Implementation and evaluation of training in a systems thinking methodology for health services.

Abstract

Background/aim: Systems thinking (ST) is an approach to problem-solving that considers ‘problems’ as part of an overall system, rather than as an isolated problem. The World Health Organisation advocates ST as an important approach for ‘strengthening health systems’. However, a systems approach to addressing complex problems has not been routinely used within health services. Group Model Building (GMB) is a technique developed to support ST and to develop a shared understanding of the relationships within a system. This study sought to evaluate and explore how training in ST may influence consumer engagement, capability, and confidence of rural regional health service personnel to utilise ST thinking methodologies, such as GMB, within their organisation. Population/setting: A two-day ST training program, held at Grampians Health, was conducted with 24 staff from local rural and regional health services. Methods: Participants completed two online questionnaires (pre- and post- training), along with a follow up interview exploring their perceptions of the training and its impact. The questionnaire was developed using the Kirkpatrick model of training evaluation and highlighted potential areas for improvement, overall training effectiveness, and its impact upon participants confidence with implementing GMB within their organisation. Results/findings: Preliminary coding of interview data revealed a positive reaction to the training, with participants expressing a desire to implement GMB in practice. However, they emphasized the importance of gaining further practical experience. Limited capacity and resources were highlighted as key constraints to implementation. Conclusion: Training in ST was found to have improved the confidence, engagement and capability of rural and regional health service staff. Translational impact/implications for future practice: This study addresses several gaps in evidence relating to the potential feasibility and effectiveness of ST in health services. It also highlighted the importance of providing opportunities for the practical application of learned skills, in order to maximize the effectiveness of the training.