The Tau Conceptual Framework for Understanding Healthcare and Human Services Programs

Earlier this month, Dr. Kenneth Gossett traveled to Oxford University, in the United Kingdom, to  present his conceptual model for understanding and improvement of healthcare programs at the Oxford Research Symposium. He presented the Tau Conceptual Framework, on behalf of Colorado State University-Global Campus, to researchers from around the world. Here, he shares how he was moved to develop this framework, how he uses it with his students, and how it can transform the state of healthcare globally.

Three years ago, I watched Dr. Darlene Disch, a professor from the University of Minnesota and the President of the American Nursing Association, give a testimony before Congress. Dr. Disch stated that if you want to understand why the healthcare system is so dysfunctional in the United States, you need to know these ten things about how our healthcare system works:

1. The complexity of healthcare problems.
2. The nature of healthcare systems.
3. The nature of financial reimbursements.
4. Time pressures to do things quickly.
5. Growth and problems in the use of technology.
6. Strong tradition in healthcare that discourages people from speaking up.
7. Failure to look at problems from a system’s perspective.
8. Human factors.
9. Communication errors.
10. Leadership problems.

After listening to what she said, I woke up in the middle of the night and realized that even though I had worked in the healthcare and human services field for over 40 years, I had never taken the time to “really look at the problems from a system’s perspective.”  I was just as guilty as everyone else. I spent the remainder of that night creating my initial model of the healthcare system as a negative feedback system. Since then, I have worked with over a dozen students, helping them create a model for their studies.

The students who use these models will take their experience and knowledge into their professional endeavors within the healthcare administration field. This adaptation of interdisciplinary methods may impact tomorrow’s industry in its continuous evolution.

Since a picture is worth a thousand words, my students are ecstatic to share the details of their studies, as well as their research results.

Applying complexity sciences — an interdisciplinary approach for theories and concepts — to how healthcare and human services relate to variables in a complex adaptive system (CAS) supports a deeper understanding of how to restructure or align products and services necessary to support the goals of the healthcare continuum. The combination of academic thinking and healthcare’s complexity sciences serves to influence new perspectives and create clarity for leaders who are challenged with meeting inconsistent and contradictory healthcare reforms.  

This model allows students and professionals to assess the influence of using complexity sciences to identify system behaviors — a practice which is based on evidence that are directly (+) or inversely related (-) to understanding the current and potential future state of the healthcare services in the United States. The benefits of using this approach as a learning tool for students and healthcare managers serves to help them evaluate research, potentially enhancing outcomes. Using complexity sciences, we’ve established links related to access, safety and quality issues, cost considerations, and stakeholder satisfaction.

So, how does this framework help with the direction that healthcare administration is headed, to help professionals best adapt to the future of the field and overall healthcare? This model was created to benefit students and professionals alike by using evidence-based practices to show how access, safety and quality of services can be improved, stakeholder satisfaction can also be increased, while we can take steps to reduce the costs of healthcare services since we spend more than twice the amount of any other country in the world.

Our conclusions, based on this exploration, accurately reflect the importance and relevance of viewing healthcare delivery as a multifaceted feedback system that helps professionals understand and improve the effectiveness of complex healthcare networks. Our analysis revealed healthcare delivery could be changed and improved by embracing complexity sciences and adding the findings from evidence-based research. Future investigators should apply systematic thinking and empirical modeling to improve healthcare outcomes in industry organizations. The outcomes achieved could assist healthcare managers to organize and develop universal practices, engaging in system development and influence needed healthcare reforms.  

This model can be used to clearly see that we have a trillion dollars of waste (30 to 35 percent of what we are currently spending); that safety and quality could be improved by reducing preventable medical errors; and that, with the savings, we could provide coverage for every man, woman, and child in the United States and still have money left over afterward.