Stakeholders and subsystems in a public hospital system

Consider a public hospital as a system. It exists to serve the population of a city. It is owned and operated by the government, and has many suppliers that supply its various needs. Depending upon a person’s circumstances, the hospital provides its services either free of charge, or at nominal charges. Its services include ambulance services, diagnostic and surgical services, outpatient services,emergency services and all the ancillary administrative services.

1. Identify the key stakeholders of the system.
2. Identify what the system is for from the perspective of each of the stakeholders. Write these as a set of requirements from each perspective.
3. Draw a context diagram for the hospital, indicating all the key interfaces and the system boundary.
4. Identify at least 3 subsystems of this system, and construct a high level system hierarchy diagram.
5. Consider ONE of the subsystems that you have identified above and indicate the contributions that it needs to make to the hospital system. (One table, 1 page maximum)
6. What is the required emergence of this subsystem so that it may make any ONE of these contributions? You may indicate this as the “input-transformation-output” of the system.

Considering a public hospital as a system, the following are the stakeholders identified (Thompson, 2018).

Stakeholder	Perspective
Government	Government is a key stakeholder in this system. The government owns the public hospital thus they have the highest interest on the hospital and also have the highest power over the hospital. The following are the requirements of the government on the public hospital as a key stakeholder in the system; · The government expects the hospital to be fully operational at all times · The government expects the funds and resources allocated to the hospital to be used properly. · The government expects the hospital staff to perform their duties effectively and efficiently. · The government expects the suppliers to make supplies when needed. · The government expects the suppliers to be paid for their respective supplies. · The government expects all services provided by the hospital to be provided to different types of patients
Hospital staff	The hospital staff is a key stakeholder in this system. The hospital staff are very important to the system because without the hospital staff the hospital would not be operational. However their influence or power is not very high as considered to the government who owns the hospital (Gray, 2011). The following are the requirements of the hospital staff; · The hospital staff expect the hospital to have all resources necessary for them to do their jobs. · The hospital staff expect salaries for their jobs. · The hospital staff expect supplies to be made by suppliers · The hospital staff expect patients to pay for the services if they fall under that bracket
Suppliers	Suppliers are a key stakeholder in this system. Suppliers are important to the hospital but do not have any influence or power on how the hospital is ran. The following are the requirements of the suppliers; · Suppliers expect to receive supply requests from the system · Suppliers expect to supply supplies to the hospital · Suppliers expect to be paid by the hospital for their supplies.
Patients	Patients are another key stakeholder in this system. Patients have low influence or power on how the hospital as a system works but should be closely monitor as the hospital functions to serve them. The following are the requirements of the patients; · Patients expect to get services when they visit the hospital · Patients expects the hospital to keep a record of their visits.

The three subsystems identified for this system are;

Supplier subsystem
Patient subsystem
Hospital staff subsystem.

The following are the contributions that the supplier subsystem needs to make to the hospital system;

Supplier subsystem	Hospital system
The supplier subsystem should keep a record of all suppliers who make supplies to the hospital	The hospital system should be able to use the supplier subsystem to get a list of all suppliers who make supplies to the hospital.
The supplier subsystem should keep a record of all supplies made by the suppliers.	The hospital system should be able to use the supplier subsystem to get all supplies that have been made by different suppliers.
The supplier subsystem should be able to keep a record of all payments that have been made to different suppliers for their respective supplies to the hospital	The hospital system should be able to use the supplier subsystem to track all payments made to different suppliers for their respective supplies.
The supplier subsystem should be able to prepare a supply request to be sent to a supplier.	The hospital system should be able to use the supplier subsystem to make a supplies request.
The supplier subsystem should be able to accept goods that have been supplied by suppliers.	The hospital system should be able to use the supplier subsystem to track goods that have been delivered by a suppliers
The supplier subsystem should be able to show all items that are running out and need to be supplied by a certain supplier.	The hospital system should be able to use the supplier subsystem to know all the items that are running out and need to be supplied by a certain supplier.

For the supplier sub system to keep a record of all suppliers who make supplies to the hospital, the following input-transformation-output is needed (Nickols, 2012);

Input	Transformation	Output
Supplier details	Save details in the database	Supplier reports

The hospital is privatized and now owned by a private company that operates for profit.

Stakeholder	Perspective
Private owner	Private owner is a key stakeholder in this system. The private owner has the highest influence or power on the hospital system. The private owner also has the highest interest on the hospital because he or she expects returns on investments (Gudavajhala, 2017). The following are the requirements of the government on the public hospital as a key stakeholder in the system; · The private owner expects the hospital to be fully operational at all times · The private owner expects the funds and resources allocated to the hospital to be used properly. · The private owner expects the hospital staff to perform their duties effectively and efficiently. · The private owner expects the suppliers to make supplies when needed. · The private owner expects the suppliers to be paid for their respective supplies. · The private owner expects all services provided by the hospital to be provided to different types of patients · The private owner expects the hospital to generate profits thus giving a return on his or her investment.
Hospital staff	The hospital staff is a key stakeholder in this system. The hospital staff are very important to the system because without the hospital staff the hospital would not be operational. However their influence or power is not very high as considered to the government who owns the hospital. The following are the requirements of the hospital staff; · The hospital staff expect the hospital to have all resources necessary for them to do their jobs. · The hospital staff expect salaries for their jobs. · The hospital staff expect supplies to be made by suppliers · The hospital staff expect patients to pay for the services if they fall under that bracket
Suppliers	Suppliers are a key stakeholder in this system. Suppliers are important to the hospital but do not have any influence or power on how the hospital is ran. The following are the requirements of the suppliers; · Suppliers expect to receive supply requests from the system · Suppliers expect to supply supplies to the hospital · Suppliers expect to be paid by the hospital for their supplies.
Patients	Patients are another key stakeholder in this system. Patients have low influence or power on how the hospital as a system works but should be closely monitor as the hospital functions to serve them. The following are the requirements of the patients; · Patients expect to get services when they visit the hospital · Patients expects the hospital to keep a record of their visits.

The conflicting stakeholder requirements between the private owner and the government are shown below.

Private owner	government
A private owner expects the hospital to return profits for their investment	The government does not expect profits doe their return investment.

A trade study is aimed at identifying a preferred solution in a list of other qualified solutions. In this case the trade study is done to address the conflicting requirements stated in section 6 above for a private owner or a government owner. Different criteria can be used to evaluate the two conflicting requirements but performance will be the main criterion used for this case study (Elm, 2012). Thus the main question to be asked here is whether the hospital would perform better with government as the owner or the hospital would perform better with a private owner.

The main difference between a private ownership and government ownership is that private ownership requires the hospital to generate profits while the government expects the hospital to operate efficiently without incurring any losses in such a way that it is able to sustain itself. However, the hospital would perform better with a private owner because there is more accountability because the hospital is expected to generate profits thus all resources and capital will be well utilized.

If the ownership of the hospital is transferred to a private owner, additional constraints would be imposed on operations of the system. These constraints would be imposed on the patient’s subsystem as follows;

The patient subsystem would be required to capture details of services given to patients.
The patient subsystem would be required to capture payments done by patients for various services or products.

Considering a public hospital as a system, the following key points were noted;

The hospital as a system has four different types of stakeholders; internal executive stakeholders, external executive stakeholders, internal operational stakeholders and external operational stakeholders
The two main factors that determine what type of a stakeholder a stakeholder are power and interest to the system.
Internal executive stakeholders are the hospital staff. They have high interest on the system but are not very powerful.
External executive stakeholders- the external executive stakeholders in this case is the government or the private owner if the hospital ownership is transferred to a private owner. These stakeholders have the highest power and interest on the hospital.
External operational stakeholders- These type of stakeholders have high interest but have no power on the hospital system. These stakeholders are the suppliers.
Internal operational stakeholders- these type of stakeholders have low interest and low power on the hospital system. In this case, these stakeholders are the patients.

References

Elm, J. (2012). The Value of Systems Engineering. Insights. Retrieved 12 April 2018, from https://insights.sei.cmu.edu/sei_blog/2013/05/the-value-of-systems-engineering.html

Gudavajhala, S. (2017). Top 5 Stakeholder Analysis Techniques in Projects | Stakeholder Analysis in Project Management. Master of project. Retrieved 12 April 2018, from https://masterofproject.com/blog/510874/top-5-stakeholders-analysis-techniques-in-projects-stakeholder-analysis-in-project-management

Gray, D. (2011). Stakeholder Analysis. Gamestorming. Retrieved 12 April 2018, from https://gamestorming.com/stakeholder-analysis/

Nickols, F. (2012). The Difficult Process of Identifying Processes. nickols.us. Retrieved 11 April 2018, from https://www.nickols.us/difficult_process.htm

Thompson, R. (2018). Stakeholder Analysis. Mind Tools. Retrieved 11 April 2018, from https://www.mindtools.com/pages/article/newPPM_07.htm

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