Systems Approaches to Healthcare Systems Design and Care Delivery: An Overview of the Literature

Abstract

The healthcare sector is facing significant challenges that require a systems approach, resulting in a rapid growth in the application of systems approaches in healthcare since the beginning of the 21st century. Consequently, healthcare practitioners and policymakers now desire to understand the evidence-base for the approach, but little evidence of the kind desired exists. This paper is a first step in conducting a narrative review of the application of systems approaches in healthcare based on a systematic review of the academic and grey literature. First, the emergence of the approach in healthcare is explored. Second, specific examples of applications of systems approaches in healthcare are examined to identify any missing elements in current practice. Third, fourteen reviews of the approach in healthcare published in the last ten years are analysed. The results suggest that the use of the approach in healthcare will most likely continue to increase, however, significant work remains for the design and systems community to demonstrate the effectiveness of systems approaches, specifically in providing convincing measures of impact on patient and service outcomes.

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

“…The use of this model in identifying the components of a mental health system strongly complements the application of a systems approach to improvement (Clarkson et al, 2017 , 2018 ). Systems approaches have received increasing recognition in recent decades as an effective way of dealing with the complexities in improving health and care system (Komashie, Hinrichs-Krapels, et al, 2021 ; Komashie, Ward, et al, 2021 ). A systems approach essentially involves four key perspectives on People , Systems , Design and Risk .…”

The Role of Systems Approaches in Health and Care

“…There has been a growing interest in design and systems engineering within healthcare, especially over the past two decades (Komashie et al, 2021). This is because engineering has a lot to contribute to health improvement (Clarkson, 2018).…”

“…It has been argued that engineering design has the potential to make significant contributions to addressing the complex challenges facing modern society, including health and care systems (Clarkson, 2018;Eppinger and Maier, 2019). With growing interest in the emerging field of Health Systems Design (Komashie et al, 2021), several fundamental questions need to be revisited to explore what they mean for how we design -what is 'health'? What is a system?…”

Human resources for health and maternal mortality in Latin America and the Caribbean over the last three decades: a systemic-perspective reflections

“…Based on an ecological and descriptive analysis, this comment discusses, from a systemic perspective [ 21 ], the evolution of the MMR (maternal deaths per 100,000 live births in women aged 15–49 years) for 1990–2021, its relationship with the provision of HRH among LAC countries, and the implications of this relationship for the health systems of LAC and other regions of the world. All this is a basis for proposing strategies that seek to close existing gaps identified by the MDGs in 2000, the SDGs in 2015, and COVID-19 initiated in 2020.…”