A systems approach to the management of a hospital for short-term patients

The endemic problems of health system management are reviewed, as is the difficulty of taking a systems viewpoint. It is argued, and demonstrated, that, by using some very simple ideas of system structure it is remarkably easy to draw up a diagram of system influences. Such a diagram is drawn for the case of psychiatric patients who recycle in the system. The diagram is analyzed from the point of view of its properties as a feedback control system, and it is shown that there are alternative, and probably more satisfactory, management practices. Suggestions are made for the practical implementation of such policies. Finally it is argued that influence diagrams may be useful as agenda for discussions, and that they offer advantages over conventional agenda.