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What is a system?

In this step, we'll define systems thinking and its application in different sectors.

A simple definition of a system is that it is ‘a complex whole; a set of things working together as a mechanism or interconnecting network’ (Oxford Dictionaries 2008).

Other definitions describe a system as:

… a perceived whole whose elements ‘hang together’ because they continually affect each other over time and operate toward a common purpose.
(Senge 1994: 90)
… a set of interrelated elements. Each element connects to every other element, directly or indirectly.
(Ginter, Duncan and Swayne 2012: 23)
Leadership across organizational and geopolitical boundaries, beyond individual professional disciplines, within a range of organizational and stakeholder cultures, and often without managerial control.
(Van Dyke 2013: 4)

Using the principle that a system is an interacting or interrelating group of elements that work together for a common purpose, the key aspect to understand is that, within a system, the actions and performance of one part of this system are, either wholly or in part, dependent on the actions and performance of another part of the system. High-quality patient care can only be achieved if all the relevant parts of the healthcare system are working in harmony.

Consider that even the most skilled surgeon relies on the supply of surgical equipment, instruments and personal protective equipment, sterilising services, oxygen supplies, anaesthetics, antibiotics and analgesia drugs before an operation can even start.

Surgery is performed with the support of anaesthetists, skilled nurses and theatre staff and needs a team of hospital staff, inducing therapists and community-based healthcare staff to care and rehabilitate the patients once the surgery is completed.

If the reason the patient needed this surgery was that they had been involved in an accident, they were probably brought to the hospital by ambulance or helicopter, which may also have involved the support of the other emergency services.

If the patient needed surgery as part of cancer treatment, their journey to the operating theatre would have involved diagnostics and pathology services and general practitioners. Their ongoing care may involve radiology, chemotherapy, pharmacy and hospice services.


Oxford Dictionaries (2008) Concise Oxford English Dictionary 11th edn. Oxford: Oxford University Press

Ginter, P., Duncan, W., and Swayne, L. (2013) The Strategic Management of Health Care Organizations. 7th edn. New York: Wiley

Senge, P. (1994) The Fifth Discipline Fieldbook: Strategies and Tools for Building a Learning Organization. New York: Doubleday

Van Dyke, M. (2013) Systems Leadership: Exceptional Leadership for Exceptional Times [online] available from [21 April 2020]

© Coventry University. CC BY-NC 4.0
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Understanding Systems Thinking in Healthcare

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