Principles of Health Sciences
Health Care Systems
Systems Theory
Name:
Date:
# of Students:
# of IEP Students:
Program: Health Sciences
Major Content: Health Care Systems
Unit Title: Health Care Systems
Age/Grade Level:
# of GSSP Students
9-12 grade
# of LEP Students:
Course Principles of Health Science
Lesson Length: 5 days
Lesson Number and Title: Systems Theory
Course Task Number: 10, 11
Context
Students, as potential health care professionals, need to understand that any business, organization, or family can be
called a system. The health care system is a complex system that can best be understood by using the systems theory.
Systems theory is a way of studying a system as one unit, instead of individual parts and helps to focus on the primary
mission, or purpose, of the system. By examining a system as a whole, it is easier to understand how each part
contributes to the overall mission. Additionally, the systems theory makes it easier to pinpoint flaws in the system.
Objectives
Students will be able to:
1.
2.
3.
4.
5.
6.
7.
8.
9.
Describe systems theory and its components.
Construct a general systems model using inputs, throughputs and a feedback loop.
Construct a health care delivery system model.
Predict where and how factors such as cost, managed care, technology, and aging population, access to care,
alternative therapies, and lifestyle behavior may affect various health delivery system models.
Predict outcomes as interconnected components of modified health care delivery systems using the same client
procedures.
Design a system analysis process that evaluates the following outcomes: client satisfaction, productivity, cost
effectiveness, and efficiency.
Analyze the cause and effect on health care system change based on the influence of technology
epidemiology, bio-ethics, socioeconomic and various forms of complimentary medicine.
Incorporate HOSA using competitive event guidelines, leadership and team skills in all content areas
Meet above objectives to 80% mastery or above
Connections
Core Content
PL-HS-3.1.2 Students will compare products and services based on various factors (e.g. price quality, features,
etc.) to consider when making consumer decisions. DOK 3
PL.-HS-3.1.5 Students will describe the relationship among private, public and nonprofit health agencies and
compare the services provided by each agency: • private health care facilities (e.g., private physicians,
nursing homes, rehabilitation facilities) • hospitals • public health departments and clinics • DES
(Disaster and Emergency Services) • Family Resource Centers • Medicare/Medicaid nonprofit health
organizations (e.g., American Heart Association, American Red Cross, American Cancer Society)
Kentucky Skill Standards
Health Care Delivery System 3.21 Construct a health care delivery system model.
Health Care Delivery System 3.31 Diagram the interdependence of health care professions within a given
health care delivery system, pertaining to the delivery of quality health care
Health Care Delivery System 3.32 Design system analysis process that evaluates the following
outcomes: client satisfaction, productivity, cost effectiveness, and efficiency
Asses
Assessment Plan
In tabular format, organize how each objective will be assessed. Include copies of assessment instruments and rubrics (if
applicable to the lesson plan).
Objective
Number
Type of
Assessment
1-8
formative
1-8
summative
Objective/Assessment Plan Organizer
Depth of
Description of
Knowledge Level
Assessment
Questioning, bellwork
responses
2
Written exam
2
Adaptations and/or
Accommodations
Prompts / cues
Peer learning groups
Open Response
Resources, media and technology
 Diversified Health Occupations by Louise Simmers
 Student Handouts
 Adapted from North Carolina Health Science Resources
http://www.ncpublicschools.org/cte/health_occupations/course-descriptions.html
 PowerPoint “Healthcare Systems – Systems Theory”
Accommodations for Special Populations
Procedures
After introducing topic and reviewing PowerPoint, choose from the following reinforcement activities
Handout Activities
 Complete the Systems Theory organizer while viewing the PP
 Health Care Analysis
Project Based Activities
 Healthy Living Clinic Game
 Designing a Health Care Facility Game
Research Activities
 Non-Profit Organization Investigation
 BioMedical Debate or Researched Persuasive Speaking using HOSA Competitive Guidelines found at
http://www.hosa.org/natorg/sectb/index.html using the following or similar topic

“All Americans Deserve Access to Preventative Medicine”
Introduction
Allow students to brainstorm and discuss a list of positive and negative points of the American health care system.
Presentation
Health Care Systems


System Definition
A system is an orderly and complex arrangement of parts.
There are many types of systems:
 Physiological Systems: The digestive system, neurological system, and
 Economic Systems: Capitalism and Socialism
 Computer Systems: Network, mainframe, and PC computer systems
circulatory system
Systems Theory
 Systems, in general, have the following elements:
o Input: Resources entering the system
o Throughput: Work done on those resources used to produce a product
o Output: The final product
o Feedback: Information taken from the output to control or correct errors in throughput
System Components
 Example of Payroll System
o Input: Information entered on the number of hours worked and the pay rates of each employee.
o Throughput: The work done by the computer to calculate the amount of pay, and the payroll taxes.

Example of Payroll System
o Output: The paychecks and payroll reports.
o Feedback: Check figures provided to show that the calculations were correct (number of employee
paychecks processed, total payroll paid, etc.)
Systems Thinking
 One approach to problem solving is systems thinking, or systems analysis.
 It expands analysis to include the system as a whole, and the relationship of interconnected parts.
 It recognizes that the whole is greater than the sum of the parts.
Backwards Thinking
 Systems thinking involves backwards thinking.
 It begins with the end objective, and works backward, analyzing the relationship of each component to the final
objective.
Example of Backward Thinking
 If the objective of a team is to produce a low cost but high quality medical product, then backwards thinking
would start with the final end product, then evaluate each input and throughput to see if:
 It was necessary to the manufacture of the product
 It increased quality
 It reduced cost
Advantages of Systems Thinking
 Is a global approach to problem solving
 Helps employees “see the forest for the trees.”
 Enables team members to understand the big picture.


Advantages of Systems Thinking
Focus: Systems thinking allows problem solvers to identify cause and effect relationships. It focuses on the
activities necessary for change.


Advantages of Systems Thinking
Teambuilding: Systems thinking helps team members identify the objective of the team, and understand how
their individual activities contribute to that objective.
The American Healthcare Delivery System
 The American healthcare delivery system is one of the largest and most complex systems in the world.

Inputs
o Human and financial resources
o Patients

Human and Financial Resources
o
o


Human resources are the professionals who diagnose and treat patients, as well as the personnel
who provide support services.
Human resources consist of the doctors, nurses, respiratory therapists, certified nurse assistants,
administrators, dieticians, housekeepers, and accountants that work within the healthcare delivery
system.
Patients
o Patients are the individuals who enter the system for preventive, diagnostic, or treatment healthcare
services.
Entry Point
o How does a 55 year old male with vertigo know where to enter the system?
o An ambulance?
o A general practice doctor?
o A neurologist?
o The emergency center?
o A well-defined entry point provides:
o Triage (screening to determine priority of treatment)
Throughput
 Throughput is the step where the patient is treated
o Resources Used in Throughput
o Educational resources
o Treatment resources
o Financing mechanism
o Management and control
o Information and feedback systems
o Educational Resources
o Medical schools
o Nursing schools
o Public health education
o Preventive healthcare education
o Treatment Resources
o Doctors
o Nurses
o Hospitals
o Outpatient clinics
o Well baby clinics
o Etc.
What kinds of services are provided in “throughput”?
 Preventive - healthcare services designed to keep the student well
 Diagnostic - healthcare services to find out what is wrong with the patient
 Treatment - healthcare services to cure the patient
Financing Mechanism
o Someone has to pay the bill!
o Who pays?
o The patients themselves (self-pay)
o Employers
o Private insurance companies
o Medicare
o Medicaid
o The health insurance industry itself
 Self-pay
o Some patients pay for their own healthcare. These are the self-employed, uninsured employed, and
the unemployed.
 Employers
o Many companies provide employee health insurance. The benefits vary widely. Most firms require that
the employee pay a portion of the premium.
o Almost all firms require cost sharing through co-payments at the time of service.
o As healthcare costs continue to increase, it appears that the employee will pay a larger and larger
percentage of total health insurance premiums.
 Private Insurance
o Some people purchase individual or family policies from health insurance carriers.


o These are usually more costly than the group insurance contracts purchased by employers.
o In addition, coverage is often limited, and some individuals are unable to qualify for coverage.
Medicare
o Medicare is a federally funded program that pays for some healthcare products and services for those
sixty-five years of age and older.
Medicaid
o Medicaid is a state-funded program that pays for some healthcare products and services of the poor.
o Benefits, and enrollment criteria vary dramatically from state to state.
The Healthcare Industry
 Many healthcare providers, most specifically hospitals, are expected to provide charity care in return for nonprofit exemption from income and property taxes.
 Most hospitals also have large amounts of bad debt.
 Many hospital emergency centers, for example, collect less than 50% of billings.
 Ultimately, the consumer pays these costs.
National Health Insurance
 In future years, it is possible that the government will replace the many mechanisms currently used to pay for
healthcare by some kind of universal financing mechanism.
 What form this mechanism will take remains to be seen.
Management and Control Mechanisms
 The American healthcare system has many management and control mechanisms.
 These include private and public planning and regulatory agencies, licensure bodies, and legislative mandates.
Information Systems
 Control is ineffective without feedback.
 Information systems include the financial and cost accounting systems used by hospitals and other healthcare
organizations.
Output
Output is the product of the system.
 How do you think we should define the product offered by the healthcare delivery system?
 Possible Outputs
 A patient?
 A hospital admission?
 A patient day?
 An individual service like an appendectomy?
 A healthy community?
 Some other definition?
The healthcare delivery system is like a mobile
 Movement or pressure on one component exerts pressure on others.
 Example
 Successful pressure to reduce costs (one barrier to entry) will affect the volume of patients entering the system
(input) and the number seen by the system (throughput).
 Example
 Greater volumes of patients entering the system (input) and being seen by the system (throughput) could
cause the finance mechanism (another component of throughput) to flounder or fail.
 Example
 More resources spent for prevention will decrease resources needed for diagnosis and treatment, both
components of throughput.
Summary
 Discussion Question 1
 Define the word “system” and give several examples of systems.
 A system is an orderly and complex arrangement of parts.
o Examples of systems:
o Physiological Systems: The digestive system, neurological system, and circulatory system
o Economic Systems: Capitalism and Socialism
o Computer Systems: Network,
mainframe, and PC computer systems


Discussion Question 2
What are the four components of a system?
o System Components
o Input: Resources entering the system
o Throughput: Work done on those resources used to produce a product
o Output: The final product
o Feedback: Information taken from the output to control or correct errors in throughput


Discussion Question 3
Explain what “backwards thinking” is as it relates to systems:
 Backwards Thinking
 Systems thinking involves backwards thinking.



It begins with the end objective, and works backward, analyzing the relationship of each component to the
final objective.
Discussion Question 4
The healthcare delivery system is like a mobile. Pressure or movement exerted on one component exerts
pressure others.
o
o
o
o
o
o
o
Give an example:
Example
Successful pressure to reduce costs (one barrier to entry) will affect the volume of patients entering the
system (input) and the number seen by the system (throughput).
Example
More resources spent for prevention will decrease resources needed for diagnosis and treatment, both
components of throughput.
Example
More resources spent for prevention will decrease resources needed for diagnosis and treatment, both
components of throughput.
Impact
Refinement
1. What did your impact analysis tell you about how your students learn?
2. What did your impact analysis tell you about the success of the strategies you used?
3. How useful were the assessments in terms of student learning?
4. What resources and/or personnel might assist you in improving student achievement?
5. How will you differentiate instruction so that all students achieve?
6. How will you differentiate instruction for students who easily achieved the performance criteria and need to
move forward?
Systems Theory Organizer
Directions: Complete the following graphic organizer as you view the PowerPoint on Systems Theory
Inputs
Throughputs
Outputs
Health Care System Analysis
For health care facilities to meet the goal of providing
quality patient care in a cost effective manner, all
components of the system must function effectively.
Use the illustration of a health care system to answer the
following questions.
1. There is a severe shortage of nursing assistants at
the long term care facility in which you work.
What component(s) may be affects and how?
2. There is an unusual high number of hospital acquired infection at your health care
facility. Using backward thinking in the system diagram, what component(s) might be
to blame?
3. The fiscal (yearly) budget for your hospital has steadily been in the red. Using the
components of the systems theory, describe 3 possible reasons for the loss of income.
a.
b.
c.
4. Patients have become increasingly dissatisfied with the quality of care at your hospital.
Examine each of the components of the system and to identify 3 possible reasons.
a.
b.
c.
5. Due to the budget cutbacks at your hospital, supplies have been severely limited.
What effect could this have on the output?
Designing a Health Care Facility Game
PROJECT ASSIGNMENT
 Working in your assigned group, you are to design a board game related to the health care
delivery system.
 The game will be modeled as a health care facility (e.g. Washington General Hospital)
 Players will play as patients making their way from illness to wellness. Game should progress
as patient with symptoms seeking diagnosis and treatment. Scenarios can be written for
complications, refusal of insurance to pay, loss of job & insurance, hospital acquired infection,
referral to specialist, etc.
 The game must have a creative name and include as many facts as possible from this unit.
 The game must have written directions and rules for playing.
 If you need dice or game cards, you must make these.
 It must be colorful and fun!!
 Poster board for each group will be provided, as well as markers.
 This will count as a project/test grade.
_____________10 points
Creative name for game.
_____________10 points
Colorful game board and playing pieces if needed.
_____________10 points
At least 15 facts or terms included in the game
_____________10 points
Written directions and rules.
_____________10 points
Oral Presentation (Be creative)
** Your group will have 10 minutes to complete your oral presentation on _______________.
Complete this form and turn in at the end of class
.
Name ____________________________________
Date _________________________
Health Care Facility Game Progress Sheet
Members present in group:
Name of game:
Person(s) who is to write and present the rules for the game:
People who designed the game:
Person(s) who will present the commercial for the game:
List 10 health care delivery system facts included in your game:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
What did each person contributed to the project today. Be very specific. Is anyone supposed to
bring something from home for the next class?
Systems Theory Test
1. Resources entering a system are known as:
a. input
b. throughput
c. output
d. feedback
2. Human resources, the professionals who diagnose and treat patients, as well as the
personnel who provide support services, are examples of:
a. input
b. throughput
c. output
d. feedback
3. When you begin with the end objective, and works backward, analyzing the
relationship of each component to the final objective, you are:
a. developing the mission statement of the organization
b. identifying budget abuses
c. researching new policies and procedures for the organization
d. using backwards thinking to identify areas that may need improvement
4. The government funded insurance program which usually includes individuals with
low incomes, children who qualify for public assistance, and individuals who are blind
or physically disabled is:
a. Medicare
b. Medicaid
c. Preferred Provider Organizations
d. Health Maintenance Organizations
5. This government funded insurance program is for any citizen age 65 or older.
a. Medicare
b. Medicaid
c. Preferred Provider Organizations
d. Health Maintenance Organizations
6. Screening to determine priority of treatment is:
a. observation
b. signs and symptoms
c. vital summary
d. triage
7. The step where the patient is treated is:
a. input
b. throughput
c. output
d. feedback
8. Healthcare services such as vaccinations that designed to keep an individual well are:
a. Preventive
b. Diagnostic
c. Outpatient
d. Treatment
9. Your doctor schedules a blood test and urinalysis. These are examples of what type of
services:
a. Preventive
b. Diagnostic
c. Outpatient
d. Treatment
10. Resources used to pay for health care such as Medicare and private insurance are examples of:
a. input
b. throughput
c. output
d. feedback
Short Answer
11. List and describe 2 qualities of a well-defined entry point.
a.
b.
12. List two advantages of systems thinking.
a.
b.
13. Explain the term “backwards thinking” and why it is useful in a healthcare system.
Principles of Health Sciences
Systems Theory
The largest employer in your town has closed, leaving employees without health insurance.
Approximately 30% of your patients were insured by this employer.
a. Insurance payers are part of which component of the systems theory?
b. Thoroughly explain two possible examples of the affect this will have on the system.
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Score
Criteria
1
Correctly identifies the component
and clearly explains, using details, 2 possible affects on the system.
Correctly identifies the component
and clearly generally explains 2 possible affects on the system.
Correctly identifies the component
and generally explains 1 way possible affect on the system.
Correctly identifies the component
and/or generally explains 1 way possible affect on the system.
0
Student’s response is totally incorrect or irrelevant.
4
3
2
Points
100
80
70
60
0