A systems thinking framework to improve care of the terminally ill An Australian case study

摘要

This paper argues the value of systems thinking to patients, family members and medical practitioners in end-of-life care, particularly as a mechanism for considering when palliative care should be introduced as preferred treatment.It applies a well-established set of tenets in systems thinking retrospectively to a case study of patient care in Australia.This highlights how and where different decisions might have been made, based on a holistic consideration of the patient’s best interests.The case is written from the perspective of a family caregiver.It argues that early, deliberate conversation, framed by systems thinking tenets, can support the call for the more timely intervention of palliative care.As a precursor to effective conversation, the case supports recent calls for increased training in systems thinking in graduate and continuing medical education.A change in medical practice would both facilitate and be enabled by a broader cultural change in public attitudes toward dying, end-of-life care and death.Encouraging the documentation of single case studies, written or co-written by medical practitioners and family carers can contribute to the evidence base of both medical and public education.Experience Framework This article is associated with the CultureandLeadership lens of The Beryl Institute.