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Systems thinking methods: a worked example of supporting emergency medical services decision-makers to prioritize and
Cassandra Rehbock1,2, Thomas Krafft3, Anja Sommer1,2
1Department of Health, Ethics and Society, Care And Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, 6229 ER, The Netherlands.
Health Research Policy and Systems
|June 5, 2023
Summary
Systems thinking, using causal loop diagrams, helps decision-makers understand complex issues and tailor interventions for better implementation in emergency medical services. This approach aids in prioritizing actions for improved system dynamics.
Area of Science:
- Healthcare Systems Analysis
- Implementation Science
- Systems Engineering
Background:
- Systems thinking offers a participatory approach to analyze complex implementation contexts and intervention dynamics.
- Causal loop diagrams (CLDs) are a key systems thinking method previously used to illustrate implementation contexts and prioritize interventions.
- Understanding local dynamics is crucial for effective intervention selection and implementation.
Purpose of the Study:
- To explore how systems thinking methods can help decision-makers understand the causes and effects of key issues and their interconnections.
- To identify the most relevant interventions that best fit within a given system.
- To prioritize potential interventions through contextual analysis of the system and interventions.
Main Methods:
- A case study approach was employed in a regional emergency medical services (EMS) system in Germany.
- A causal loop diagram (CLD) was developed with decision-makers to map causes and effects of rising EMS demand.
- Interventions were identified, prioritized based on impact, delays, and system fit, and contextually analyzed using pathway analysis.
Main Results:
- A CLD identified 37 variables across five interlinked subsystems related to rising EMS demand.
- Five key variables were identified as optimal for implementing three prioritized interventions.
- Pathway analysis revealed contextual factors, delays, and feedback loops influencing intervention implementation, such as staff resource limitations.
Conclusions:
- Systems thinking methods empower local decision-makers to comprehend their implementation context and its dynamic influences.
- This understanding facilitates the development of tailored implementation and monitoring strategies for interventions.
- The study demonstrates the utility of systems thinking in optimizing intervention effectiveness within complex healthcare systems.
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