Management decision
The Stages of TSI
There are three stages in the TSI process, namely creativity; choice; and implementation. In the creativity phase, different aspects are revealed in terms of the better functioning of an organization (1991). The choice phase indicates several options or methodologies that can potentially help the organization’s dilemma as discussed in the creativity phase. The implementation phase applies the methodology that was selected to induce suggestions for changes.
Seven principles
- organization complexity
- range of system metaphors
- metaphors linked to system methodologies
- combine metaphors and methodologies
- evaluate strengths and weaknesses
- iterative across phases
- facilitative
Creativity
At the step of creativity, the dilemma and its circumstances are introduced through the utilization of the appropriate system metaphors. However, in this paper the perspective is determined through the utilization of the system category and metaphor. More often than not, in different stages of the project the system categories and metaphors of dilemmas are not the same. As a result of the brainstorming session within our group, we thought at the start of the problem, its dilemma was one corresponding to social and culture metaphors. To test this perspective, we scheduled an interview for the hospital staff and the patient, and the results supported the conclusion of our group.
Choice
At this step, SOSM, which suited perfectly to the category and metaphor of the dilemma, was selected on the basis of results of the creativity step.
Implementation
At this stage, the group utilized SOSM to direct the problem investigation and give us answers or solutions.
QUESTION # 1
In the last five years, the medical profession has seen so much activity in terms of massive changes in the appropriate learning tools that must be used in critical situations. These changes range from changing perspectives of patients to different learning strategies. These activities are expected to continue over the course of the next ten years.
Reflective practice coupled with the Soft Systems Methodology (SOSM) represents one of the leading learning and problem solving tools in the medical profession in terms of the effectiveness and efficiency. It has also one of the widest following among other learning and problem solving tools made possible through a global network of learning tools and strategies.
Reflective practice uses in principle the Soft Systems Methodology (SOSM), and this approach has allowed this learning and problem solving tool to pursue an integrated approach in handling critical situations.
However, the main questions remain. Does this learning and problem solving tool produce more effective results than the others in terms of handling critical situations? Do the adopted learning tools allow differentiation in the culture of the medical profession to influence choices of patients?
The critical incident that happened to me took place when I was rushed into the emergency department of Philippine General Hospital and presented a very swollen and painful right ankle. This had happened three days ago while I was playing netball. I was able to walk on it at the time although walking with a limp. One day, however, as I woke up and put my foot to the floor, I experienced a lot of pain and collapsed on the bed suffering to a temporary loss of consciousness.
The Nurse Care Practitioner failed to take an apposite history that would have
led to a diagnoses (or differential diagnoses). There were parts of the history
that were omitted but they were vital parts in this situation. What he failed to
ask was the presenting complaint. He made a judgment that it was just another
ankle injury, asked for the past medical history, examined the ankle and told me
it was not broken, go home, rest it and take some painkillers.
I
replied with a very surprised look and said ‘I know it’s not broken, I have come
about the reason for me losing consciousness’
A very disturbed Nurse Practitioner entered into a confrontational dialogue with
me and proceeded to blame everybody else including the receptionist. I burst
into tears and rushed out of the department.
QUESTION # 2
Cultural Metaphor
A. Biological Issues
The real cause of my unconsciousness was yet to be determined. Apparently, the ankle injury occurred as an end result of me losing consciousness. It is important first to determine the main health problem that’s been bothering me before any specific course of action can be done. This will prevent any further injury that might occur as a result of a wrong diagnosis. The ankle injury obviously was only a secondary issue. The underlying health problem within me can be determined by determining if I had any history of diseases or conditions that can somehow be related to me getting unconscious.
B. Social Issues
It is alarming to know that there are ill-tempered nurse care practitioners who don’t know how to treat patients desperately needing help. These are people whom you entrust to save your life, but instead they even help in aggravating the case. These people need to be re-trained and apprehended since their attitude poses a great danger to the lives of innocent patients.
C. Psychological Issues
Definitely, it is me who’s the one that’s more psychologically shocked than anyone else, based on the treatment I got form that ill-tempered nurse care practitioner. I will always remember the fact that once in her lifetime, a nurse care practitioner, of all people, caused me so much fear and pain at a time I badly needed help. I will also somehow develop a bad impression regarding most nurse care practitioners as a result of this bad experience. On the other hand, we, the general public, would also worry that someday, this incident might also happen to us. Somehow, our trust and confidence with our own medical doctors and health professionals would be diminished a little bit.
SOFT SYSTEMS METHODOLOGY (SOSM) APPLICATION
The soft systems methodology under the pluralist dimension was the one I chose to use as a tool to reflect on my experience of a hospital placement. I found this more appropriate and easy to follow. It also follows points that I will use as a guide to fully reflect on this incident. A danger with using the experiential cycle in this way is that learners do not have a basis for generating solutions to new problems, but have to tackle each new situation as if it were unique. The next stage of development of this course will involve searching for and adopting a clear model of the communication process to form a basis for analysis of reflections on experience. This would complete the learning cycle and help to link the experience to theory in a way, which developed an understanding of the communication process as well as developing competence in specific situations requiring communication skills (1998).
Current thinking in nursing advocates the need for some nurses to be educated in ways that develop their autonomy, critical thing, sensitivity to others and their open-mindedness (1997) There have been many books written on this subject and each author expresses their variations in different ways.
RESULTS AND DISCUSSIONS
A. Feelings
Communication in this incident was paramount. At the time this was taking place I could only feel empathy for myself as I was clearly becoming more upset. The nurse practitioner was acting in a non-professional manner and I felt angry at the fact that he was abusing his position and not following his code of conduct. Contrary to this, there was also a feeling of gratification on my part. Reflecting in action, I knew that if I could make a dialogue with the nurse practitioner, this would put me in a position where I could approach him properly and have the opportunity to examine him. I felt that this situation was not instigated by myself, but I could turn this to my advantage.
I issued my feelings like these because I believed that I had to:
A) Remain in control of the situation. Being in control of that particular emergency situation would enable me to command the respect and confidence of the public. Thus, I would be able to expand my responsibilities through continuous improvement in other aspects of my profession.
B) Gain more confidence and experience. The actions that I laid down in trying to pacify my condition were able to somehow increase my confidence and experience handling unexpected situations like that. As a result, hopefully I would be able to earn more credibility; and
C) Thrive and learn in emergency cases
Evaluation of Feelings
A. Good Points
The good point about my feelings was that a good opportunity presented itself to me to determine my readiness to handle tough situations in case of emergency. Having been neglected by a nurse care practitioner, it would be really tough for me to regain the trust and confidence of that hospital. But as long as an opportunity like these would come along, it’s always nice to take advantage of it.
B. Bad Points
The bad point about my feelings is the fact that I might have developed a bad image on most nurse care practitioners. Therefore, I might have the tendency to refrain from cooperating with them.
QUESTION # 3
Soft Systems Methodology (SOSM) Thinking for Organizational Learning
In lieu of the present developments in systems thinking, there have been significant visions of organizational learning that evolved. A majority of these learning visions are based on the idea that organizational learning is a social process where knowledge is denied instead of being acquired passively. Organization learning, then, transforms into an interactive process. The interaction is being verified through the help of the participants in the organizational learning process such as the Hospital coordinators and the health care personnel. In this framework, high quality of organizational learning would mean the continued guidance and support of the active learning process of the hospital. Obviously, this would call for an intensive and phased guiding strategy (1990).
When in the active pursuit of organizational learning, the interaction of the Hospital management with the public forms an integral part towards its success. Collaboration as a method of organizational learning is gradually being used by most medical organizations nowadays. Through this approach, the general public can learn from the hospital management through the imitation of their techniques in the socialization processes. In the process, the general public is able to obtain the chance to see their own ideas in a different aspect and therefore be able to take alternatives into consideration. The relative effectiveness of this approach is determined with the capability of the public to continuously challenge their pre-acquired knowledge by trying to adapt to the interpretations of the hospital management.
The recent efforts of most hospital management to educate the public in terms of systems thinking would definitely make learning easy for every individual who desires to do so. Also, the growing impact of information and communications technology (ICT) fits in with the larger transformation towards a knowledge-based hospital environment. Most medical institutions are already adapted to ICT. Nowadays, medical institutions are more and more using artificial intelligence systems in order to educate people.
Organizational learning processes in the hospital environment are being influenced by the interaction of two major factors. On the one hand, the instructional factors: the educational philosophy brought about by the medical personnel and its conversion into didactical ideas. On the other hand, organizational factors: the staff, infrastructure and policies related in this area. It is obvious that the hospital must possess a sound vision of policies and the efficient use of the operating budget in order to effectively perform its educative role in society.
Nevertheless, these medical institutions need an interaction between both factors. This is because in order to respond to the new visions of learning, they will eventually transform into a model together with the various aspects of the hospital environment. In return, the general public will have to continuously monitor their limitations and along the process introduce innovations.
CONCLUSION
The results of the analysis carried out on the Soft Systems Methodology (SOSM) indicated very significant effects, even amidst the threats of unrest. Therefore, we could conclude that the Soft Systems Methodology (SOSM)’s role of educating the public could still be expected to increase faster than average.
The review of the capabilities of Soft Systems Methodology (SOSM) revealed very little inconsistencies regarding its strategies in educating the public. This is coherent with its traditional inside-out approach. However, the need to reconcile both the inside-out and outside-in approaches becomes imperative now.
The analysis among the hospital environment as well as the educating capabilities of the medical personnel revealed certain gaps, most of which are biased towards the environment. However, these gaps paved the way towards determining a number of recommended strategic options to secure the competitiveness of the hospital.
Also, the health personnel has to find a balance between adherence to internal forces within the hospital environment and to the changing forces of the environment in order to implement such strategic options in educating the public.
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