Application Systems Theory

Application Systems Theory

Working as registered nurse who is devoted to providing home care, I have had vast experience in this sector of health care. Choosing to work and stay this career was a deliberate decision I took. I preferred the work environment in the home care setting. Some other perks include the registered nurse gets to enjoy autonomy that not many other disciplines in nursing can claim. Additionally, if one fancies the traditional concept of nursing, then home care would be best. The patients that have been in my care have had the opportunity to heal in an environment that is familiar to them (Benton, González-Jurado, Beneit-Montesinos, & Pilar Fernández Fernández, 2013). I work alone without the influence of managers and supervisors in the hospital or other health care settings.

Despite all this autonomy, I am not an island; I do not manage myself. My work is supervised and paid by one of the major home care agencies based in New York City. I work as a Nurse Evaluator whose job description and responsibilities are well defined. The job revolves around implementing the Uniform Assessment System for New York (UAS-NY) for initial legibility of different Managed Long Term Home Care Programs (MLTC) (Bielecki & Stocki, 2014).

This organization runs other registered nurses who perform similar functions for me in other patient’s homes in NYC. MLTC has had to deal with a perennial problem that has been an issue for the organization over the years. MLTC has faced the problem of high staff attrition especially with their nursing staff like me. The team almost always never holds on to the registered nurses for three years. High staff attrition has meant that the organization faces continuing staff shortages in the nursing department (Meyer & O’Brien-Pallas, 2014). All the registered nurses employed by MTLC seem always to find better pay working elsewhere for other organizations that are not involved in home care services.

Analysts from the organization have conducted several studies to try and figure out the main reason as to why the nursing staff never find sufficient satisfaction working in the home care setting. Most hypotheses postulated have pointed to lower income in the field as compared to other nursing areas, some registered nurses just don’t get enough thrill and challenge while working in the home of patient they have been assigned to care for (Meyer & O’Brien-Pallas, 2014). The stakeholders need to approach the problem using an open systems approach to try and tackle it.

Using the open systems approach, MTLC is an organization, the unit, the system or the entity as a whole. Within the system which is MTLC are subsystems. The subsystems could be the building parts that make up MTLC as a whole. When approaching this problem, one thing that should be appreciated is that the subsystems are interdependent. Because of this interdependence, one subsystem cannot function effectively if another subsystem is problematic or dysfunctional (Benton, González-Jurado, Beneit-Montesinos, & Pilar Fernández Fernández, 2013). The problem of one subsystem affects the functionality of another which consequently leads to the failure of the whole organization. Organization’s management, therefore, has to ensure that all subsystems function properly for it to succeed. In MTLC, the organizations could include the departments like human resource, the employees of the organization like the registered nurses and the management of the organization.

Still within the open systems approach, one needs to view MTLC as the system that exists in an environment. The context, in this case, is NYC; to be more specific the environment comprises the patients in NYC in need of long-term care services. Now, within the system is a series of inputs, throughputs, outputs and then a feedback mechanism. The environment provides inputs to the organization; the organization processes the input via its throughput and provides an output that goes to the environment. The output could be goods or services offered by the organization (Meyer & O’Brien-Pallas, 2014). The organization also has a feedback mechanism that allows the environment to provide either a positive or negative feedback with regards to the output they have received. MTLC receives inputs in the form of health care fees and funds from Medicaid insurance plus the patients who need the long-term care services that the organization is offering through its registered nurses.

The problem of high staff attrition is n the throughput of MTLC as an organization. Due to high attrition by the registered nurses the organization can no longer provide long-term care services for the patients who need it. The organization finds out this problem from the negative feedback they receive from the environment which is NYC. The nurse to patient ratio is small, and some homes that are in dire need of it go without nurses because there are few to distribute around (Peters, 2014). Using the open systems approach to solving this will reveal that the organization needs to address the problems with hiring to be able to retain their nurses.

The desired outcome in the bid to solve MTLC’s problem will be to keep the registered nurses within the organization by cutting down the high staff attrition. To achieve this, the problem-solving committee will have to set short-term objectives that will aid in the achievement of the primary goal (Peters, 2014). First, by three weeks, the staffing department will have conducted an investigation to find out why the nurses are leaving the organization. Secondly, by the end of two months, the remuneration and benefits subsystem will have developed a better payment and allowances scheme to help retain the registered nurses (Benton, González-Jurado, Beneit-Montesinos, & Pilar Fernández Fernández, 2013). Finally, MTLC’s hiring unit will create a new staffing framework to ensure the organization only hires registered nurses who are ready for home based care provision.

All these goals once achieved will be helpful in achieving the primary aim which is to retain the staff. The new payment scheme will be carried on and mad a policy of the organization. The agency should adopt the new payment plan for nurses working for the organization. The new policy remuneration and benefits will help retain the nurses that the agency has hired (Bielecki & Stocki, 2014). The new staffing framework will also adopt by MTLC as its hiring policy. The new structure will ensure that the organization only hires registered nurses who have an interest in the home based care and not those who will leave the group after a short time.

It is the professional obligation of registered nurses and MTLC as an organization to uphold the patients’ rights in this case the patients who need long-term care services in their homes. The patients have a right to access quality health care services that they have paid for. the organization can ensure this by implementing its new policies on hiring the registered nurses and keeping them (Bielecki & Stocki, 2014). When this problem is resolved, the organization’s and individual mission of the nurses to “be the leading service provider of home health care and medical personnel staffing services by defining industry quality standards through cost effective provision of innovative service delivery models, staff training and education and through the use of advanced technology to improve client care” will be upheld.




Benton, D., González-Jurado, M., Beneit-Montesinos, J., & Pilar Fernández Fernández, M. (2013). Use of Open Systems Theory to Describe Regulatory Trends. Journal Of Nursing Regulation4(3), 49-56. (15)30131-9

Bielecki, A. & Stocki, R. (2014). SYSTEMS THEORY APPROACH TO THE HEALTH CARE ORGANIZATION ON NATIONAL LEVEL. Cybernetics And Systems41(7), 489-507.

Meyer, R. & O’Brien-Pallas, L. (2014). Nursing Services Delivery Theory: an open system approach.Journal Of Advanced Nursing66(12), 2828-2838.

Peters, D. (2014). The application of systems thinking in health: why use systems thinking?. Health Research Policy And Systems12(1).