Using healthcare system archetypes to help hospitals become learning organisations

Abstract

Purpose – Internationally, change in healthcare is often a result of a knee jerk reaction to high-profile adverse events. Alternatively, change is driven by a reductionist set of targets and indicators, which do not reflect the complexity of hospitals. This paper posits that hospitals would benefit from promoting organisational learning, and that system archetypes offer a mechanism for achieving this. It seeks to examine the application of healthcare system archetypes in an Australian hospital.

Design/methodology/approach – Archetypes do not describe any one problem specifically. They describe families of problems generically. Their value comes from the insights they offer into the dynamic interaction of complex systems. As part of a suite of tools, they are extremely valuable in developing broad understandings about the hospital and its environment.

Findings – Diagnostically, archetypes helped the hospital managers recognize patterns of behaviour that are already present in their organizations. They served as the means for gaining insight into the underlying systems structures from which the archetypal behaviour emerges. The application of system archetypes to the strategic analysis of the hospital case reveals that it is possible to identify loop holes in management's strategic thinking processes and it is possible to defy these fallacies during policy implementation as illustrated by the results of the archetype simulation model. In this study, hospital executives found that policy modification helped to avoid such pitfalls and avoid potentially cost prohibitive learning had these policies been implemented in practice.

Originality/value – The paper demonstrates how system archetypes were deployed within a hospital to improve organizational learning, and provides an approach that may be deployed in other large complex health care organisations.