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Table 2 An illustrative example of the application of SSM tools

From: Re-energising the way we manage change in healthcare: the case for soft systems methodology and its application to evidence-based practice

Root definition

A system to implement evidence-based guidelines, by using a hospital-level generic process, to provide patients with best available and equitable care, owned and managed by hospital administrators, healthcare professionals and policy makers.

PQR formula – Do P by Q in order to achieve R

 P Implement evidence-based guidelines

 Q by using a hospital-level generic process

 R in order to provide patients with best available and equitable care.

CATWOE

 Customers

Patients, healthcare professionals

 Actors

Healthcare professionals, administrators

 Transformation

Guidelines implemented and adhered to

 Worldview

Evidence-based guidelines support best available and equitable care

being delivered to patients

 Owners

Policy makers, administrators, healthcare professionals

 Environmental

Inner and outer context - multiple and interacting factors

constraints and enablers

Three E’s – Criteria for assessing the outcomes of the improvement intervention, including:

 Efficacy – does the intervention lead to higher adherence to guidelines?

 Efficiency – is the improvement being achieved with minimal use of resources?

 Effectiveness – does the intervention help achieve higher quality of care for patients?

  1. An illustrative example of a Root definition, a PQR formula, CATWOE and the three E’s applied to the problem of getting evidence into practice using evidence-based guidelines