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

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)

-

5000

10000

15000

20000

25000

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

Em

be

dd

ed

Hrs

Date

F111Rs

F111Cs

F111Gs

The right answer

5960

7401

7315

6596

7618

6390

7082

6923

6867

7146

7205

6697

4965

6742

7347

7608

7285

7177

7130

7503

7744

7194

7470

7824

7028

7888

7779

7091

5484

5443

7090

4000 4500 5000 5500 6000 6500 7000 7500 8000 8500 9000

AC

Total Airframe Hrs

0

100

200

300

400

500

600

050100150200250300350400450500

Hrs

to

Ra

mp

Se

rvic

e

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.

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

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

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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