Case Study – General Hospital
General Hospital is a public owned and administered hospital that provides hospital
services for a population of 300,000 people. The Hospital reports to the Regional
Health Authority, The Regional Health Authority reports to the Health Service Chief
Executive and the Chief Executive reports to the Government Minister of Health. The
general Hospital is managed by an executive board which has roles such as chief
executive, finance director; medical director and nursing director, there are also two
representatives of the community.
The hospital has eight wards each with twenty four beds, it operates an Accident and
Emergency unit. It has an intensive care unit which has eight beds. The hospital has
three operating theatres.
The hospital provides a full range of clinical specialities, out patients department and
services such as physiotherapy.
There are various groups of staff employed by the hospital, consultants, junior
doctors, sisters, nurses, auxiliaries, porters, cleaners, catering.
The budget for the hospital is allocated by the Government directly to the hospital.
To stand still and to continue providing the existing services the hospital budget
needs to increase by 3% per annum, the drivers for this continual increase are the
increase in the age of the population and the cost of new drugs. However, the
Government has instructed the hospital to reduce its budget by 2% per annum for
the next five years.
The Government also sets the hospital targets in many areas which are measured
and reported upon. Examples of these targets are: admissions to Accident and
Emergency should receive treatment within four hours of arrival, Patients referred to
the hospital should be seen within four weeks, waiting times for operations should be
no longer than eighteen weeks.
The Hospital has relationships with a number of suppliers of drugs, medical
equipment and staffing agencies who provide doctors/nurses at short notice.
The Hospital also has links and relationships with a number of community health
1. Identify three possible systems of interest from the General Hospital case
study. For each system identified describe the system components –
input/output, transformation, feedback, boundary, environment, hierarchy.
2. Identify the strengths and weaknesses of your three system definitions.
3. For each system of interest identified in question 1 produce a CATWOE and a
4. Identify the possible stakeholders and stakeholder groups for the hospital. For
each stakeholder/stakeholder group identify state their possible perspective.
5. Discuss the role models play in a systemic analysis.
6. Discuss the potential weaknesses of using models in a systemic analysis.
7. To produce an effective analysis of a situation the use of soft systems
approach is more effective than a hard systems approach. Discuss this
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