Systems Thinking

Welcome to Module 1.

We live in a world of systems: cities, public transit, nature, ourselves as humans, even our phones. Our organizations are systems too, but unlike public transit or phones, organizations are made up of human systems, each with their own needs, challenges, and motivations.

In the realm of clinical laboratories, we encounter intricate systems daily, ranging from instrumentation to sample processing protocols. However, it's crucial to recognize that laboratories are comprised of complex human systems, with a mix of individuals with unique requirements, obstacles, and drives. Unlike the predictable functionality of instruments or protocols, the human element introduces dynamism and unpredictability, often posing challenges to problem-solving endeavors. Nonetheless, it is within this human dynamic that the most innovative solutions originate. The key lies in adeptly navigating between various perspectives. By zooming in and out, one can grasp the broader dynamics of the laboratory system while remaining attuned to the individual needs and motivations of its personnel. This balanced approach fosters an environment where creativity flourishes, ultimately leading to novel and effective problem-solving strategies.

Systems thinking enables people to look at problems in new ways — and that leads to new solutions.

In this module, you will learn what systems thinking is and how you can use systems thinking to approach problems and challenges in new ways. You will be asked to think about how systems thinking applies to your own work setting.

Note: You can turn on closed captions by clicking the CC button on the video player navigation bar.

If you have trouble watching the lectures due to a slow Internet connection, try downloading the lecture or the transcript listed below each video. Right click the link and select "Save Link as" to download.

Learning Objectives

After completing this module, you will be able to:

  • Offer a personal definition of systems thinking that includes its characteristics;
  • Explain the concept of systems blindness and give an example;
  • Apply systems thinking to a specific challenge in the workplace;
  • Compare event-oriented thinking to systems thinking;
  • Model a system of concern;
  • Define Just Culture; and
  • Differentiate between Just Culture and Blame Culture.

Video: The Value of Systems Thinking (7 minutes)

The following video was produced by the Alliance for Health Policy and Systems Research. It features experts and policymakers from LMICs providing their views on systems thinking and its potential contribution to health systems strengthening in developing countries. The manual mentioned in the video is listed below as an optional resource.

Optional Resource: WHO – Systems Thinking for Health Systems Strengthening

Overview of Systems Thinking (9 minutes)

In this first module lecture, Dr. Stephen Polyak will introduce you to the concept of systems thinking.

Downloads: Video (15.1 MB), Audio (4.1 MB), Transcript

Reading: Introduction to Systems Thinking (45 minutes)

Next, this article from Daniel Kim provides you with a foundation to the concept of systems thinking. In this article, we will further our understanding of systems thinking, define a system, introduce you to the iceberg concept, and review a couple examples of managing systems.

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Source: Kim, D.H. (1999). An introduction to systems thinking.

Video: The Systems Iceberg Explained (7 minutes)

In the previous article, you learned about the Systems Iceberg Model, let’s dive a little deeper and look at how you can use it to think more deeply about the events that happen in the world around you.

Assignment: Set and System (15 minutes)

Let’s begin the process of engaging and experiencing systems thinking with a short learning activity.

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Video: Characteristics of Systems Thinking (10 minutes)

In this next video lecture, Dr. Stephen Polyak will review some of the characteristics of health systems.

Downloads: Video (17.4 MB), Audio (4.7 MB), Transcript

Reading: Solving Problems with Systems Thinking (15 minutes)

This next online article explores concept of systems thinking and its relevance in project management. It discusses the characteristics of systems, the challenges they present, and the importance of analyzing interconnected elements to make informed decisions and solve complex problems effectively. The article emphasizes the shift from viewing problems in isolation to considering them within the broader context of interconnected systems, highlighting the need for holistic thinking to address contemporary challenges in project management and problem-solving.

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As you read the article, self-reflect on the following questions:

  • How can the principles of systems thinking outlined in the text be applied to improve the operational efficiency and problem-solving capabilities within our clinical laboratory?
  • In what ways can we integrate the concepts of systems thinking to better understand and address the interconnected challenges and dynamics present in our laboratory environment, such as workflow complexities, equipment maintenance, and personnel interactions?

Source: Medium.com

Reading: Feedback Loops in Systems Thinking (15 minutes)

This next online article explores the concept of feedback loops in systems thinking, distinguishing between reinforcing and balancing feedback. This article emphasizes the importance of understanding and leveraging feedback loops as a powerful tool for managers in driving desired outcomes and maintaining system stability.

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As you read the article, self-reflect on the following questions:

  • How can the principles of feedback loops in systems thinking, be applied to enhance problem-solving and decision-making processes within clinical laboratory operations?
  • In what ways can we leverage the examples provided in the article to identify and implement effective feedback loops in our laboratory workflows, ensuring both continuous improvement and stability in our operations?

Source: Medium.com

Assignment: Feedback Loops (30 minutes)

Feedback loops show causality, the influence of system parts on each other. Two types of feedback loops exist that control system behavior, reinforcing and balancing.

  • A reinforcing feedback loop causes growth or decline in a system.
  • A balancing feedback loop keeps stability in a system by self-correcting itself.

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Reading: Causal Loop Construction – The Basics (15 minutes)

A causal map shows multiple relationships within a system. Or, in other words, it shows relationships between actions and effects in a system.

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Think back to your feedback loop assignment and the answer key provided. In a causal loop diagram, reinforcing feedback loops are typically represented by a loop with arrows pointing in the same direction, indicating a cycle of growth or decline. Balancing feedback loops, on the other hand, are represented by a loop with arrows pointing in opposite directions, indicating a cycle of stability or self-correction.

For example, in a causal map loop diagram for the reinforcing feedback loop (growth), you might have arrows connecting "Introduction of new technology" to "Increased efficiency and throughput," then to "Attraction of more clients," and back to "Introduction of new technology," forming a loop that reinforces growth.

In contrast, for the balancing feedback loop (stability), you might have arrows connecting "Introduction of a new diagnostic assay" to "Implementation of quality control measures," then to "Reduction in errors," but with an opposing arrow from "Potential relaxation of quality control measures" back to "Introduction of a new diagnostic assay," forming a loop that maintains stability by self-correcting potential deviations.

These causal loop diagram representations help visualize how feedback loops operate within a system and how they influence system behavior over time. Do you see any feedback loops in your causal map?

Video: Habits of a System Thinker (7 minutes)

Systems thinkers use numerous habits of mind for problem-solving. These habits include seeking to understand the big picture, seeing patterns and trends in systems, recognizing how a system’s structure causes its behavior and identifying cause and effective relationships. They also include surfacing and testing assumptions, finding where unintended consequences might arise and finding leverage points to change a system and finally, resisting the urge to make quick conclusions.

In this next video lecture Dr. Stephen Polyak looks at some of these habits in more detail.

Downloads: Video (11.5 MB), Audio (3 MB), Transcript

The following resource Habits of a System Thinker from Waters Center for System Thinking highlights 14 additional habits of systems thinkers to help you better understand how systems work and how actions taken can impact results seen over time. Take some time to review the habits listed on this website and flip through the interactive cards. If you’d like to learn more about systems thinking, Waters Center for System Thinking offers free online courses.

Video: How a systems thinking approach can help in a crisis (3 minutes)

Using a systems thinking approach to systematically break down a complex situation can help to accomplish your goals.

Watch the following video vignette with guest speaker Jennifer Greenwood, Senior Remote Testing Site Manager at the University of Washington’s Department of Laboratory Medicine and Pathology, where she talks about how systems thinking helped her as a Senior Remote Testing Site Manager improve operations during the start of the COVID-19 pandemic.

Downloads: Video (26.8 MB), Audio (1.3 MB), Transcript

ILP Assignment: Systems Thinking Self-Assessment (15 minutes)

Please complete this assessment on Systems Thinking. Then answer the question in the ILP. 

Download a Word Version of your ILP to capture all of your responses throughout the course and refer to them in the future.

Go to ILP Assignment

ILP Assignment: Systems Thinking Perspective Exercise (15 minutes)

Please complete the Systems Thinking exercise. Then answer the questions in the ILP.

Go to ILP Assignment

Video: Shared Vision (5 minutes)

In the following video, Peter Senge discusses his concept of shared vision, emphasizing the importance of aligning individuals within an organization around a common purpose or goal.

Shared vision aligns with systems thinking by acknowledging the interconnectedness of all components within an organization. Systems thinking involves understanding the relationships and interdependencies among various elements to achieve a shared objective. A shared vision acts as a unifying force, enabling individuals to perceive themselves as integral parts of a larger system. This encourages collaboration and coordinated action towards a common purpose.

Moreover, a shared vision can impact feedback loops by providing a guiding direction for feedback mechanisms within the organization. Feedback loops serve to reinforce positive behaviors and outcomes or correct deviations from desired goals. A shared vision offers a reference point for evaluating feedback and making adjustments to ensure actions are in line with the overarching vision. For instance, feedback mechanisms may assess progress towards the shared vision and identify areas requiring course corrections to maintain alignment.

Additionally, shared vision contributes to the establishment of a Just Culture by promoting fairness, transparency, and accountability among organization members. It establishes clear expectations for behavior and performance, fostering a shared understanding of values and principles guiding decision-making. In a just culture, individuals are encouraged to voice concerns, report errors, and contribute to continuous improvement efforts without fear of reprisal. A shared vision cultivates a collective commitment to learning from mistakes, addressing systemic issues, and upholding ethical standards in pursuit of common goals.

Reading: Just Culture Model (30 minutes)

A 'Just Culture' is an environment that emphasizes learning from situations rather than placing blame for a situation. Just Culture, in relation to systems thinking, emphasizes that mistakes are generally a product of faulty organizational cultures, rather than solely brought about by the person or persons directly involved. In a Just Culture, after an incident, the question asked is, "What went wrong?" rather than "Who caused the problem?". The framework of a Just Culture ensures balanced accountability for both individuals and the organization responsible for designing and improving systems in the workplace. Engineering principles and human factors analysis influence the design of these systems so they are safe and reliable.

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As you read the article, self-reflect on the following questions:

  • Think about errors that should require disciplinary action within a Just Culture work place. How can you incorporate Just Culture into your professional work?

Source: Morris S. Just culture-changing the environment of healthcare delivery. Clin Lab Sci. 2011 Spring;24(2):120-4. PMID: 21657146.

Video: A Just Culture Model in the Laboratory (13 minutes)

In this next video, Dr. Stephen Polyak introduces the concept of Just Culture in the clinical laboratory.

Downloads: Video (53 MB), Audio (6 MB), Transcript

Reading: Just Culture: A Foundation for Balanced Accountability and Patient Safety (30 minutes)

The framework of a Just Culture ensures balanced accountability for both individuals and the organization responsible for designing and improving systems in the workplace. Engineering principles and human factors analysis influence the design of these systems so they are safe and reliable.

Download PDF

Source: Boysen PG 2nd. Just culture: a foundation for balanced accountability and patient safety. Ochsner J. 2013 Fall;13(3):400-6. PMID: 24052772; PMCID: PMC3776518.

Quiz (15 minutes)

The quiz is due Sunday, April 12, at 11:59 pm PT.

Late submissions will not be penalized.

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Reading: Module Summary (5 minutes)

Congratulations on completing the first module in this course. Systems thinking is a valuable approach to solving problems and challenges in new innovative ways. Through the resources shared in this module, we hope you have developed your own definition of systems thinking and the characteristics of the systems thinking mindset. We also hope you understand the concept of systems blindness and how that might apply to your own workplace, particularly to a specific challenge you have experienced in your own laboratory. You have analyzed and compared the difference between event-oriented thinking to systems thinking. You then considered a system of concern and how to deal with this model in your own environment.

Optional Resources