Sometimes, QI projects in health care involve ‘wicked problems’ that consist of a mix of organisational development, quality planning, and stakeholder engagement issues. However, in health and care, we often organise ourselves into separate functions and approach these issues from each angle individually, rather than taking a more holistic and joined-up approach.

I recently completed an MSc in Systems Thinking in Practice at the Open University, where I was directed to apply what I’d learned to the complicated, messy situations I encounter in my professional life. This practical focus made the theories not just understandable but genuinely usable in real-world scenarios.

I was drawn to this programme because I realised in my professional life that there were many barriers and obstacles to change that were rooted in how we approached change. For example, project management methodologies are commonly used in healthcare, but they often view change as a predictable series of activities leading to deliverables and benefits. In my experience, projects rarely unfold in this way.

I used to think that the problem was my own performance, but I now understand that it is often the result of a more systemic issue.

In my experience, this is particularly relevant to quality improvement work.

So what is systems thinking?

Systems thinking is all about developing your ability to think about complex situations in a holistic way. This means looking at all the different parts of a problem and how they’re connected to each other. It’s about understanding how different perspectives can shape our understanding of a situation, and learning how to use the tools and techniques developed by systems thinkers including Peter Senge and Peter Checkland, to make sense of it all.

Causal loop diagrams can be used to identify and understand the relationships between different variables in a system, and how they influence one another. The rich picture tool can then be used to visually represent a problem that is hard to define in written or spoken language. (See links below). It captures the various elements, relationships, and perspectives involved.

 Applying systems thinking in the workplace

As part of my dissertation project, I investigated knowledge-sharing practices within my organisation. I identified several critical insights that could be implemented to enhance our knowledge-sharing practices.

This led to me initiate a programme called ‘Quality Month’. This was a comprehensive, month-long series of staff engagement events aimed at fostering a culture of excellence and continuous improvement. The initiative featured 35 events across 16 diverse subjects, drawing a total attendance of 255 participants in both virtual and face-to-face settings.

One participant said:

Quality Month has provided a valuable opportunity to gain insights into the broader initiatives within our organisation. After today’s session, I’m leaving with a much clearer perspective on how to approach another challenge that I’ve been facing.

The feedback received about Quality Month was very positive, confirming its value as a catalyst for organisational improvement.

Systems thinking can change the way you work, for the better

By applying the learning to my professional work, I learned how to think in a more systemic way, look at things differently and accept that life is not as systematic as we might hope. By that I mean understanding how all the different parts of a problem are connected.

The programme helped me become more aware of how I act to bring about improvements in complex situations. So, how I turn up for work and engage and work with different stakeholders is critical to making changes.

I found myself engaging with people from a variety of professional backgrounds including healthcare, business, engineering, climate change, IT management, and organisation change.

I gained insights into how other people think about problems and learned how to apply concepts, tools, and techniques developed by systems thinkers to my own work. I would highly recommend the course to Q Community members.

Get involved

To continue the conversation and connect with other Q members interested in systems thinking, join our SIG: Complexity approaches to support quality improvement.

Further resources

Find out more about Open University’s MSc in Systems Thinking in Practice.

Get to grips with causal loop diagrams.

Learn about rich pictures.