This article presents the application of the systemic problem structuring approach Viable System Diagnosis (VSD) within the Department of Orthopedic Surgery in a large hospital in Norway. It explains why systemic thinking is relevant to this uniquely complex form of human organization. The department was coping with systemic dysfunction and VSD was chosen because previous applications demonstrated VSD excels at diagnosis of what is causing dysfunction. VSD was employed through a participatory framework that included in the process, among other stakeholders, medics, technologists, managers, administrators and, as far as possible given the sensitive nature of patient information, the patient. VSD guided thinking about what the organization is set up to do and the existing organizational arrangements to achieve that. The outcome was an agenda for debate that guided stakeholder discussions toward ways and means of improving organizational arrangements. The article briefly reviews previous applications of VSD in the hospital sector and other large complex organisations.

本文介绍了系统性问题结构化方法可行系统诊断 (VSD) 在挪威一家大型医院的骨外科内的应用。它解释了为什么系统性思维与这种独特复杂的人类组织形式相关。该部门正在应对全身功能障碍，并选择了 VSD，因为以前的应用表明 VSD 擅长诊断导致功能障碍的原因。VSD 是通过一个参与性框架来使用的，该框架包括其他利益相关者、医务人员、技术人员、经理、管理人员，并尽可能考虑到患者信息的敏感性，包括患者。VSD 引导思考组织的目的是做什么以及实现这一目标的现有组织安排。结果是一个辩论议程，引导利益相关者讨论改进组织安排的方式和方法。本文简要回顾了 VSD 在医院部门和其他大型复杂组织中的先前应用。