Search results

A whole‐systems approach, which seeks to optimize an entire system for multiple benefits, not isolated components for single benefits, is essential to engineering design for radically improved sustainability performance. Based on real‐world applications of whole‐systems design, the Rocky Mountain Institute (RMI) is developing educational case studies to help engineers expand their whole‐systems thinking. The purpose of this paper is to evaluate the effectiveness of these case studies in multiple sections of a first‐year engineering course.

The comprehension of whole‐systems principles by 165 first‐year engineering students at Clemson University was evaluated through surveys and open‐ended questionnaires, before and after introducing the educational case studies.

The pilot study results show that introducing the case studies improves students' consideration of several essential whole‐systems design concepts. The case studies were particularly effective in strengthening student consideration of the clean sheet approach, integrative design, design for multiple benefits, optimization of the entire system, and the possibility of drastic efficiency increases with current technology.

This study was conducted at a single institution and with a fairly homogeneous group of students. These factors should be considered when interpreting the implications of the findings for other groups.

This preliminary research shows that case study examples like these can help increase consideration of the whole‐systems design approach that leads to improved sustainability performance.

This article explores the front‐line experience of a two‐tier shire county, Nottinghamshire, in using a whole‐systems working approach to the promotion of independence and well‐being for older people. Nottinghamshire has been one of the eight national pilot sites for LinkAge Plus. The experience of managing a whole‐systems approach in practice in implementing LinkAge Plus is explored. The importance of ensuring the systematic engagement of older people in the process is emphasised. The article describes six learning areas which helped the development of preventative and well‐being services in the context of whole‐system working and older people's engagement.

Top‐down or outside‐in change methodologies are increasingly seen to be ineffective. Systems thinking suggests that change in organizations is a much less straightforward and more subtle phenomenon than previous models allow. Since the late 1970s and as organic metaphors have become used more, the concept of organizational learning has emerged as central to the issue. However, an understanding of how this may take place is still undeveloped. Recently technologies for whole systems development have emerged based on Weisbord′s dictum that for change or learning to occur we need to “get everybody into improving the whole”. Whole systems development can offer a way to realizing the learning organization. Provides a case study of whole systems development in action within Walsall Metropolitan Borough Council in the UK. Begins with a brief account of the ideas on which whole systems development is based and concludes with a commentary on the case study.

Whole system working is critical to improving health and social care services while using scarce resources more efficiently and this article aims to look at the urgent need to develop measures for it. It seeks to describe the development of a simple, practical, set of measures for benchmarking and analysing local use of key whole system resources as the basis for discussion and planning. Practical and usable tools are needed urgently as national measures are not available at present and key resource decisions need to be made now.

The paper looks at a simple framework for looking at integration in localities and some proposed measures as the basis for discussion. It describes the development and application of a simple, practical set of measures to use locally in the absence of a national set. It uses nationally available, comparable measures wherever possible to minimise work. It briefly describes how the comparative data enables localities to identify key differences in use of resources and outcomes and areas for improvement.

Taking a whole system, whole person approach and applying it across localities provides a useful framework to help local health and social care systems focus on improving patient outcomes while reducing unnecessary costs – particularly unnecessary use of high cost institutional care. The measures including the Audit Commission whole system measures identified key issues re different use of resources, costs and outcomes between localities. This article looks ahead to the implications of greater personalisation of services and the need to develop more effective information systems based on the individual patient which allow more rigorous measurement of service effectiveness including outcomes as well as activity.

In the absence of national measures of whole system integration, this paper describes how a simple, practical framework and measures were developed to analyse use of resources and identify key areas for improvement. It can be used by localities to provide a quick benchmark of use of resources and outcomes (especially whole system use of expensive institutional resources) to support value for money and service effectiveness work. It describes how it worked in practice and looks at how information systems could be further developed in line with personalisation to allow ongoing improvement based on individual outcomes, costs and service effectiveness.

This study describes the need to develop whole system measures to show the effectiveness of moves towards integration. In the absence of national measures, it describes the development of a simple set of local whole system outcome measures based on a framework based on recent work on whole system integration. The paper uses both health and social care evidence and summarises key elements that work. It shows how the measures have been applied in practice in localities as a first step in a local system improvement programme.

This paper discusses the conceptual and theoretical foundation upon which whole systems change interventions are based The paper first describes six methods of intervention that are currently being utilized to change whole systems: (1) future search, (2) search conferences/ participative design, (3) open space, (4) large scale interactive process methodology, (5) simu‐real, and (6) fast cycle full participation and the conference model. Next, six common values and assumptions underlying these large scale change interventions are identified: (1) organizations are seen as “whole systems,” (2) viewing organizations as whole systems requires the creation of dialogue among all organizational stakeholders, (3) organizations do not exist, but organizing processes and procedures do, (4) what we perceive as our collective organizational reality becomes the organization that is created, (5) individuals within organizations have the capacity to self‐organize and redefine their reality, and (6) humanity shares a set of universal values that are inherently “good” and these values will ultimately influence voluntary collective action. The paper concludes with an appeal for interventionists and users of large group techniques to be cognizant of the assumptions that drive their choice of intervention.

This paper considers intermediate care as part of a whole‐systems approach to care. It argues that this perspective allows a wider appreciation of the potential benefits of intermediate care, and that this would also be a welcome feature in future research studies. The paper draws on an evaluation of intermediate care in Cornwall and outlines the central role of intermediate care co‐ordination in the whole system. The example of residential rehabilitation is then used to examine how an individual service relates to the system as a whole. Finally, factors that may also influence local systems such as partnership working and rurality are considered; these are seen as important considerations for any other authorities which might seek to replicate the Cornwall approach to intermediate care.

New reforms in the public sector mean that many organisations are attempting to cope with turbulent environments. Traditional models of change have been found to be too static and unable to change the “whole system”. Explores processes for changing the whole system for public sector organisations operating in a turbulent environment. A case study is used to discuss the implications.

Abstract This article looks at the benefits of and obstacles to using a whole systems approach to plan and deliver personality disorder services. It does so using the example of the Leeds Managed Clinical Network, a community pilot service that employs whole system working to support people with personality disorder.

This article describes the strategy for delivering integrated care in Trafford on a whole‐systems basis. It describes an approach to integrating services across primary care, community health services, social services and acute care. It covers the (clinically led) process of developing the strategic framework, the principles developed and used, and the specific programme to be carried out in 2010/11.

This paper considers the impact of reimbursement on delayed transfers and whole‐systems planning. The paper argues that making hospital discharge work with the focus only on the interface between health and social care will have limited and short‐term results. More radical cultural change is needed to tackle the problems of an ageing society. The paper draws on recent thinking which challenges the way in which services are currently provided to older people, and calls for new ways for services to be commissioned and provided. The paper advocates changes towards community‐based processes and pathways, across a wide range of services and within a much broader whole‐systems framework, to support independence.