Understanding Systems Thinking and Sociotechnical Design for Effective Problem-Solving

1. Systems Thinking September 22nd, 2023 Sune Dueholm Müller, Department of Informatics, University of Oslo hisp.uio.no | dhis2.org

2. Agenda • Systems thinking and sociotechnical design • Systems thinking • Soft Systems Methodology • Questions

3. Systems Thinking and Sociotechnical Design • Lectures on “From IT to IS Design and Digitalization” • Focus on digitalization and sociotechnical systems design • From IT design to sociotechnical systems design • Successful digitalization is not only about implementing an IT solution but designing a sociotechnical intervention

4. Systems Thinking and Sociotechnical Design

5. Systems Thinking and Sociotechnical Design • Systems thinking is a mode of thinking that underlies sociotechnical design.

6. Systems Thinking • “Systems thinking is a set of synergistic analytic skills used to improve the capability of identifying and understanding systems, predicting their behaviors, and devising modifications to them in order to produce desired effects” (Arnold and Wade, 2015: 675). • According to Wikipedia, systems thinking is “a way of making sense of the complexity of the world by looking at it in terms of wholes and relationships rather than by splitting it down into its parts”. • “Systems thinking is, literally, a system of thinking about systems” (Arnold and Wade, 2015: 670). • BUT also acting upon systems!

7. Systems Thinking

8. Systems Thinking

9. Systems Thinking • Systems thinking is a problem-solving approach that involves analyzing and understanding complex systems in their entirety, rather than focusing only on individual components or parts. It emphasizes the interconnectedness and interactions between various parts of a system and how different relationships affect the behavior of the entire system. • Systems are composed of many interrelated and interacting parts. Changes to one part of a system may have ripple effectsacross the entire system. Systems thinking seeks to identify and understand the underlying structures and patternsthat govern the behavior of a system to develop effective strategies for solving problems. Focusing on and changing individual parts is considered “symptom treatment”.

10. Systems • According to Merriam-Webster, a systemis “a regularly interacting or interdependent group of items forming a unified whole”. • “Information Systemsare the combination of hardware, software, and telecommunications networks that people build and use to collect, create, and distribute useful data, typically in organizational settings” (Laudon, 2016). • “The most fundamental system idea is that the entity as a whole has so-called ‘emergent properties’, properties which are properties of the whole and are meaningful only at the level of the whole” (Checkland, 1988: 243).

11. Information Systems

12. Systems Thinking Approaches There are many approaches to problem-solving and decision-making that are useful in complex situations where the problem situation and the solution are unclear. • Such approaches need to facilitate an understanding the perspectives and experiences of stakeholders to develop effective solutions, and it fosters learning and shared understanding of the problem situation among a group of stakeholders rather than trying to solve a pre- defined problem. •

13. Implications and Questions Systems Thinking brings attention to: • The analyst’s “worldview” (weltanschauung) • Are you mindful of yours? • Consider how you can work with it? • Competing “realities” and worldviews (perspectives on goals, the problem situation, and solutions) • How does it show in your organization or unit of analysis? • Is everybody being heard? If not, should they and how? • Common understanding, involvement, and consensus as prerequisites for change • How can you avoid the not-invented-here syndrome?

14. Systems thinking can be used to understand… • the interdependencies of different patient care processes. For example, diagnostic and treatment processes involves many different stakeholders and their actions influence patient outcomes. Systems thinking can help identify bottlenecks / process breakdowns, reduce risk and improve patient safety. • the complexity of health information systems. EHR and HMIS (like DHIS2), are large-scale systems that often interact with multiple other systems. Systems thinking can be used to understand how these systems interact, to optimize data flow and to improve information use in decision-making. • the dynamics of health information exchange, including the technical, organizational, and infrastructure aspects that influence information sharing across healthcare institutions. …as a basis for making informed decisions and taking action!

15. Systems thinking can be used to investigate… • the potential and obstacles to patient-centered care, which requires an appreciation of patients’ needsand preferences, the roles and interestsof different healthcare professionals, and the potential and limitations of technologyin supporting this goal. • the socio-technical dynamicsof health information systems implementation and use, including perceived benefits and barriers, interactions between users and systems, and the influence of norms, culture, and context. • the process of implementing and using EHR and HMIS implementation, including the perspectives of different stakeholders (doctors, nurses, administrators, etc.), the technical challenges, and the organizational or even institutional changes needed.

16. A Hypothetical Example

17. A Hypothetical Example • A hospital is experiencing inefficient and uncoordinated patient care processes. The result is long waiting times, medical errors, and poor patient outcomes. Faced with this problem situation, a team is assembled to analyze and improve patient care processes. • The problem situation is explored through interviews, observation, and document analysis to get different perspectives on the challenges. Disagreements on what the real problems are and how they need to be addressed are uncovered. • Several different systems that could potentially improve efficiency and coordination are conceptualized, such as a “My Pathway” system, a new EHR system, and a logistics and communications platform. • These systems are pictured using conceptual models that describe key activities, inputs, outputs, control mechanisms, etc. This facilitates discussion of the “ideal” care process.

18. Soft Systems Methodology Soft Systems Methodology (SSM) is attributed to Peter Checkland (originally described in Checkland, 1981). • According to Wikipedia, SSM is “an organised way of thinking and it can be used to tackle general problematic situations that arise in the real world and in the management of change by using action”. • SSM is an approach to problem-solving and decision-making that is particularly useful in complex situations where the problem situation and the solution are unclear. • SSM emphasizes the importance of understanding the perspectives and experiences of stakeholders to develop effective solutions, and it fosters learning and shared understanding of the problem situation among a group of stakeholders rather than trying to solve a pre- defined problem. •

19. Soft Systems Methodology • In plain English: Soft Systems Methodology (SSM) is a qualitative approach for dealing with complex, ill-defined problems where there is no consensus on what the problem is or how to solve it.

20. Soft Systems Methodology • Shared “philosophy” with other methodologies, e.g. participatory design, contextual design, design thinking, etc. • An approach to investigating and designing socio-technical systems

21. The Seven Steps of SSM Enter the problem situation 1. Express the problem situation 2. Formulate root definitions of relevant systems of purposeful activity 3. Build conceptual models of the systems captured by root definitions 4. Compare models with real-world situations 5. Define feasible and possible changes 6. Take action to improve the problem situation 7.

22. A Rich Picture (Express the Problem Situation)

23. Root Definitions • A root definition is a concise statement that describes the essential purpose or function of a system as perceived by the stakeholders. • Different root definitions? • The root definition is developed through a process of inquiry and dialogue with the stakeholders with the goal of achieving a shared understanding of the system and its purpose. • The root definition helps the involved stakeholders better understand the system and its purpose, which in turn helps identify improvements and guide decision-making about how to change the system to realize its goals.

24. Root Definition and Conceptual Models

25. Other Examples of Conceptual SSM Models • Rich Picture:A graphical representation of stakeholders, their concerns, and relationships between them. It helps identify the perspectives and values underlying the problem and it facilitates discussion and understanding among stakeholders. • Influence Diagrams:A visual representation of the cause-and-effect relationships between different parts of a system. It helps identify the key drivers and factors affecting the problem, and it facilitates evaluation of different solutions. • Mind Maps:A diagram connecting different ideas or concepts from a central theme or topic. It helps explore different assumptions and values underlying different perspectives on the problem and it facilitates creative solutions development. • Conceptual Models:A simplified representation of a system, using a set of concepts and relationships between them. It helps test and evaluate different scenarios, and it facilitates identification of feasible solutions. • Flowcharts:A diagram that shows process flows, using symbols to indicate different activities and decisions. It helps identify bottlenecks and breakdowns in the system and it facilitates the testing of different improvement scenarios.

26. Other Examples of “SSM-like” Models

27. SSM Axioms • Problems do not exist independently of human beings, they are constructs of the mind, defined by individuals’ worldviews (➝focus on the problem situation rather than the problem in isolation). • Problems are multiple and interrelated (➝changes and solutions have ripple effects). • Different worldviews are equally valid. • Solutions are also constructs of the mind and no ‘problem’ exists in isolation. • Successful solutions require sharing of perceptions, persuasion, and debate (➝analysts are facilitators rather than experts). • Analysts cannot divorce themselves from the problem.

28. Questions