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Systems thinking in advanced nursing practice | dnp | Chamberlain College of Nursing


· Describe the selected problem from two of the three systems levels (micro-, meso-, and macro).

The selected problem I would like to discuss currently affects the microsystem and the mesosystem level. I work in a pediatric gastroenterology clinic that has 9 attending physicians, 3 fellows, 1 NP, and 4 nurses. Currently we have clinic Monday-Friday with many satellite clinics, about 85 percent of patients get blood work done outside our facility. Our lab slip currently states to fax results to providers once finalized, we were having a hard time receiving results for a long time. We often received junk faxes, or faxes that were not intended for our providers which turned into so much wasted paper. We came up with an idea to start using an efax system that could decrease the amount of lost faxes and also decrease the amount of wasted paper.  With an effective efax machine means we can receive faxes directly to our emails and this can mean a faster turnaround for patient treatment.

· Explain how the outcomes of one system level effect the other level?

Delays in test results can lead to patients not receiving appropriate care in a timely fashion and often times require an admission and or readmission. Both admission and readmission can be very costly. With delayed results patients and physicians will likely complain and these complaints will be directed at the mesosystem level. With decreased patient satisfaction comes poor survey scores; which is never a good thing.

· How is a systems approach beneficial in improving healthcare quality and safety?

This system approach is helpful in improving patient care by ensuring patient results are received in a timely fashion. This will also help patients be treated sooner for infections and GI disorders. This system approach will also decrease the amount of wasted paper on junk faxes. Efaxing allows for a quicker turnaround time for physicians to view results.


Pandhi, N., Kraft, S., Berkson, S., Davis, S., Kamnetz, S., Koslov, S., Trowbridge, E., Caplan, W. (2018). Developing primary care teams prepared to improve quality: A mixed-methods evaluation and lessons learned from implementing a microsystems approach. BMC Health Services Research 18(1), 847. https://doi.org/10.1186/s12913-018-3650-4.


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