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← 大厅
7/7 · 行动
30 人 · 34 个想法
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7
行动
演示 · 不计入
障碍 · 持有链接的任何人 · 公开列出 · 已开启联盟
主持人：它的主持人（已封存）
30 人 · 34 个想法 · 2 个小组 · 3 个房间 已结成联盟
通行证 → · 逻辑 → · 记录
↗ 分享这张地图
在其他网站上，作为实时地图：
作为图片： https://truecauses.org/d/4b093a1/map.svg
作为数据： 本房间每一个已判断的卡片对（CSV）. 每个主张都有自己的地址 /c/4b093a1/<card>，列在地图下方。
发布时请注明出处： Causal map: True Causes, https://truecauses.org/d/4b093a1
问题

Why is the emergency department always behind?

提出该做什么，再判断每项行动能否撼动每个根源。

封存于 9 天前：这个房间已不再知道谁曾在其中；只有主持人仍然留名。它得出的结论保留。
30 人在座 （其中 29 名为模拟成员） · 针对 6 个根本原因已提出 3 项行动。添加一项，然后判断每项行动能否撼动每个原因。
正以访客身份查看。输入用户名即可加入并参与。
有些主张在一个循环中相互影响
↺ Winter money arrives in November for a plan ne → Every part of the system optimises its own bud → One-year funding buys agency staff, not perman → A saving in social care is a cost here and nob → …
循环可能是一项真实的发现——一个自我强化的回路——也可能是一条方向从未真正确定的关联。地图把这组主张视为一个节点，所以其中没有一项单独是根源。如果是后一种情况，值得把这个卡片对重新交给房间。
先给根本原因打分
为什么
本方法自身的做法，在提出任何行动之前：每个根本原因按 1–5 分打分——解决它的可行性有多高、解决它会带来多大影响、不加干预它自行解决的可能性有多大。优先考虑影响大、可行性高、自行解决可能性低的根源——优先级 = 影响 + 可行性 − 可能性。分数在小组内取平均，并显示有多少人打了分。
1 = 低，5 = 高。这是你自己的分数；旁边是小组的平均分。
根本原因可行性影响自行解决优先级
We report to eleven bodies and none of them to each other––––
Beds are full because nobody can be discharged––––
Nobody owns the whole patient journey––––
People wait hours in a corridor before anyone sees them––––
The estate is older than anyone working in it––––
Nobody is paid for the patient who did not need to come––––
每项行动能撼动每个根本原因吗？
竖列：大家提出的行动。横行：地图找出的根本原因。每个格子都是对一个问题的一次投票——这项行动能否显著减少那个原因？一方必须达到所投票数的 75% 才算定下；达不到，格子就保持分裂。 每个格子显示其投票分布——是 / 更糟 / 否——当其中一项达到四分之三时，该格子就定下了。
为什么
以所投票数的 75% 定下，和这里的其他所有问题一样。分裂表示有人投了票，但没有一方达到这个标准——这是一个结果，不是排队等待，它会一直保持分裂，直到足够多的人改变主意。没有人定下的格子保持未定；它永远不会变成否。逐对单独判断，能防止一项受欢迎的行动被记上它根本没触及的功劳。
行动根本原因 · 左边的行动能减少它吗？
We report to eleven bodies and none of them to each otherBeds are full because nobody can be dischargedNobody owns the whole patient journeyPeople wait hours in a corridor before anyone sees themThe estate is older than anyone working in itNobody is paid for the patient who did not need to come
Fund on a ten-year plan, not a winter 讨论尚未确定
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尚未确定
Pay something for the patient who did not need to come 讨论尚未确定
尚未确定
尚未确定
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尚未确定
尚未确定
One budget for discharge, held jointly 讨论尚未确定
尚未确定
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地图上的行动
显示的是房间判断过的所有行动：它直接作用于 6 个根本原因中的 0 个。 有 6 个没有直接作用。
只依据房间在行动阶段定下的格子，别无其他。绿色的根本原因至少被所显示行动中的一项减轻；灰色的，没有一项直接作用于它；红色边框表示其中某项会使它更糟。
分享此视图： 作为图片 · 作为供其他网站使用的实时地图
Winter money arrives in November for a plan needed in June → Every part of the system optimises its own budgetWinter money arrives in November for a plan needed in June → One-year funding buys agency staff, not permanent onesVacancies are counted as savings in the same month they are a crisis → We are measured on activity, so activity is what we producePeople wait hours in a corridor before anyone sees them → The incentive is to treat, never to preventEvery part of the system optimises its own budget → Winter money arrives in November for a plan needed in JuneEvery part of the system optimises its own budget → A saving in social care is a cost here and nobody nets itThe estate is older than anyone working in it → The incentive is to treat, never to preventOne-year funding buys agency staff, not permanent ones → Staff leave faster than we can hire themNobody is paid for the patient who did not need to come → The incentive is to treat, never to preventA saving in social care is a cost here and nobody nets it → Staff leave faster than we can hire themStaff leave faster than we can hire them → Every part of the system optimises its own budgetStaff leave faster than we can hire them → A saving in social care is a cost here and nobody nets itBeds are full because nobody can be discharged → People wait hours in a corridor before anyone sees themThe incentive is to treat, never to prevent → An improvement takes two years and a chief executive lasts eighteen monthsThe incentive is to treat, never to prevent → The same patients come back within a weekThe data we report is a year old by the time it is published → We have never once been asked to plan for ten yearsWe report to eleven bodies and none of them to each other → Politics changes the target every electionWe report to eleven bodies and none of them to each other → Nobody owns the whole patient journeyNobody owns the whole patient journey → People wait hours in a corridor before anyone sees themWinter money arrives in November for a plan needed in JuneWinter money arrives inNovember for a plan neededin June属于一个反馈回路⟳Vacancies are counted as savings in the same month they are a crisisVacancies are counted assavings in the same monththey are a crisisEvery part of the system optimises its own budgetEvery part of the systemoptimises its own budget属于一个反馈回路⟳The estate is older than anyone working in itThe estate is older thananyone working in it所显示的行动对这个根本原因的作用没有行动直接作用于它One-year funding buys agency staff, not permanent onesOne-year funding buysagency staff, not permanentones属于一个反馈回路⟳Nobody is paid for the patient who did not need to comeNobody is paid for thepatient who did not need tocome所显示的行动对这个根本原因的作用没有行动直接作用于它A saving in social care is a cost here and nobody nets itA saving in social care isa cost here and nobody netsit属于一个反馈回路⟳Staff leave faster than we can hire themStaff leave faster than wecan hire them属于一个反馈回路⟳Beds are full because nobody can be dischargedBeds are full becausenobody can be discharged所显示的行动对这个根本原因的作用没有行动直接作用于它The data we report is a year old by the time it is publishedThe data we report is ayear old by the time it ispublishedWe report to eleven bodies and none of them to each otherWe report to eleven bodiesand none of them to eachother所显示的行动对这个根本原因的作用没有行动直接作用于它Nobody owns the whole patient journeyNobody owns the wholepatient journey所显示的行动对这个根本原因的作用没有行动直接作用于它Politics changes the target every electionPolitics changes the targetevery electionWe have never once been asked to plan for ten yearsWe have never once beenasked to plan for ten yearsWe are measured on activity, so activity is what we produceWe are measured onactivity, so activity iswhat we producePeople wait hours in a corridor before anyone sees themPeople wait hours in acorridor before anyone seesthem所显示的行动对这个根本原因的作用没有行动直接作用于它The incentive is to treat, never to preventThe incentive is to treat,never to preventAn improvement takes two years and a chief executive lasts eighteen monthsAn improvement takes twoyears and a chief executivelasts eighteen monthsThe same patients come back within a weekThe same patients come backwithin a week
地图上的每个编号标出该行动所减轻的一个根本原因。
① Fund on a ten-year plan, not a winter
② Pay something for the patient who did not need to come
③ One budget for discharge, held jointly
我们预期接下来会发生什么
关于各项行动的预测：每项应改变什么、如何衡量、何时检查。到了那一天，曾在房间里的某个人会在旁边写下实际发生了什么。
为什么
地图说明哪些行动能撼动哪些原因。它不说明是否有人做了这些行动，也不说明是否有什么改变了。这里的每一条都是一项预测，带有日期和要衡量的东西，在地图定下后写成。日期到了，实际发生的情况会写在旁边，而预测保持原样：错误的预测才是有用的那种。没有人对这些投过票，它也不改变房间发现的任何东西。
到期：24 Mar 2027
行动One budget for discharge, held jointly
预期a patient ready to leave is not held by whose budget it is
衡量指标median days of delayed discharge per patient
估计房间：5（15 人的中位数，范围 2 到 12）