Evidence-based care system design – part 2. Systems within systems

In the previous edition of Future Healthcare Journal , there was a ­focus on using a systems engineering approach to healthcare design and improvement.1 Review articles highlighted the development of this approach in healthcare, with both concept translation into a framework, the approach in patient safety, training requirements, and application in international settings. In this edition we get down to more of the ‘brass tacks’ with a number of very concrete ­examples of applying a systems approach to care redesign. Commonly changes and innovations in healthcare delivery are based on ‘a good idea’, or perceived best practice that may have a varying level of evidence to support it, or are pragmatic because of a pressing need. Evaluation is key, but not easy, particularly as by its very …