HSYP806 Systems Science in Healthcare Assessment Task 2: Case study report
Analyse the case study provided – “Breast cancer screening error: fatal mistake or lucky escape?” published in
the BMJ (2018; 361: k2063), and write a report using the attached ‘Writing a case study response’ as a guide.
You will find additional resources on your iLearn site.
You need to report on your analysis of the case while using a range of theoretical concepts related to systems thinking which you believe are relevant to the case, including: resilience; sociotechnical systems; case study methodology; safe systems; consumer participation, and systems evaluation methods.
In your analysis you should demonstrate your understanding of:
Your case study report must include the following headings and you must use the ‘Writing a case study response’ guidelines.
Guide for assessment/marking of assignment 2
The guide which the marker will use to assess your assignment (marking rubric) is included at the end of this assignment. Please note the weighting which will be applied to each section, in the marking rubric. For example, you can see that the ‘Discussion’ section is given the most weighting (50%).
Please refer to the MPH Noticeboard on iLearn particularly in relation to academic integrity and assignment guide. It is essential that any resources, journal articles, reports, books, web pages etc. referred to are appropriately referenced using the Vancouver citation style. Citation software is used to check all assignments for plagiarism.
The word length guide for this assignment is 2,500 words. Those who exceed (or are below) this by more than 200 words will be penalised.
Writing a case study response
What is a case study?
A case study is a description of a real-life problem or situation which requires you to analyse the main issues involved. These issues need to be discussed and related to the academic literature and/or research findings on the topic and conclusions then drawn about why the situation occurred and how best to respond to it.
A case study is a way to apply the theoretical knowledge gained from the academic literature to real life situations that you may encounter in your work.
Writing a case study response enables you to
Before you start writing, you need to carefully read the case study and make a note of the main issues and problems involved as well as the main stakeholders (persons or groups of persons who have an interest in the
A case study response would include the following elements:
Introduce the main purpose of the case study and briefly outline the overall problem to be solved.
Write a brief description of the case under discussion giving an outline of the main issues involved. Always assume that your reader knows nothing of the assignment task and provide enough information to give a context for your discussion of the issues.
Discuss the issues raised one by one, using information gained from your research of the academic literature. Your discussion may include:
Finally, sum up the conclusions that you have come to and give recommendations to resolve the case. Give reasons for your recommendations.
Checklist for a case study response
Case Study Report
This study analyses the reason for breast cancer which has been happened within among 270 women and they would have died. It has been already found in 400000 older women of England has not been alerted in the breast cancer screening before their birthday of 71st(Elgot, 2019). This study focusses on the critical analysis of the system through which those women would have been indicated that there would not be any cause or issues found in for which the breast cancer. The reason for breast screening is found in this case study and all the breast screening for and against this incident. The study has also tried to find out the exact reason for which breast cancer screening would be totally reliable.
This case study has researched on an incident where due to an error occurring in the computer programme system a good number of women lady (around 270) cannot go through the breast cancer screening test. Thereby, it has been assumed that those women may get short lives than those who have undergone screening test successfully(Elgot, 2019).
This fatal is caused on in sudden that there is no way of recovering as the main error has happened from the programming side. For this reason, researchers and the IT programmers have not found any clue as this screening programme has been successfully going on from the late 1980s.
It is only due to the misalignment within the policy, delivery of the test, the projected IT system and the AgeX trial algorithm which have been worked within this case.
After investigation, it has been found that there are a lot of issues come at the time of taking the right decision of screening test and that effect on the application of screening test
At this stage, the stakeholder of the company, like government and breast screening programme become the victims if this incident. Other than this the NHS group are also found to be involved with this fatal screening test.
The consequences of this test are thus found that the screening programme has to be reset and at the same time, the test is disabled due to some error occurring within the system. In both cases, the quality has to be check as lots of people become affected by this fatal cause.
From the case study, it has been found that due to the failure of computer algorithm the automatic invitation for breast cancer check-up has failed. For this reason, the invitation, for the final breast scan would have been missed. This variation thus made in such a way that the invitation would be made for the invitation which is a great factor of this system. The Health secretary of NHS screening programme, Mr Jeremy Hunt has said that there are 450000 people would be provided as independently as they review and has taken apology for this technical mistake(Elgot, 2019).
From this incident, many gets shocked as the leaders of GP would be potentially become many significant. This problem has come in light in the year 2018 under the analysis through the PHE that is found as the number for the invitations of one final mammogram. Those women having age within 68th to 71st are mainly found to fall under this error of computer programming(BBC News, 2019).
This computer error has found and come into light when the Public Health England has been spotted some anomalies within their database from the trial of the program AgeX. This program has found within the cluster randomised trials which have been run in a periodic way within the laboratory of Oxford University. They also try to investigate all types of benefits and risks that are associated with the younger and the older ages(Matthews-King, 2019). These numbers would be found to be randomised within the screening of older group which is very low according to the PHE spokesperson.
It has been blamed that there are IT system failures that would include the age parameters and the programme system. Due to the missed up the check-up this PHE modelling may lead that there would be 135 to 270 lives women become shortened(Newscientist.com, 2019). Thus, the calculation has been performed by the professor of risk management at Cambridge University, David Spiegelhalter. He has come to the conclusion after running a screening programming in the system that there would be 1 within 400 women may be affected with early death can be prevented in each screen(Newscientist.com, 2019). If we have now divided the total number 450000 with 1400 it becomes 321 and thus only 70% of entire women may go for the screening test. Other 225 which is 70% of 321 would not go for the screening according to Hunt(BBC News, 2019).
In the same way, another professor at Cambridge University in the discipline of Cancer Epidemiology has provided his thought over this screening test that most of the women are old and there is no evidence that exactly how many women would get affected within the single screen within this screening test.
For making a decision and analyses the cases, I would like to take help from some of the theories that I have learnt in my curriculum. First of all, I would like to mention the concept of complex adaptive systems (CAS) and the safety systems which have been very much important to consider in this case study (Belohlavek, 2015). I have learnt from this concept that adaptive behaviour is considered as the common ground within the traditional perspective of the market processes and the CAS. Therefore, the economics and the complexity would be provided within similar way where out-coming the interactions of supply or demand and other self-correcting mechanisms. Those differences may lie within the assessments that have been described under the same phenomenon(Russell, 2019).
In the same way, in this case, the adaptive behaviour of the PHE and IT programme has to be analysed from earlier stage as the feedback loop as it would modify the system nature and that helps to change those parameters under the demand of and that would survive as those can be the part of the network providers(Belohlavek, 2015).
Again, from the sociotechnical systems, it has referred that the core dimensions of the organization can be individually reflected and synergized with the strategy and it can be redesign for the governance mechanism. It would accommodate a new type of models in the work system as it is needed to consider for this case study as well. It is thus needed to maintain a new model which will be very much effective and also efficient in nature. The technological structure of GE would be designed for the concepts under the customer value, its innovation and their leadership within the technology(Botla and Karaca, 2018). It is also needed to take into consideration that there is commercial excellence, globalization and also with the growth of leadership that may be applied for this situation of screening programme as well. Again the STS technology provides a new- to-the –world customer value that will meet the demand under the environment and also for same time that is align with the strategy. Thus the core dimensions of the organization have been found to check the best policies which have to be applied to check the cancer screening process in details(Lu, Lo and Lin, 2013).
Finally, I would like to emphasize on the information system evaluation method that is necessary in this case study for taking the measurement of each component in a periodic manner. The system evaluation study thus is found to grow up under the critical domain under many types of disciplines and also the research context(Botla and Karaca, 2018). It has been thus found that there are subsequent studies that can be extended over the theories and concepts. Thus the diversity research context and its perspective can be evaluated for this screening incident. According to Stteheimer and Cleveland (1998) have proposed that there is a theoretical classification model that has been presented within the diversity of this research programme(Lu, Lo and Lin, 2013). There are other primary forces that represent the organizational context and their interactions. It is needed to enhance all types of explanation that the model for stakeholders’ force and the interaction causes within those forces. In this case, all the primary forces of the organization are found to have interacted with other forces. Thus the new taxonomy framework for IS evaluation thus is needed for the structural interactions which have been focused for the user system(Nováková and Hájková, 2017). This framework also includes user organization, user task along with the user to the stakeholder interactions.
In this case of user-system, the structural interaction is very much needed as it can measure the system satisfaction through considering various factors under the quality and performance of the system. Thus, the user-task of the structural interaction is found to focus on their job satisfaction and the measures of the attitudes of the user for this task. Also there are two interactions which are characterised with the measure if their task-technology is found to be fit. This user-stakeholders’ is also needed to measure the innovation diffusion theory and it also includes the relative advantage, the trialability, compatibility, complexibility and the observability factors. Those factors are actually needed at the time of system configuration in the case of screening test issues(van Gorp, 2018). Again this evaluation system needs the organizational support over this system. It is needed to measure through the behavioural controls along with the policy drivers’ mechanism.
Therefore, in the case of screening processes, the women who have missed the invitations for the system failure are needed to check and detect the cancers as early as possible. In these consequences, when as the families of those have been died, they should claim in a regular way to attend the screening(Botla and Karaca, 2018). According to Leigh Day, the solicitors specialised within the medical negligence can think that there are damages occurred as they may run within their million. But at the same time proving this case is also not very easy(van Gorp, 2018).
Other than the government and breast screening programme, media is found to take a direct role in the same way so that they may have some benefit. Sometimes, medical authorities are found to be hosted the same petard.
In this case, according to Pharoah, there was the Independent UK panel established in 2012 based on the Breast Cancer Screening test(Russell, 2019). At every stage, the breast cancer death would be prevented as there would be three cases as the breast cancer would have been found under the stage of “overdiagnosed”. These overdiagnosed cancers are considered as the cancers diagnosed process under the screening process. Within this, the overdiagnosed cancers may harm the life of women as they would not have the screening(Nováková and Hájková, 2017). It is needed to detect thus the small and early tumours which may actually cause harm rather do well for them.
Again, as there becomes a gap for the benefits of screening older women, there is number of experts those are commented for the benefits and the limitations from the breast screening programme. For this reason, Sir Richard Peto, the famous professor under the discipline of medical statistics and the epidemiology within the University Oxford, has suggested that there are several benefits which may extend with various age ranges. It includes screening and also includes those women under the age of 70(Newscientist.com, 2019). He also emphasises on the fact that after the age of 70, there would be randomised AgeX trial can be addressed among all them which is even not expected for yielding the reliable results in a medical process from the year of mid 2020s(Russell, 2019).
Thus, this discussion helps us to find out the problem errors and at the same the solutions of those problems. For this reason, there are user-system structure is mentioned here as to be implemented under the system evaluation method.
Further, the challenges adopted in this case is the breast screening programme that is processed for running within the value for breast screening process under the contentious subject for the arguments. The overall role is needed for engaging all the debate which has provided the viewpoint on the effectiveness of this breast screening. Otherwise, it is needed to check the policy, the operation of those programmes. It can be achieved under the objective which would reduce the mortality from breast cancer as it may be properly administered. Other than this, the other screening programmes are recommended for the same experience and knowledge for the breast screening programme.
In the discussion, the process models like a complex adaptive system and its safety systems, sociotechnical systems and the systems evaluation methods are discussed. These three concepts and theories have various applications. The complex adaptive system is the most appropriate solution to find out the error in the screening programme. Further the sociotechnical system shows that in which way, the screening programme can be reutilised as per the system demand and console. It is also needed to compare with the work process of stakeholders who provide suitable support for this system. Finally the evaluation process can be utilised to ensure that the programme can be used for overtime in a day.
Besides these, a new review system has to be recommended and that would ensure that this programming system can be applied among more than 5000 women. This can prevent the system from systemic IT errors.