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Alexander Komashie

Dr Alexander Komashie

Area of study
Systems and culture
Fellowship level
Year awarded
Host university
Department of Engineering
University of Cambridge
Alexander is a post-doctoral interdisciplinary fellow working on diagrammatic approaches to help understand the complexities of care delivery systems in the NHS.
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Healthcare systems visualisation (Project complete)


Too often, healthcare systems fail to deliver on the promises made to patients. And these failures can occur when system requirements are not aligned with expected outcomes.

But aligning expected performance with the requirements of a system is a common practice for engineers. And diagramming is a key way engineers achieve this.

Engineers consistently make use of diagrams and drawings in designing and delivering complex engineering systems such as cars, aeroplanes, and computer software.

This project aims to apply the diagrammatic approach used in engineering to understand the complexities of healthcare delivery systems in the NHS and implications for quality improvement.


In particular, this project will look at Degenerative Cervical Myelopathy (DCM). It is believed that patients’ outcomes can be greatly improved if DCM could be identified earlier.

The project will use a systems approach and systems mapping to understand the current clinical approach to identifying DCM and explore opportunities for improvement focused on early detection.

The objectives of this project, together, form a step towards a structured approach to describing healthcare systems. They include:

  1. Exploration: leading to a better understanding on the value and role of diagrammatic or visual representation in the context of a systems approach to healthcare improvement.
  2. Creation: resulting in a new diagrammatic approach for describing and communicating the complexities of healthcare delivery systems.
  3. Evaluation: of the approach and guidance for using it.
Watch and listen to find out more about Alex’s fellowship project

Alex gave a lightning talk about his research project at our 2020 annual event, THIS Space.

Research articles

Towards a better understanding of mental health care delivery systems: From stories to system components

Systems approach to health service design, delivery and improvement: A systematic review and meta-analysis

Systems approach to improving traumatic brain injury care in Myanmar: a mixed-methods study from lived experience to discrete event simulation

A systems approach to healthcare: from thinking to practice

Peer-reviewed conference papers

Designing mental health delivery systems: Describing the relationship between system components

Exploring Healthcare Systems Design Research and Practice: Outcomes of an International Meeting

Requirements for diagramming in the design of mental health delivery services

Healthcare systems design: A sandbox of current research themes presented at an international meeting

Systems approaches to healthcare systems design and care delivery: an overview of the literature

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