Combining Soft Systems Methodology, ethnographic observation, and discrete-event simulation: A case study in cancer care

Figures & data

Figure 1. Sample of CATWOE definitions produced.

Figure 2. Activity model.

Figure 3. Simulated impact of change scenarios on patient waiting times.

Figure 4. Simulated impact of increased advanced preparation under increased workload.

Figure 5. Blueprint for the redesigned chemotherapy administration process.

Table 1. Mapping the case study to the four activities of SSM (Checkland & Poulter, 2010).

SSM stages	Project stages
I. Finding Out	1. Observation and interviews, time-study	4. Visits and interviews in other hospitals
II. Making Purposeful Activity Models	2. Multiple root definitions, conceptual modelling, DES modelling	5. Defining scenarios and simulating them through DES	8. Design of new service blueprint
III. Using Models to Structure Discussion About the Situation and Its Improvement	3. DES validation	6. Debate on scenarios	9. Discussion of impact of new process and actions needed to get there
IV. Defining “Action to Improve”		7. Choice of solution principle	10. Building the case for the proposed change and bringing it to executives

Checkland, P., & Poulter, J. (2010). Soft systems methodology. In M. Reynolds & S. Holwell (Eds.), Systems approaches to managing change: A practical guide (pp. 191–242). London: Springer London.

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