Table 1 The “3 + 3 Decision Framework”
From: A systems science perspective on the capacity for change in public hospitals
The 3 + 3 Decision Framework: sources of resistance to change | |
|---|---|
Structural resistance group | Contextual resistance group |
1. The dysfunctional characteristics found in most organizations | 1. The inherent complexity of delivering high quality, safe, and affordable modern inpatient care in a hospital setting |
2. The particular dysfunctions of professional health sector organizations | 2. A set of specific market failures in public hospitals, which limit the scope of the standard financial incentives and reform measures |
3. The additional dysfunctional dimensions of politically managed organizations | 3. The unique problem of generalized and localized anxiety, which accompanies the delivery of medical services, and which suffuses decision-making on the part of patients, medical staff, hospital management, and political actors alike |