems and
health care delivery
 Self -care is the first level, which is nonprofessional care.
It is performed within the family, and the population
group counts from one to 10 persons.
 Primary professional (medical) care is a care of the “first
contact” of the individual withe the health care service,
which is provided in ambulatory settings by qualified
health professionals (general practitioner-GP, family
doctor, or nurse)

11. Organizational culture cont…
Secondary or intermediate level of care is general
specialist Care, delivered by “general specialist doctor”
for more Complex Conditions, which Could not be
resolved by the general practitioner or primary
professional care level.
Tertiary or central level of care is sub-specialist care
including highly specific services, which might be
delivered in specialized institutions or by highly
specialized health professionals & sub-specialists.
Internal factor affecting organizational culture are:-
leadership, learning, communication… & external factors
like political, economic, social and technological…

12. Methods to measure organizational
culture in the system thinking
Organizational culture could be defined as the atmosphere that permeates the workplace and the
way in which employees behave and relate to each other
The following are methods to measure organizational culture in system thinking
1. Survey:-Survey is defined as the act of examining a process or
questioning a selected sample of individuals to obtain data about a
service, product, or process. is particularly useful tool for all those
companies that wish to innovate and improve their practices and strategies,
through the collection of ideas and opinions of their own employees.
Questionnaires designed to review the beliefs behaviors and practices of
company vs. how they are perceived by the employees of the organization
2 Program & Event KPIs (Key Performance Indicators):- measure the
health of culture is to track attendance at social events or wellness campaigns over
time.
3 Anecdotes:- Anecdotes are stories or tales told with regards to an already
ongoing discussion. An anecdote is a form of a brief story that comes up during a
conversation in the form of reference.Make a point to review the anecdotes in
leadership meetings weekly, monthly, or quarterly. Some examples of places a
person can collect these include exit interviews, Glass door reviews, and social
media posts.

13. Methods cont…
4. HR (Human Resources) Work force KPIs (Key
Performance Indicators) :-Tracking HR KPIs is key
to understanding important cultural shifts (positive and
negative). These KPIs include turnover rate, rates of
absenteeism, internal promotions, and referrals.
5. Kudos - Analytics and Insights:- kudos refers
to praise given for achievement. measure key
components of culture, like the value-based behaviors
just discussed the collaboration between people and
departments, and contributions to morale through the
recognition and appreciation messages shared on the
Kudos platform.

14. Methods cont…
6. Tracking behavior:- Tracking the prevalence of the
behaviors associated with values can be a good
indicator of culture’s strength.
7. Business KPIs (key performance indicators):-
Tracking business KPIs in conjunction with efforts to
improve culture can also provide valuable insight. Work
with finance team for data like:
- Customer retention rate, is the percentage of
existing customers who remain customers after a given
period
- Customer satisfaction (Net Promoter Scores)
- Revenues
-Sales

15. System thinking theories
Evolution of Systems Theory:- The notion of thinking about
things in wholes rather than parts, have been discussed by early
philosophers.
1. General systems theory (GST) was developed by a
biologist, named Ludwig von Bertalanffy which refers to
“a general science of ‘wholeness’.According to
Bertalanffy, it is important to look at systems as a
whole, because in the past, science tried to explain
observable phenomena by reducing them to an
interplay of elementary units investigable
independently of each other. in short ‘systems’ of
various orders not understandable by investigation of
their respective parts in isolation

16. System thinking theory cont….
2. Complex-Adaptive Systems:- Some systems, with
various levels of hierarchies, networks, and layers of
complexities, have the ability to learn to adapt to its
changing components and environment. The complex-
adaptive systems (CAS) “are made up of interacting
components (the system) whose interactions may be
complex (in the sense of nonlinear) ”.CAS are also
sometimes referred to as, complexity science.
• Like all systems, complex-adaptive systems start off as a
simple system. According to Norberg and Cumming, The
story of how life on earth developed gradually.

17. Thank you