The ultimate goal of healthcare systems is rather straight forward – Better care for all. Modern healthcare delivery, however, involves several processes with complex interactions and often requiring multiple systems. The ultimate care that a patient receives has become hugely dependent on processes and systems that work all the time. However, it is known that systems that work all the time do not just happen – they have to be planned, designed and built. Unlike the engineering sector, design capacity in healthcare is minimal. The challenge, therefore, is how to support healthcare practitioners in designing systems that work with all its human elements and where to start. In this paper we examine the current literature and identify opportunities for a simple diagrammatic language that enables healthcare practitioners to describe care delivery processes and systems in ways that are intuitive, systematic and engender shared understanding.
We reviewed the academic literature from Web of Science and Scopus from 2000 to date. Several search term combinations were used that resulted in 300 papers from Web of Science, 114 from Scopus with 5 duplicates. The entire process involved two levels of filtering, then scanning, sorting, reviewing and analyses.
The result of this review suggests that not only does healthcare lack the capacity to practice design but there has also been very little academic research specifically focusing on a systematic approach to and the tools for designing complex healthcare systems. We also find that the place to start is to give healthcare practitioners a way of describing systems and processes that is specific to their domain. The result shows several diagramming languages and techniques that are taken from engineering and other sectors and applied to healthcare often in an ad hoc manner.
The importance of ensuring that healthcare works well as a system is becoming more and more obvious. This is because it may be appreciated that having the best doctors, best medication, and best technology in a badly designed system will lead to bad experiences for patients. Traditionally, healthcare research has focused hugely on developing medications and diagnostic technologies. With the emergence of the importance of well-designed systems that balance the needs of professionals, patients and politicians (funders), this may present significant opportunities for researchers and practitioners in human factors and complex systems.