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System thinking: an introduction

In this step, we introduce you to systems thinking.

Leading and managing services within large complex systems like healthcare is challenging. The problems facing organisations are so complex that they defy simple solutions, and leaders are often trying to navigate many competing and conflicting challenges and relationships when making decisions.

Systems thinking is an approach to problem-solving that views ‘problems’ as part of a wider, dynamic system. It is the process of understanding how things influence one another as part of a whole. The video in this step provides a visual introduction to systems thinking and complexity in health.

The management science of systems thinking has evolved, as advocated by American academic Peter Senge in his seminal work The Fifth Discipline: The Art and Practice of the Learning Organisation.

Senge (2006) argues that organisations have become increasingly more complex and dynamic and, in order to deliver success, they must become a learning organisation. He identifies five key disciplines to becoming a learning organisation, of which systems thinking is the essential fifth element.

Senge argues that systems thinking integrates the four other elements of organisational learning, namely:

  • Personal mastery
  • Mental models
  • Building a shared vision
  • Team learning

Systems thinking involves much more than a reaction to present outcomes or events. It demands a deeper understanding of the linkages, relationships, interactions, and behaviours among the elements that characterise the entire system.

Commonly used in other sectors where interventions and systems are complex, systems thinking in the health sector shifts the focus to:

  • The nature of relationships among the building blocks
  • The spaces between the blocks (and understanding what happens there)
  • The synergies emerging from interactions among the blocks

We’ll explore this in more detail in the next step.


Senge, P. (2006) The Fifth Discipline: The Art and Practice of the Learning Organisation. London: Random House Business Books

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Understanding Systems Thinking in Healthcare

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