Advancing the application of systems thinking in health

s, journal names and corresponding author’s affiliation. Number of publications mentioning these search terms was 1386 as of 14 August 2014. Adam Health Research Policy and Systems 2014, 12:50 Page 2 of 5 http://www.health-policy-systems.com/content/12/1/50 The applicability of a wide range of tools and approaches This Series illustrates how research approaches that are commonly used in various disciplines, such as realist evaluation, sense-making (as a mental model), or program evaluation theories, can be applied within a systems thinking approach to address complex health systems questions. It does so by showing that the types of questions asked are the most important element that shape the orientation of the analysis, not the tool itself. For example, in the paper by Prashanth et al. [7], systems thinking and complex adaptive systems approaches added depth to the realist evaluation by digging deeper into the drivers of, and the context in which the differences in responses of health workers in the two subdistricts were observed and what triggered them. They could show that settings with committed staff and positive intentions to make changes demonstrated more Figure 2 World map of the 1,386 MEDLINE records mentioning the te “systems science”. Source: GoPubMed, which reports the frequency that t abstracts, journal names and corresponding author’s affiliation. This data w positive outcomes and an ability to use existing opportunities to solve problems and improve performance. Further, that commitment alone was neither crucial nor sufficient as demonstrated by findings from another setting with committed staff but different outcomes. Finally, that in settings with a lack of commitment from staff, strong leadership became more pronounced in driving the change into better outcomes [7].s, journal names and corresponding author’s affiliation. This data w positive outcomes and an ability to use existing opportunities to solve problems and improve performance. Further, that commitment alone was neither crucial nor sufficient as demonstrated by findings from another setting with committed staff but different outcomes. Finally, that in settings with a lack of commitment from staff, strong leadership became more pronounced in driving the change into better outcomes [7]. Systems thinking and mixed methods As discussed by Peters and demonstrated by several of the Series papers, both qualitative and quantitative methods contribute in their own way to our understanding of complexity [6,8]. As some of the early systems thinking literature originated from quantitative disciplines such as physics and biology, it may give the impression that relevant systems thinking approaches are rms “systems thinking”, “complex adaptive systems”, or erms appear in MEDLINE indexes for publications, which include titles, as obtained on 14 August 2014. Adam Health Research Policy and Systems 2014, 12:50 Page 3 of 5 http://www.health-policy-systems.com/content/12/1/50 predominantly quantitative. Perhaps one of the main contributions of this Series is demonstrating how qualitative methods commonly used in fields such as social science or anthropology add equally important value and depth to analyses of complex health systems questions and phenomena [8-12]. For example, they are often used to provide a profound initial understanding of the problem that can then be complemented by quantitative approaches that incorporate the learning into a more realistic and sophisticated quantitative analysis [6]. Exploiting the potential of visual interpretations of

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