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AFMS Uses Systems Thinking to Keep Everyone on the Same Team

  • Published
  • By Col. Anthony Tvaryanas and Peter Holstein
  • Air Force Surgeon General Public Affairs
A system is a collection of parts, each with particular characteristics and relationships to one another, which together produce something of value. A common example is a sports team, designed and managed to operate at peak effectiveness.

Imagine a medical system designed and managed to operate like a sports team, comprised of team members possessing particular characteristics, but working in conjunction to complement each other. To support adoption of the Trusted Care model, the Air Force Medical Service is developing a similar approach to health care management and delivery.

“In sports, every member of a team has their own skill set, like finesse, speed or power. Teams draw up plays to define relationships and place a premium on avoiding errors,” said Col. Anthony Tvaryanas, a Human Systems Integration Technical Advisor at Wright-Patterson AFB. “In health care, a team of doctors, nurses, technicians and support staff use their skills in a complimentary way to take care of the patient.”

Tvaryanas said successful systems are deliberately engineered to provide optimal outcomes; however, this does not always occur.  “Too often in health care, we design complex systems on the fly. Health care workers create or change processes as they go along, and that becomes the standard way of doing things.”

This lack of consistent planning can create risk in complex medical environments, according to Tvaryanas. In response, the AFMS is seeking to transform its culture to focus on deliberately designed and tested processes that predictability deliver optimal, patient-centered health care outcomes.

“We need to ask ourselves if systems are designed to provide maximum value to the patient,” said Tvaryanas. “This means quality and safe care, but also considers cost, time and convenience from the patient’s perspective.”

The first step to apply systems thinking in the AFMS is to define consistent, system-wide processes for all 75 Air Force military treatment facilities. “Right now, we focus on the uniqueness of each facility, but we need to focus on how they are the same,” said Tvaryanas. “We are gradually applying system thinking principals in conjunction with other elements of Trusted Care.”

The system thinking approach will help the AFMS minimize errors and achieve predictable results across the entire AFMS health system. “When a medical Airman makes a “good catch” that prevents a potential problem, we want to be able to capture and replicate that across all Air Force facilities,” said the colonel.  “We also want to understand why the problem arose, and eliminate the conditions that created it. That is only done by permanently changing some aspect of the system.”