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24 September 2021
Using Participatory Systems Approaches to Improve Healthcare Delivery: The role of Soft Operational Research, Problem Structuring Methods, Systems Thinking and Design
Planning and delivery of healthcare services is a thorny issue. Due to an aging population base and an increasingly high prevalence of chronic diseases, healthcare systems are under strain. Moreover, the provision of healthcare services is often very fragmented, at a time when more and more patients present interacting comorbidities that require coordination between specialties and providers. How to tackle these issues is a fundamental social and political challenge that regularly generates public debates.
In this context, there is a need to develop and use tools, concepts and principles that can help make sense of the fragmented healthcare structures. It is the belief of the Health Systems journal that healthcare problems need to be viewed holistically within an integrated system with multiple interacting components. To achieve this we need to bridge across areas, communities, disciplines and specialties by engaging with a variety of stakeholders to explore and analyse the issues faced and to identify feasible and desirable solutions. The effective management of healthcare problems has considerable implications for patient care and deserves a focused attention. It requires not only clinical evidence, but also ways of capturing everyone’s interests, values and desires. The integration of the visions of the different professionals also demands methods that facilitate debates between care providers, care commissioners, healthcare professionals, patients and relatives. This integrative view on healthcare allows for the design of collectively agreed (models of) healthcare delivery services.
This special issue invites papers that take an integrative perspective in designing and analysing healthcare systems. The aim of this special issue is to highlight the state-of-the art and to explore the contributions made by:
- Soft Operational Research and Problem Structuring Methods,
- Systems Thinking, and
- Systems Design.
Although these approaches have sometimes been treated separately, they share the core principles of being systems-informed, interdisciplinary and participative. By systems-informed, we mean that they are mindful of boundaries, interdependencies and embeddedness into broader systems, and aware of multiple coexisting perspectives on a situation. By interdisciplinary, we mean that these methods help bridge across groups and communities, whether they are academic or professional. By participative, we mean that these approaches use systems models as a basis for dialogue and engagement with stakeholders, and often rely on facilitated conversations to enable a shared framing and tackling of issues in healthcare planning and delivery.
A variety of paradigms, approaches and perspectives that embody these principles are welcome. Some examples of approaches include:
- Soft Systems Methodology
- Causal mapping and causal loop diagramming
- Safety-focused participatory approaches
- Co-design and participatory design
- Service design
- New, emerging approaches developed to support systems approaches to improving healthcare delivery
- Multimethodological interventions that combine two or more of the aforementioned approaches
The special issue is especially interested on the practical impact of using these approaches. We welcome empirical case studies, conceptual papers so long as they remain application-oriented, methodological contributions illustrated with application-oriented examples or case studies.
All areas of healthcare provision are welcome. This includes prevention, primary care, secondary care, community care, public health, and global health. Similarly all healthcare specialties are welcome, from general practice or mental health to surgery, anaesthesia or nutrition.
We welcome submissions from all over the world.
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