title: "Running the vicious cycle backward" and other systems solutions to nursing problems.
abstract: Peter Senge's book, The Fifth Discipline: The Art and Practice of the Learning Organization, is a business bestseller. The fifth discipline refers to systems thinking, a conceptual framework for making the full pattern of complex, interrelated actions clearer and helping people see how to change them. This article summarizes selected key concepts from Senge's work and explains how nurse executives can use systems thinking to gain a deeper understanding of the forces operating in recurrent situations and identify opportunities for leverage to benefit patients, staff, and healthcare organizations.
authors.affiliation: Madden and Associates, Inc., Montclair, NJ.
authors.forename: M C
authors.initials: MC
authors.lastname: Tonges
authors.forename: M J
authors.initials: MJ
authors.lastname: Madden
mesh_terms: D006801:Humans; D017146:Models, Organizational; D009718:Nurse Administrators; D009740:Nursing Staff / Q000191:economics / Q000458:organization & administration; D009937:Organizational Objectives; D010561:Personnel Staffing and Scheduling; D011340:Problem Solving; D011787:Quality of Health Care; D013598:Systems Theory