SYFSA: a framework for systematic yet flexible systems analysis

Abstract

Although technological or organizational systems that enforce systematic procedures and best practices can lead to improvements in quality, these systems must also be designed to allow users to adapt to the inherent uncertainty, complexity, and variations in healthcare. We present a framework, called Systematic Yet Flexible Systems Analysis (SYFSA) that supports the design and analysis of Systematic Yet Flexible (SYF) systems (whether organizational or technical) by formally considering the tradeoffs between systematicity and flexibility. SYFSA is based on analyzing a task using three related problem spaces: the idealized space, the natural space, and the system space. The idealized space represents the best practice-how the task is to be accomplished under ideal conditions. The natural space captures the task actions and constraints on how the task is currently done. The system space specifies how the task is done in a redesigned system, including how it may deviate from the idealized space, and how the system supports or enforces task constraints. The goal of the framework is to support the design of systems that allow graceful degradation from the idealized space to the natural space. We demonstrate the application of SYFSA for the analysis of a simplified central line insertion task. We also describe several information-theoretic measures of flexibility that can be used to compare alternative designs, and to measure how efficiently a system supports a given task, the relative cognitive workload, and learnability.

Keywords: Flexibility; Human factors engineering; Information theory; Problem space analysis; Systematic Yet Flexible systems.

Figure 1

The idealized problem space. The initial state is square and the goal state is a diamond. The black circle is a state in which the central line is in place but the sterile dressing is not yet applied.

Figure 2

The natural central line insertion space. The initial state is the square in the lower right quadrant of the central image. The goal state in which all operators have been applied is the black diamond in the upper left corner. Black circles are states in which the central line has been placed. White circles are states where the central line has not been placed.