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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.
 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