Broadening Boundary Perception in a Multi-organizational Context: Study of a Community Mental Health Program in New York State

This paper reports how systems perspective and simulation modeling method can help healthcare administrators and practitioners broaden their boundary perception and create shared understanding of their system. The case used in this study involves a community mental health care program in New York State where systems thinking and system dynamics are used to uncover misalignment in the system boundary perceived by the different levels of health care administrators. The difference in the perceived system boundary can have a critical impact on the success of a healthcare program if the perception drives planning and assessment of the program implementation. More specifically, this study looks at how the perceived system boundary influences assessment of workload and capacity issues in the program. The study finds that without a systems perspective, unintended consequences of disparate boundary perception can persist without being recognized at the state level, as the local efforts are arranged to alleviate unwanted pressures in the system.