PhD ceremony Mr. T.C. Broesamle: Designing health care services using systems thinking: a theory, a method and their application in the Dutch community pharmacy

PhD ceremony: Mr. T.C. Broesamle, 11.00 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Designing health care services using systems thinking: a theory, a method and their application in the Dutch community pharmacy

Promotor(s): prof. J.J. de Gier, prof. J.J. van der Werf

Faculty: Mathematics and Natural Sciences

The dissertation of Timothy Broesamle reflects on the thesis that through understanding the relationships between the different health care providers and the variability of patients, health care service processes can be designed which efficiently, efficaciously, and effectively address the needs of the patient being provided for.

Providing health care services is complex. Health care services must be able to function given multiple environmental influences. They have to take into consideration organizational constraints stemming from multiple organizations, fit the professional standards of those providing the service (i.e. be evidence based), meet scientific standards, and meet the needs of the patient.

Using the theory of systems thinking Broesamle developed a theory for understanding different types of health care service system designs that address the needs of the patient based on the amount of variation introduced by the patient that the service must be able to handle. System thinking also provides a basis for a proposed design method that combines the iterative nature of soft systems methodology and the need to provide evidence that the service is functioning as intended. Broesamle explored the practicality of the proposed Health Cares Service System Design Typology by applying the theory in analyzing the designs of pharmaceutical care services both in daily practice and in a pilot study of a medication review process. Broesamle conducted an action research study with a group of first line providers in designing a new geriatric care service using the theory developed in the first half of the dissertation and soft systems methodology.