NR-534 Week 3 Discussion: Open and Closed Systems Impact of Decision Making Within (GRADED A)
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Course
NR 534
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Chamberlain College Of Nursing
Facilitating: Over the next five weeks (3-7) you are engaging in group forums within which you explore issues related to weekly lesson topics. For one of these you will assume role of facilitato r and the remainder of the weeks you are a participant. Your role as facilitator has specific guidelines...
nr 534 week 3 discussion open and closed systems impact of decision making within graded a
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NR 534
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NR 534 Week 3 Discussion: Open and Closed
Systems Impact of Decision Making Within
Professor McDermott and Group,
Our lesson this week goes into great detail explaining the differences between systems theory and
systems thinking and how this theory applies to system-based practice. There are three specific types of
systems as pertains to our learning. These systems are closed, open and complex adaptive systems. An
example of a closed system would be a facility that has all services occur within the boundaries of that facility.
It is independent and autonomous and never communicates outside their own boundary (CCN, 2018). This
type of system is very rare, especially in the US. If the hospital has materials, food or supplies brought in, this
must have required outside communication and therefore would not be a completely closed system. An open
system is one that includes outside input, to include payer systems, staff and receives materials and goods
from outside sources (CCN, 2018). This is very common for todays healthcare institutions. Complex adaptive
systems tend to be very diverse and are parts of larger systems that demonstrate collaboration and
communication within networks of the community (CCN, 2018).
Organizational levels can then be broken down into three groups, micro, meso and macro (CCN, 2018).
Micro includes frontline staff working on the individual units, meso are middle level managers and directors
who have impact on how well the individual departments perform and the macro level are considered the
senior executives and are responsible for how well the entire facility functions as a whole (CCN, 2018).
An example of this can be seen in the emergency department (ED). When the ED nurses and providers
receive a critical patient, communication must be efficient and effective to deliver quality of care to save the
patient’s life. This is an example of micro communication at the horizontal level. The manager or director is
responsible for the department and staff having the necessary training and equipment to care for the critical
patient. This may include advocating for hypothermia protocol to be implemented after spontaneous return of
circulation for post code patients, which by evidenced based practice, gives the patient the best possible
chance of recovery. This is an example of macro communication and vertical decision making. An example of
system wide is the patient then moving to the intensive care unit (ICU) and making a full recovery, the patient
is then sent home and communicates the quality of care they received to friends and family. The quality of care
spreads throughout the community increasing the likelihood of other patients using the same facility. This in
turn generates revenue to the organization, which maintains its viability.
At our facility, the chief nursing officer (CNO) and/or other senior executives in conjunction with the
department directors reach out to the patient to invite them to a life savers banquet, which highlights the
efforts of all staff involved in their recovery. Also invited are EMS paramedics and EMT’s, their chiefs, the
dispatch operator if applicable and all staff involved in the care. The staff involved are presented with a plaque
describing the event with the date. It is an honor to receive and has been a successful event with community
involvement for several years.
Decisions made starting at the micro level can make or break an entire organization. Without effective
communication, translation is lost. Patient outcomes become affected as well as relationships among staff,
patients and senior executives. Healthcare organizations have the goal to not only treat patients but also
generate revenue, without communication, there is little hope that the organization can remain successful and
subsequently viable. Lack of recognizing this importance will no doubt lead to failure for the organization and
the individuals within said organization.
Becky
Chamberlain College of Nursing (2018). Week 3: Open and Closed Systems: Impact of Decision Making Within.
[Online lesson]. Downers Grove, IL: DeVry Education Group
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