ABSTRACT: A systems approach to investigating what happens when things go wrong puts the emphasis on changing the system and not blaming, punishing and removing individuals. This article introduces Root Cause Analysis as a means of investigating problems in organizations.
One means of understanding why individuals perform particular behaviors is to apply the Theory of Planned Behavior. This is helpful in comprehending and explaining individual behavior but it does not primarily address group behavior. A useful way to understand the behavior of groups of people (e.g. families, Pediatric Speech Therapy team, teachers within a school, volunteer helpers) is to use a systems approach. A system can be defined as “a group of interrelated, interacting or interdependent elements forming a collective entity” (Layton and Martin, 2006:17). Thus, a whole organization or a Department within an organization, or even a Team within the Department can be considered a system. The approach encourages us to see people not as isolated units but as functioning within a wider social system. We begin to see how change in one part of the system will affect all other components.
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One way of understanding systems better is by investigating what happens when things go wrong (this is analogous to the ways in which neurolinguists have better understood how the brain processes language by studying damaged brains, e.g. such as when a person has a stroke and a resultant language deficit known as aphasia).
From my own field of work in the UK National Health Service, the National Patient Safety Agency (NPSA) devotes its time to investigating so-called Patient Safety Problems. These are defined as any unintended or unexpected problem which could have or did lead to harm for one or more patients receiving care. A problem itself is defined as any deviation from expected results. The NPSA has developed a Root Cause Analysis Toolkit (NPSA, 2004a) that assists those investigating problems to focus on systems rather than the individuals within those systems. One can, therefore, contrast a person centered approach with a systems approach, as follows.
|person centred approach||systems approach|
|Individuals who make errors are ‘careless, at fault, reckless’||Poor organisational design sets people up to fail|
|Blame and punishment||Focus on the system rather than the individual|
|Remove individual = improve safety||
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