The use of these terms is not consistent across or within scientific fields, including systems sciences, and the continuum from tool to method to theory and framework is often blurry. The systems thinking theory combines understanding how complex systems integrate with each other and solve complicated problems that involve multiple inputs outputs from these systems. In much of public health and medicine, we use research evidence on the efficacy of interventions to inform decisions with an expectation about their future effect. Systems thinking Health care is a complex system with many inter-related actions and consequences. In healthcare, this approach is used to model waiting lines, disease screening, and public health. Systems thinking is a core skill in public health and helps health policymakers build programs and policies that are aware of and prepared for unintended consequences. Rwashana Semwanga A, Nakubulwa S, Nakakeeto-Kijjambu M, Adam T: Advancing the application of systems thinking in health: understanding the dynamics of neonatal mortality in Uganda. Apply a Holistic Approach to Solving Problems Difficulties in solving problems often stem from the fact that they do not occur in isola-tion, but rather in relation to each other. Participatory Impact Pathways Analysis involves workshops and a combination of tools to clarify the logic of interventions and a mapping of the network [21]. We use systems thinking to apply the Baldrige Framework to US population health. In this journal supplement, for example, Bishai et al. Social innovation is at the core of finding new ways to drive positive population health outcomes. Family health usually includes programs like family planning, nutrition assistance for mothers and children, and pediatric care. This can lead to identifying possible policy solutions that may not have been readily apparent, which can be helpful in the realm of using policy to improve the health and wellbeing of populations. The paper reviews the origins of systems thinking, describing a range of the theories, methods, and tools. Conviviality. The author declares that he has no competing interests. PubMed  Public Health is important due to aiding and prolonging life. As touched on earlier, another key aspect of population health is health equity within a community. The Report offers practical explanations for complex issues ranging from the design of system-oriented interventions to evaluating their effects. 1978, London: Pitman, Ashby WR: An Introduction to Cybernetics. Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Room E8527, 615 N Wolfe St, Baltimore, MD, 21205, USA, You can also search for this author in Systems thinking is way to make sense of a complex system that gives attention to exploring the relationships, boundaries and perspectives in a system. It is to these uses that we now turn. It is essential to look at determinants of overall health, the people most affected, and what kind of socio-economic impacts they may have. Whole systems analysis. Optimizing access to things like family planning, pediatric care, and breastfeeding support can have an immensely positive impact on population health. 2014, 12: 47-. 7 “Systems thinking is an approach to thinking about how things interact with one another,” he said. This new way of thinking permits us to see things we didn’t see before. statement and Grasping the concept of systems thinking is essential to being a social innovator in the health field. Apply systems thinking and an intersectoral approach to public health issues. , the new Public Health Foundation Enterprises. It is much more challenging to discern what health services are truly lacking because the needs are less clear. We often make connections when conducting and interpreting research, or in our professional practice when we make an intervention with an expectation of a result. http://pespmc1.vub.ac.be/books/IntroCyb.pdf, http://ageconsearch.umn.edu/bitstream/52515/2/ILAC_Brief05_Histories.pdf, http://creativecommons.org/licenses/by/4.0, http://creativecommons.org/publicdomain/zero/1.0/, Advancing the application of systems thinking in health. Through the prevention of health issues, individuals can spend more of their years in good health. Several papers in this supplement use similar approaches for a variety of situations, including to build leadership capacity for health systems in South Africa [32], to develop sustainable physical rehabilitation programs in Nepal and Somaliland [33], and to build sustainable maternal and child preventive health services in Northern Bangladesh [34]. The models involve multiple individual agents that work at different scales, some decision-making rules (e.g., simple rules on how they reproduce, interact with others or pursue objectives), processes for adaptation, and a space in which the agents operate. Network mapping, social network analyses, and process mapping involve a range of tools to illustrate and analyze connections between people, organizations, or processes in both qualitative and quantitative ways. In many cases, this approach can have a significant impact within diverse urban communities where population health trends can be inconsistent. It is intended to enhance understanding through participation with beneficiaries, implementers, and other stakeholders in a project. When resources and social services are provided to families in need, the overall health of each household can increase, which can then be scaled to improve the overall health of communities. 2006, Princeton, NJ: Princeton University Press, Valente TM: Social Networks and Health: Models, Methods, and Applications. © 2020 BioMed Central Ltd unless otherwise stated. Epstein JM, Axtell R: Growing Artificial Societies: Social Science from the Bottom Up. This paper explores the question of what systems thinking adds to the field of global health. Discussions around population health focus on the root causes of health problems, and the resulting outcomes from these issues. California Privacy Statement, SYSTEMS THINKING Systems Thinking is a powerful set of problem solving tools and techniques based on system analysis and design, explained by Peter Senge in The Fifth Discipline, that helps us avoid unintended consequences and find optimal solutions to complex problems. How does population health impact communities and society as a whole? Not every group in society has the same access to health care, nutrition, clean air, or safe streets, for example, and the gaps between those with the most access and the least access determine the level of health equity across communities. Health Policy Plan. A system is not the sum of its parts, but rather the product of their interaction. Heluna Health is working to improve population health outcomes by providing fiscal sponsorship and other support services to organizations, helping to bridge gaps across systems and revitalize community health. Systems thinking is defined as a practice that takes a comprehensive approach to complex events or phenomena seemingly caused by a myriad of isolated, independent, and usually unpredictable factors or … Continuously evolving and improving programs is a key way to optimize population health. The study of complex phenomena and systems has evolved across multiple disciplines and research streams over time to form an overlapping set of sciences with a common philosophical basis (Castellani 2014). Introduction to range of tools/methods that support systems thinking and systemic design in practice 5. 2014, 12: 45-, Box GEP, Draper NR: Empirical Model Building and Response Surfaces. present a very simple systems dynamics model to illustrate the trade-offs and unintended consequences of policy choices related to allocation to preventive and curative services [29]. Part of Systems thinking analyses the problem together with its system of interrelated elements. Agyepong IA, Aryeetey GC, Nonvignon J, Asenso-Boadi F, Dzikunu H, Antwi E, Ankrah D, Adjei-Acquah C, Esena R, Aikins M, Arhinful DK: Advancing the application of systems thinking in health: provider payment and service supply behaviour and incentives in the Ghana National Health Insurance Scheme - a systems approach. Health equity addresses the varying levels of access to opportunities for health improvement among different groups. Health Res Policy Syst. There is often little motivation for the private sector to invest in population health initiatives because the financial gains resulting from population health improvements take time. Google Scholar, Forrester JW: Principles of Systems. The shift to Whole Systems Thinking – be it through the evolution of the Primary Health Care Model in developing nations or the emergence of the New Public Health within the developed world – constitutes a change in the way that we think about the achievement of health gain that constitutes a paradigmatic shift. For example, a woman may choose to go to a private doctor for an annual exam, but then choose to go to a free clinic in order to receive other services. Article  Many community members suffer health problems merely because they do not have access to the services they need. Another major challenge facing professionals in population health research and population health program implementation, in general, is finding ways to diversify funding sources. Primarily, systems thinking is being applied to schools in one of two ways: as a problem-solving framework that enhances students’ understanding of a subject; and as a restructuring tool for creating a more effective educational system (see “Systems Thinking in the Classroom: Two Accounts” for an example of how systems thinking is being used in the classroom). In this supplement, Rwashana and colleagues use systems dynamics models to examine neonatal mortality in Uganda [28], while other authors use systems dynamics models to examine the effects of policy interventions [29]. Heluna Health optimizes population health by providing strong fiscal and administrative support services to its clients and partners. One of the key diminishing factors of population health is the lack of access to health services and facilities. 1968, Portland, Oregon: Productivity Press, 2, Williams B, Hummelbrunner R: Systems Concepts in Action: A Practitioner’s Toolkit. Heluna Health believes that by taking a systemic approach and addressing the unique needs of a community, it can provide a more feasible way to create measurable goals for improving health outcomes. Public health activists in local communities are lobbying for zoning law requirements on property developers that they include paths for walking and biking in any new housing development, in order to make opportunities for exercise more readily available to residents. Health Research Policy and Systems (2014) 12 (1) 51. map out the network of actors involved in physician’s seeking advice in Pakistan [30]. Introduction. 2014, 12: 35-10.1186/1478-4505-12-35. Systems thinking is a big-picture approach to tackling workplace problems. A review of the public health literature reveals a dearth of research that focuses on applying management theories to public health work. Rather than use the pre-existing templates of systems archetypes, causal loop diagrams (CLD) are created without a template, and involve drawing out people’s understanding of how elements of a problem are related to each other [19]. 10.1002/smj.4250140304. Systems Thinking can help us see why measures that may superficially seem likely to worsen the situation may, in fact, be optimal solutions. Rather than focusing on individual parts of your company, it tries to study the workplace as a whole. In addition, it may be difficult to isolate factors that may be contributing to poor health outcomes within a specific group and across groups. They can also be balancing or negative feedback loops, where a positive change in one leads to a push back in the opposite direction, such as when increasing body temperature produces sweating, which in turn cools down the body. The Series was coordinated by the Alliance for Health Policy and Systems research, World Health Organization with the aid of a grant from the International Development Research Centre, Ottawa, Canada. Population health is a field that has grown with increasing interest in recent years as professionals seek to improve public health systems and access to health resources. It is important for communities and health experts to advocate for equitable access to health services in underserved communities, with a focus on reducing disparities. This section provides several examples of how systems thinking pertains to public health problems: body mass index (BMI) screening in schools, tobacco control in the United States, obesity modeling in the United States, and obesity prevention in the United Kingdom. By supporting health experts and community leaders to work together more effectively, Heluna Health supports communities to improve health outcomes. Thinking in Systems. It then becomes more difficult to evaluate the needs this woman may have when there may not be an easy way of consolidating the data across the doctor’s office and the clinic. Why is systems thinking important for developing models of the health risks posed by climate change? Much of the work in systems thinking has involved bringing together scientists from many disciplinary traditions, in many cases allowing them to transfer methods from one discipline to another (inter-disciplinarity), or to work across and between disciplinary boundaries, creating learning through a wide variety of stakeholders, including researchers and those affected by the research (trans-disciplinarity). A model is simply a way we compactly represent and understand an object, phenomenon, or system. For example, where individual people interact directly with one another (e.g., transmitting disease) while moving about in an explicit space such as a city, agent-based modeling [1, 2] may be especially powerful. The benefit of systems thinking is that you can see problems caused by how the parts of your business fit together. 2008, 11 (4): 12-. Time will tell, of course, but in the meantime, it is helpful to consider why we would use systems thinking in a field that already draws upon a rich collection of theories, methods, and tools from the health sciences, social sciences, engineering, mathematics, and other disciplines. Overcoming this challenge requires presenting systemic concepts and tools at the right “strategic moment,” when leaders are confronting a performance issue and are ready to learn a different approach. Finally, the older and elderly population segments are also important to assess when measuring community health. 1. PubMed Central  The theory can also help us to build a clear vision about the system while proposing a solution that considers seeing the complex system as a whole picture rather than individual parts. 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