Systems Thinking Toolkit
Systems thinking is a discipline that allows individuals to understand and intervene in complex systems. It helps those that use it to look at realities with a holistic lens, focusing on how the whole system is composed of sub-components that are interconnected and have inter-dependent and emerging behaviors (de Savigny & Adam, 2009). Systems thinking is comprised of theories, methods, and tools that assist with addressing complex problems (Peters, 2014). This systems thinking toolkit is categorized into six different systems thinking characteristics that were commonly found in systems thinking literature (Stave & Hopper, 2007). Corresponding with each characteristic are systems thinking tools that assist with achieving the characteristic.
Recognizing and understanding interconnections and system structure
This characteristic is comprised of the recognition and understanding of the key actors within a health system, as well as the overall structure of the system. It enables the stakeholders within the system to create shared goals and acknowledge how the health system can work together to implement successful health actions.
Systems Thinking Tools | Description | Resources |
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Stakeholder mapping/analysis | A visual process of analyzing, prioritizing, and diagramming of the stakeholders involved in the system (https://frescopad.com/stakeholder-mapping-definition/ and https://miro.com/blog/stakeholder-mapping/). | https://frescopad.com/stakeholder-mapping-definition/
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Social network analysis | "Social Network Analysis is a set of techniques for analyzing social systems. It can be used to understand networks and their participants, that is, to grasp and describe the organization of the network as a whole as well as the position of individual actors. It offers a variety of techniques for measuring, visualizing, and simulating relationships and allows analyzing these relationships in visual as well as mathematical terms."-Systems Concepts in Action, Chapter 3 |
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Sociogram | A tool for depicting the relationships within a group. It creates a visual of social links among a system and uncovers underlying relationships within a system. (https://www.6seconds.org/2017/07/03/sociogram-definition/) | https://www.6seconds.org/2017/07/03/sociogram-definition/
study.com/academy/lesson/sociogram-definition-examples-quiz.html
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Process mapping | Illustrates the workflow in a system to understand, analyse and optimize processes (Durski et. al, 2020). | https://www.cedu.niu.edu/~bailey/ftf564/pmapping.pdf
https://pubmed.ncbi.nlm.nih.gov/33033054/
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Causal loop diagram | An analytical tool to document, model, and visually map the different interactions among a system’s elements, variables or subsystems, and represent the nature and direction of their relationships. | https://thesystemsthinker.com/causal-loop-construction-the-basics/
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Logic models | “a systematic and visual way to present and share your understanding of the relationships among the resources you have to operate your program, the activities you plan to do, and the changes or results you hope to achieve.” (Volf, n.d.) | https://www.ies.ncsu.edu/blog/what-are-logic-models-and-when-should-you-use-them/ |
Reflective practice | “learning through and from experience towards gaining new insights of self and practice” (Finlay, 2008). | https://libguides.cam.ac.uk/reflectivepracticetoolkit/whatisreflectivepractice https://www.cambridge-community.org.uk/professional-development/gswrp/index.html |
Identifying and understanding feedback
Health systems, as they are governed by feedback. Therefore, It is critical to identify cause-effect relationships, positive and negative, that occur among the parts of the health systems by recognizing feedback loops and determining chains of causality within the system.
Systems Thinking Tools | Description | Resources |
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Causal loop diagramming | An analytical tool to document, model, and visually map the different interactions among a system’s elements, variables or subsystems, and represent the nature and direction of their relationships. | https://thesystemsthinker.com/causal-loop-construction-the-basics/
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Agent-based modelling | “Agent based modeling is a bottom-up simulation technique where we analyze a system by its individual agents that interact with each other.” (Karami, 2021) | https://pubmed.ncbi.nlm.nih.gov/12011407/
https://towardsdatascience.com/intro-to-agent-based-modeling-3eea6a070b72
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Stock and flow diagrams | "Stock and flow diagrams are ways of representing the structure of a system with more detailed information than is shown in a causal loop diagram." (Venism) | https://online.visual-paradigm.com/knowledge/business-design/what-is-stock-and-flow-diagram/
https://www.transentis.com/page/stock-and-flow-diagrams
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Logic models | “a systematic and visual way to present and share your understanding of the relationships among the resources you have to operate your program, the activities you plan to do, and the changes or results you hope to achieve.” (Volf, n.d.) |
https://www.ies.ncsu.edu/blog/what-are-logic-models-and-when-should-you-use-them/
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Sociogram | A tool for depicting the relationships within a group. It creates a visual of social links among a system and uncovers underlying relationships within a system. (https://www.6seconds.org/2017/07/03/sociogram-definition/) | https://www.6seconds.org/2017/07/03/sociogram-definition/
study.com/academy/lesson/sociogram-definition-examples-quiz.html
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Identifying leverage points
Identifying leverage points can help determine where to focus the most attention in a health system. In health systems, identifying leverage points systematically illuminates key areas to intervene, allowing for more targeted health actions.
Systems Thinking Tools | Description | Resources |
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Iceberg model | "Iceberg model is a tool that allows you to shift your perspective and see beyond the immediate events that everyone notices. It helps you to uncover root causes of why those events happen." (untools) | https://untools.co/iceberg-model
jwel.mit.edu/assets/video/systems-thinking-iceberg-tool-j-wel-connections
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Scenario planning | "Scenario planning is a management tool that is designed to allow organizations to evaluate the efficacy of strategies, tactics, and plans under a range of possible future environments.” (cgma.org) | https://www.cgma.org/Resources/Tools/DownloadableDocuments/scenario-planning-tool.pdf
Scenario Planning: A Tool for Strategic Thinking, Paul Schoemaker
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Decision tree modeling | A decision tree is a specific type of flow chart used to visualize the decision-making process by mapping out different courses of action, as well as their potential outcomes. | https://venngage.com/blog/what-is-a-decision-tree/
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Logic models | “a systematic and visual way to present and share your understanding of the relationships among the resources you have to operate your program, the activities you plan to do, and the changes or results you hope to achieve.” (Volf, n.d.) |
https://www.ies.ncsu.edu/blog/what-are-logic-models-and-when-should-you-use-them/
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Group model building | “Group model building is a qualitative method aimed at engaging stakeholders to collectively consider the causes of complex problems." (Gerritsen et. al) |
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Systems dynamics modeling | Systems dynamics is an approach to describe, model, simulate, and analyse dynamically complex issues/systems at a relatively high system level. It allows to simulate feedback and accumulation effects on specific blocks of the system. |
https://www.planet-a.earth/materials-1/system-dynamics-modelling
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Understanding dynamic behavior
It is imperative to recognize that feedback loops and the interactions between the components of the health system are responsible for generating patterns of behavior. Therefore, recognizing dynamic behavior can help determine the effect that behaviors from components of the health system have on the entire system
Systems Thinking Tools | Description | Resources |
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Causal loop diagram | An analytical tool to document, model, and visually map the different interactions among a system’s elements, variables or subsystems, and represent the nature and direction of their relationships. | https://thesystemsthinker.com/causal-loop-construction-the-basics/
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Behavior over time graphs | "A Behavior over Time Graph is a simple line graph that shows a pattern of change over time – it shows how something increases and decreases as time passes.” (clexchange) |
https://thesystemsthinker.com/behavior-over-time-diagrams-seeing-dynamic-interrelationships/
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Systems archetypes | "System archetypes are common and usually recurring patterns of behavior in organizations. These patterns almost always result in negative consequences." (Taborga, 2011) |
https://thesystemsthinker.com/wp-content/uploads/2016/03/Systems-Archetypes-I-TRSA01_pk.pdf
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Stock and flow diagrams | "Stock and flow diagrams are ways of representing the structure of a system with more detailed information than is shown in a causal loop diagram." (Venism) | https://online.visual-paradigm.com/knowledge/business-design/what-is-stock-and-flow-diagram/
https://www.transentis.com/page/stock-and-flow-diagrams
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Use of models to suggest possible solutions to a problem
The use of models to suggest possible solutions to a problem displays pictorial or written depictions of applying causality, feedback loops, and variables to achieve the purpose of a health system. The models do not depict a real-world system, rather, they model potential solutions to a problem. Models can provide an improved understanding of the factors that influence health actions and help to use health resources more efficiently.
Systems Thinking Tools | Description | Resources |
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Conceptual Model | “A Conceptual Model is a diagrammatic representation of what logical activities need to be undertaken to achieve a system purpose” (Dr. Stuart Burge) | https://www.interaction-design.org/literature/topics/conceptual-models
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Theory of Change | "The Theory of Change is a comprehensive description and illustration of how and why a desired change is expected to happen in a particular context.” (theoryofchange.org) | https://www.theoryofchange.org/what-is-theory-of-change/how-does-theory-of-change-work/
https://unsdg.un.org/sites/default/files/UNDG-UNDAF-Companion-Pieces-7-Theory-of-Change.pdf
https://pubmed.ncbi.nlm.nih.gov/32760440/#&gid=article-figures&pid=fig-2-uid-1
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Creating simulation models and testing policies
Using systems thinking simulation models helps translate multifaceted scientific findings into easy-to-understand outcomes. Simulation models use qualitative and quantitative data to create a well-rounded model of the overall system and the interactions throughout the components. In health systems, simulation models can be used for assessing vulnerability, economic impact, measuring performance, emergency preparedness, and how health systems are interdependent on other systems. Using simulation models is an important part of systems thinking as it helps predict the impact a change will have and compare possible solutions to a problem.
Systems Thinking Tools | Description | Resources |
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Agent-based modelling | “Agent based modeling is a bottom-up simulation technique where we analyze a system by its individual agents that interact with each other.” (Karami, 2021) | https://pubmed.ncbi.nlm.nih.gov/12011407/
https://towardsdatascience.com/intro-to-agent-based-modeling-3eea6a070b72
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Systems dynamics models | Systems dynamics is an approach to describe, model, simulate, and analyse dynamically complex issues/systems at a relatively high system level. It allows to simulate feedback and accumulation effects on specific blocks of the system. |
https://www.planet-a.earth/materials-1/system-dynamics-modelling
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Scenario planning models | "Scenario planning is a management tool that is designed to allow organizations to evaluate the efficacy of strategies, tactics, and plans under a range of possible future environments.” (cgma.org) | https://www.cgma.org/Resources/Tools/DownloadableDocuments/scenario-planning-tool.pdf
Scenario Planning: A Tool for Strategic Thinking, Paul Schoemaker
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