Table 2

Systems Thinking for Health Actions checklist

Systems Thinking for Health Actions checklistRelevant systems thinking tools
Recognising and understanding interconnections and system structure.
  • Stakeholder mapping/analysis.

  • Social network analysis.

  • Analysis of industry documents, tactics and strategies.

  • Stakeholder interviews.

  • Sociogram.

  • Process mapping.

  • Causal loop diagram.

  • Logic models.

  • Reflective practice.

  • Identified components of the health system.

  • Visually or textually showed the connections between components of the health system.

  • Conducted focus groups and/or interviews of key stakeholders to understand the health system better.

  • Invited other relevant sectors to participate in the design of the intervention.

  • Recognised the need for stakeholder involvement.

Identifying and understanding feedback.
  • Causal loop diagramming.

  • Markov modelling.

  • Stakeholder interviews.

  • Agent-based modelling.

  • Stock and flow diagrams.

  • Systemic policy analysis.

  • Logic models.

  • Sociogram.

  • Visually or textually addressed the feedback loops that exist in the health system.

  • Identified the positive and negative effects one component of the health system has on other components.

Identifying leverage points.
  • Iceberg tool.

  • Scenario planning.

  • Decision tree modelling.

  • Logic models.

  • Group model building.

  • Systems dynamics modelling.

  • Focus groups and stakeholder interviews.

  • Business process mapping/discrete event modelling.

  • Determined the root causes of a problem through pictorial or written mapping.

  • Attempted to identify gaps.

  • Determined the key actions for leverage points.

Understanding dynamic behaviour.
  • Causal loop diagram.

  • Behaviour over time graphs.

  • Dynamic thinking.

  • Innovation/change management history.

  • Systems archetypes.

  • Stock and flow diagram.

  • Causal loop diagram with variable distinction.

  • Table differentiating the variables.

  • Showed how a problem changes over time.

  • Addressed problems between components of the health system.

  • Predicted the impact a change to one component of the health system has on the rest of the system.

  • Identified how components of the health system change over time.

  • Addressed path dependence.

  • Developed a mechanism to identify emerging behaviours in the health system.

Using models to suggest possible solutions to a problem.
  • Conceptual model.

  • Theory of change.

  • Explained the expected outcome of and action on the health system.

  • Explained why the expected outcome is anticipated.

  • Used a diagram, descriptive text or a pictorial model to represent the system.

Creating simulation models for testing policies.
  • Agent-based models.

  • Systems dynamics models.

  • Scenario planning models.

  • Simulation models.

  • Used qualitative and quantitative data to create models.

  • Used identified leverage points to test a change.

  • Interpreted model outcomes.

  • Compared solutions from different leverage points.