Ch 14

From Single Solutions to Systems Thinking-The Future of Population Health

Terms in this set (...)

systems thinking
look at impacts of multiple factors and see how they work together as parts of systems; often utilizes data derived from reductionist thinking but goes beyond to look at multiple factors causing diseases and outcomes and how they fit together
reductionist thinking
looks at one factor or variable at a time (reduces problem to one potential "cause" and one potential "effect" use to be approach to etiology and approach to improve outcome (one for each) (was good for cigarettes & lung cancer, aspirin and Reye's syndrome)
system characteristics
interacting group of items foring a unified whole; maintains existence and functions as a whole through interaction of its part; thus it changes if you take or add pieces; arrangement is crucial; parts work together; behavior depends on overall structure
translational research
bridge gaps between basic research, clinical applications and population helath implications by making research a system
systems analysis steps using system diagrams
1. identify influences on outcomes of interest (facorts/determinants that interact with each other to bring about outcomes) 2. indicate relative strength of impact of each influence or intervention (combination and using them together) 3. identify how influences or interventions interact (either work together or interfere with each other)
additionally how the system functions....
4. Identify dynamic changes that may occur in system by identify feedback loops in system (looking at changes over time due to changes in one+ influence/factor using feedback loops) (can be positive or negative impacts on outcome) [identify the feedback loops!]
5. identify bottlenecks that limit effectiveness of system
6. identify leverage points that provide opportunities to greatly improve outcomes
systems diagram
graphic means of displaying ways we understand systems to be structured and/or to function; identify key factors included in teh system and for each one indicate direction in which it operates (arrow points), if it reinforces or dampens/decreases antoerh factor/outcome (+/- signs), and indicate strength/magnitude by width of arrow
limits effectiveness of system
leverage point
provides opportunities to greatly improve outcome
seven uses of systems thinking in public health
understand interaction between factors/influcences/determinants to better understand etiology of disease, take into account interactions between diseases, understand impact of disease over life span, identify bottlenecks and leverage points that can be used to improve population health, develop strategies for multiple simultaneous interventions, look at processes as a whole to plan short-term and long-term intervention stratgies, predict future frequency of disease
requirements for successful systems analysis
limitations of system analysis approach
Systems thinking is limited by our limited knowledge of the factors that actually cause disease as well as the interactions between factors, Only useful if we understand the way feedback loops act to influence the operation of the system, Also, need adequate resources and well-developed collaborations to
take advantage of the insights, Difficult to predict years in advance because of our less than complete knowledge