TY - JOUR T1 - A systems approach to healthcare: from thinking to ­practice JF - Future Healthcare Journal JO - Future Healthc J SP - 151 LP - 155 DO - 10.7861/futurehosp.5-3-151 VL - 5 IS - 3 AU - John Clarkson AU - John Dean AU - James Ward AU - Alexander Komashie AU - Tom Bashford Y1 - 2018/10/01 UR - http://www.rcpjournals.org/content/5/3/151.abstract N2 - Medicine is increasingly complex, involving a highly connected system of people, resources, processes, and institutions. Attempts to improve care involve disruptions to this system, with the potential for wide-ranging consequences, both positive and negative. Despite this, many improvement methodologies are poorly equipped to manage either complexity or risk – instead focusing on discrete interventions whose effects are narrowly monitored. Engineers have long understood that complex problems require a systems view, and that attempts to make things better can themselves introduce new risk into a system. Given this, an engineering systems approach may be of significant value to those trying to improve healthcare. Two fundamental questions emerge from such an approach: what can we do better, and what could possibly go wrong? This paper describes the evolution of a systems approach to healthcare, and explores a recently co-developed framework outlining a systems approach based upon a synergy between healthcare and engineering. ER -