At the heart of systems-based practice (SBP) is a focus on the broader context of patient care within the multiple layers of a healthcare system.
This would include: purchasers (employers, government), insurers (commercial, Medicare, Medicaid), delivery systems (hospitals, physician networks, drug and technology companies, community resources), work group (local entity providing care such as a group practice, hospital service), providers (physicians, nurses, and others both as individuals and teams that provide direct care), and the users (patients and families). Awareness and effective use of these resources are advocated by entities such as the Institute for Healthcare Improvement to increase patient care quality and reduce error. These include: how national and local structures, systems, rules and regulations contribute to the experience of a specific patient and populations of patients; who pays for care and why it matters to both patient and physician; and factors within the culture, organization, management, and financing of the local care system that impact care of individuals and populations.
This competency domain is closely linked to PBLI because it is often through analysis of one’s practice that system-level issues are revealed. Residents need to develop abilities in this competency domain not only to provide safe and effective care, but also to enable them to act as effective practitioners within a variety of different medical practice/delivery models.
Teamwork skills are important to demonstrating competence in SBP. Participation as members and leaders of interdisciplinary teams will allow residents opportunities to develop and demonstrate abilities in using a variety of tools and teamwork skills to identify, analyze, implement, evaluate and report improvement initiatives as well as identifying system errors.
Competency information taken from the
ACGME web site on Systems Based Practice
Content pages that correspond to the Systems Based Practice competency: