Japmehr K Sandhu

Conference 2023 Presentation

 

Project title

Outbreaks and Healthcare: The Systems Thinking approach

 

Authors and Affiliations

Japmehr Sandhu1, Ganeev Singh2

1. General Medicine, Government Medical College, Amritsar, India
2. General Medicine, Sri Guru Ram Das Institute of Health Sciences, Amritsar, India

 

Abstract

Background

The pandemic has shone light on the lack of understanding of interdependence, complex relationships and systemic decision making in our population. This has made the need for a Systems approach invaluable where each individual in a complex system is well aware of their responsibilities and the impact of their decisions and actions.

Methods

To highlight the importance for a Systems Thinking approach to outbreaks in healthcare- especially keeping the COVID-19 pandemic in context, an initial framework was formed via dynamic mapping. It was then discussed and amended suitably post consultations with experts of public health.

Results

Formation of a dynamic map lead to identification of a need for a unanimous understanding of the outbreak, it’s connections, causes and consequences. Multiple interconnections were struck with unintentional as well as intentional consequences. The former included increased malnutrition in children because of no midday meals, higher reports of domestic violence, lapses in chronic disease treatments and closing down of medically charitable organizations. The latter included a delay in elective surgeries and outpatient care. Tracing all these issues in a reverse domino pattern, lead to identification of the appropriate leverage points.

Conclusions

With respect to COVID-19 pandemic, the personal protective equipment served as the first leverage point. The second leverage point of tracking infected people was however, considered debatable. The Pathway formed, provided a cohesive look to the healthcare system that allows us to prospectively evaluate, act and coordinate actions and managements in a more pragmatic manner.