The Center for Implementation, Toronto, ON, Canada.
University of Toronto, Toronto, ON, Canada.
Int J Health Policy Manag. 2021 Mar 15;10(5):281-283. doi: 10.34172/ijhpm.2020.50.
Systems thinking provides the health system with important theories, models and approaches to understanding and assessing complexity. However, the utility and application of systems thinking for solution-generation and decision-making is uncertain at best, particularly amongst health policy-makers. This commentary aims to elaborate on key themes discussed by Haynes and colleagues in their study exploring policy-makers' perceptions of an Australian researcher-policy-maker partnership focused on applications of systems thinking. Findings suggest that policy-makers perceive systems thinking as too theoretical and not actionable, and that the value of systems thinking can be gleaned from greater involvement of policy-makers in research (ie, through co-production). This commentary focuses on the idea that systems thinking is a mental model that, contrary to researchers' beliefs, may be closely aligned with policy-makers' existing worldviews, which can enhance adoption of this mental model. However, wider application of systems thinking beyond research requires addressing multiple barriers faced by policy-makers related to their capability, opportunity and motivation to action their systems thinking mental models. To make systems thinking applicable to the policy sphere, multiple approaches are required that focus on capacity building, and a shift in shared mental models (or the ideas and institutions that govern policy-making).
系统思维为卫生系统提供了理解和评估复杂性的重要理论、模型和方法。然而，系统思维在生成解决方案和决策方面的效用和应用是不确定的，尤其是在卫生政策制定者中。本评论旨在详细阐述 Haynes 及其同事在研究中讨论的主题，该研究探讨了政策制定者对澳大利亚研究人员-政策制定者伙伴关系的看法，该伙伴关系侧重于系统思维的应用。研究结果表明，政策制定者认为系统思维过于理论化，无法付诸行动，并且可以通过让政策制定者更多地参与研究（即通过共同制定）来获得系统思维的价值。本评论的重点是，系统思维是一种思维模式，与研究人员的信念相反，它可能与政策制定者现有的世界观密切一致，这可以增强对这种思维模式的采用。然而，要将系统思维广泛应用于政策领域，需要解决政策制定者在能力、机会和动机方面面临的多个障碍，以将其系统思维模式付诸行动。为了使系统思维适用于政策领域，需要采用多种方法，重点是能力建设，以及共同思维模式（或管理政策制定的理念和机构）的转变。
