A Systems-of-Systems Perspective on Healthcare: Insights From Two Multi-Method Exploratory Cases of Leading U.S. and U.K. Hospitals

Several developed nations around the world are grappling with high healthcare expenditures and unsatisfactory outcomes. The U.S. healthcare system in particular is often singled out as the least effective system amongst developed countries. This paper´s intended contribution is twofold. Firstly, to provide a system´s perspective of healthcare beyond traditional high level country benchmarking exercises, and conduct two exploratory cases of leading hospital enterprises, one from the U.S. and another from the U.K., so as to further our understanding of the inherent complexity of hospitals and explore beyond traditional hospital lean implementations. Secondly, to address a recent call from the systems engineering community to adopt a multidisciplinary research approach that combines both qualitative and quantitative methods with the goal of further supporting the systems-of-systems practice.