Metaphors maps and models for Sharing Health Systems Insights · Metaphors maps and models for...

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Metaphors maps and models for Sharing Health Systems Insights

Can we persuade and Inspire?

Geoff McDonnell UNSW

Systemswiki Health Care Section

http://www.systemswiki.org/index.php?title=Health_Care_System_Dynamics_Insights

Take Home Message

• Models are like children, not very attractive unless they’re your own.

• “We are going to have to gather up the fragments of knowledge and responsibility that we have parceled out to the bureaus and the corporations and the specialists, and we are going to have to put those fragments back together again in our own minds and in our families and households and neighborhoods.” –Wendell Berry The Art of the Commonplace p86

My Journey Through Modeling

• Data to Information to Knowledge

• Dynamic Models to Understand Complex System Interactions

• Models to Persuade Others to Act Effectively

• Improving Systems by Collective Action

• Tools to Improve our own Mental Models

• Models that Generate and Inspire Commitment to Teaming

Models to Produce Effective Action

• Mark Heffernan: ithink Mentor and farmhand

• Getting the right answer -10%

• The other 90% is convincing others it’s the right answer

• Aircraft Fleet Maintenance

Background5

FLEET DOCTOR TM - A CAPABILITY IMPERATIVE

Project schedule (Primavera)

14-Jan-04 28-May-05 10-Oct-06 22-Feb-08 6-Jul-09 18-Nov-10 1-Apr-12 14-Aug-13 27-Dec-14 10-May-16

F111Rs

F111Cs

F111Gs

The right answer

4000 4500 5000 5500 6000 6500 7000 7500 8000 8500 9000

Total Airframe Hrs

050100150200250300350400450500

Weeks to Ramp Service

Perfect Landing Metaphor

• Air frame Hours (distance to go) and Flying Hours (altitude) require balancing and spacing.

• A good death as a perfect landing?

From Concept Maps to Simulation Modelsand Pictures Online

SystemswikiInsightmaker (can share clone embed)

Google ImagesDiscussions in LinkedIn etc

http://cmap.ihmc.us/publications/researchpapers/theorycmaps/Fig1CmapAboutCmaps-large.png

Thermostat Concept Map

http://insightmaker.com/insight/735

Examples related to yesterday’sPresentations & Discussions

Love Affairs and Differential Equations

Thinking in Circles about Obesity

Chronic Illness in a Complex Health Economy

Chris Argyris Organizational Traps

Examples prepared prior to yesterday’s Discussions

Producing Health Consuming Healthcare Maps and Models

• http://www.systemswiki.org/index.php?title=Producing_Health_Consuming_Health_Care

• “It is the mark of an instructed mind to rest satisfied with the degree of precision which the nature of the subject admits and not to seek exactness when only an approximation of the truth is possible.” -Aristotle 384 - 322 B.C.

How does a Thermostat work?Initial Mind Map

How does a Thermostat work?Mind Map (1 expanded)

Thermostat Concept Map

Thermostat Simulation with Loops

Thermostat Simulation Output

Simulation with Images

Thermostat Images and Loops

Thermostat Concept Map after Model

Health Care Thermostat Metaphor

Producing Health Consuming Health Care as a Mindmap

Initial EBM Diagram as linked concepts rather than boxes or arrows

A Stock with Flows

Consistent Stocks and Flows

A Simple Steady State Model

Virtual Experiments online

Virtual Experiments Online 2

A more complex version

An Approximate Converter

Next Iteration Virtual Experiments

EBM Model Complex Structure

EBM Model Complex Output

EBM Model Rich Picture

What is exchanged in Social Interactions?

Acknowledgements

• Mark Heffernan ithink mentor and farmhand

• Gene Bellinger for Systemswiki

• Scott Fortmann-Roe for Insightmaker (and Simgua)

• My iThink and Anylogic colleagues

• My HPSIG,Skype and UNSW colleagues

• My kidney donor’s family

Additional Examples

Single and Double Loop Learning

Generative Interaction

Swimming Pool Metaphor ithink

http://www.systemswiki.org/index.php?title=Patient_Care_Flow_with_Awareness_and_Misdiagnosis

Swimming Pool Metaphor Insight

Bathtub metaphors

Bathtub dynamics in Insightmaker

Nutrient Flow Model(from Schon’s The Reflective Practitioner)

Addition of Google Image Pictures

Chronic Malnutrition Mapfrom Newman’s Chapter in Tracing Connections

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