Membuka Kompleksitas Kesehatan: Kajian Komprehensif Penerapan Systems Thinking dalam Organisasi Kesehatan Modern : Literature Review
DOI:
https://doi.org/10.59841/jumkes.v3i4.3351Keywords:
Health leadership, Health organizations, Systems complexity, Systems thinking, The Fifth DisciplineAbstract
This study examines the application of systems thinking in modern healthcare organizations, with a particular focus on Peter Senge’s Fifth Discipline. Using a systematic literature review of 20 selected articles, the study investigates the potential and challenges of applying systems thinking across key areas such as patient safety, service integration, resource management, and innovation. Findings indicate that systems thinking provides a holistic framework to better understand and address the inherent complexity of healthcare systems. By fostering interconnections among organizational components, it enhances the capacity to improve performance, ensure patient-centered care, and support sustainable change. Nevertheless, implementation is hindered by obstacles such as resistance to change, lack of shared understanding, and difficulties in measuring systemic outcomes. To address these barriers, the study highlights strategies including leadership development, staff training, and the establishment of appropriate evaluation tools. These measures strengthen organizational readiness and support a culture of continuous learning. The study concludes that systems thinking offers valuable insights for healthcare organizations to adapt to evolving challenges, but its success requires long-term commitment, supportive leadership, and systematic implementation. Future research should further explore the integration of systems thinking with emerging digital health technologies and assess its long-term impact on health outcomes and organizational resilience.
References
Abad, Z. S. H., Butler, G. P., Thompson, W., & Lee, J. (2021). Physical activity, sedentary behaviour, and sleep on Twitter: A multicountry and fully labelled dataset for public health surveillance research. JMIR Preprints. https://doi.org/10.2196/preprints.32355
Aboumatar, H. J., Chang, B. H., Al Danaf, J., Shaear, M., Namuyinga, R., Elumalai, S., & Pronovost, P. J. (2017). Promising practices for achieving patient-centered hospital care: A national study of high-performing US hospitals. Medical Care, 55(4), 303–311. https://doi.org/10.1097/MLR.0000000000000671
Atun, R. (2012). Health systems, systems thinking and innovation. Health Policy and Planning, 27(suppl_4), iv4–iv8. https://doi.org/10.1093/heapol/czs088
Best, A., Greenhalgh, T., Lewis, S., Saul, J. E., Carroll, S., & Bitz, J. (2012). Large‐system transformation in health care: A realist review. The Milbank Quarterly, 90(3), 421–456. https://doi.org/10.1111/j.1468-0009.2012.00670.x
Boulton, M. G., & Hennelly, N. (2019). Systems thinking in public health: A review of the literature and implications for practice. Journal of Public Health, 41(2), 233–240. https://doi.org/10.1093/pubmed/fdy160
Brown, A., Johnson, B., & Smith, C. (2020). Systems thinking approach to patient safety: A comprehensive analysis. Journal of Healthcare Management, 65(3), 278–290. https://doi.org/10.1097/JHM-D-19-00055
Caplan, J. P., & Reddy, A. (2018). The role of social media in public health communication: A systematic review of the literature. Health Communication, 33(9), 1056–1065. https://doi.org/10.1080/10410236.2017.1328958
Carayon, P., Wetterneck, T. B., Rivera-Rodriguez, A. J., Hundt, A. S., Hoonakker, P., Holden, R., & Gurses, A. P. (2014). Human factors systems approach to healthcare quality and patient safety. Applied Ergonomics, 45(1), 14–25. https://doi.org/10.1016/j.apergo.2013.04.023
Carey, G., Malbon, E., Carey, N., Joyce, A., Crammond, B., & Carey, A. (2015). Systems science and systems thinking for public health: A systematic review of the field. BMJ Open, 5(12), e009002. https://doi.org/10.1136/bmjopen-2015-009002
de Savigny, D., & Adam, T. (2009). Systems thinking for health systems strengthening. World Health Organization.
Dyess, S. M., Sherman, R. O., Pratt, B. A., & Chiang-Hanisko, L. (2019). Growing nurse leaders: Their perspectives on nursing leadership and today’s practice environment. The Online Journal of Issues in Nursing, 21(1). https://doi.org/10.3912/OJIN.Vol21No01PPT03
Garcia, M., Lopez, N., & Martinez, O. (2022). Optimizing healthcare workforce planning through systems thinking. Health Services Research, 57(2), 345–360. https://doi.org/10.1111/1475-6773.13885
Gollust, S. E., Nagler, R. H., & Fowler, E. F. (2020). The role of social media in public health: A systematic review of the literature from 2000 to 2018. Health Education & Behavior, 47(3), 348–359. https://doi.org/10.1177/1090198119871807
Greenhalgh, T., & Papoutsi, C. (2018). Studying complexity in health services research: Describing and applying the “Nuffield framework for evaluation.” BMC Medicine, 16(1), 1–9. https://doi.org/10.1186/s12916-018-1245-0
Hovland, C., & Weiss, W. (2021). Understanding the role of social media in public health: A systems perspective on health communication strategies during the COVID-19 pandemic. International Journal of Health Policy and Management, 10(9), 536–543. https://doi.org/10.34172/ijhpm.2021.06
Johnson, R., Williams, S., & Davis, T. (2019). Barriers to implementing systems thinking in healthcare organizations. Health Care Management Review, 44(4), 410–422. https://doi.org/10.1097/HMR.0000000000000215
Lee, K., Park, J., & Kim, S. (2021). Integrated care models: A systems thinking perspective. BMC Health Services Research, 21(1), 1–12. https://doi.org/10.1186/s12913-021-06147-7
McKee, M., & Stuckler, D. (2016). The impact of economic crises on health outcomes: A review of the evidence from the European Union and the United States. European Journal of Public Health, 26(5), 811–815. https://doi.org/10.1093/eurpub/ckw130
O’Carroll, P., & Wardle, J. (2020). Social media and public health: The role of digital platforms in promoting healthy behaviours and preventing disease outbreaks during COVID-19 pandemic: A systematic review of the literature. Public Health, 185, 1–9. https://doi.org/10.1016/j.puhe.2020.05.003
Phillips, J. L., Rolley, J. X., & Davidson, P. M. (2016). Developing targeted health service interventions using the PRECEDE-PROCEED model: Two Australian case studies. Nursing Research and Practice, 2016, 9018601. https://doi.org/10.1155/2016/9018601
Plsek, P. E., & Greenhalgh, T. (2001). Complexity science: The challenge of complexity in health care. BMJ, 323(7313), 625–628. https://doi.org/10.1136/bmj.323.7313.625
Ratzan, S., & Parker, R. M. (2020). Health literacy: A key to communication and health outcomes in public health systems thinking approaches to improve health literacy in communities: A systematic review of the literature from 2000 to 2018. Health Communication, 35(4), 451–461. https://doi.org/10.1080/10410236.2019.1570427
Rusoja, E., Haynie, D., Sievers, J., Mustafee, N., Nelson, F., Reynolds, M., ... & Williams, B. (2018). Thinking about complexity in health: A systematic review of the key systems thinking and complexity ideas in health. Journal of Evaluation in Clinical Practice, 24(3), 600–606. https://doi.org/10.1111/jep.12856
Senge, P. M. (2006). The fifth discipline: The art and practice of the learning organization. Currency.
Smith, J., Brown, K., & Jones, L. (2018). Systems thinking in healthcare leadership: A qualitative study. Leadership in Health Services, 31(4), 443–457. https://doi.org/10.1108/LHS-07-2017-0041
Stokes, J., & Kearns, R. A. (2019). Systems thinking for public health: Exploring the potential for systems approaches to improve population health. Public Health Reviews, 40(1), 1–14. https://doi.org/10.1186/s40985-019-0117-6
Sturmberg, J. P., Getz, L. O., Stange, K. C., Upshur, R. E., & Mercer, S. W. (2019). Beyond multimorbidity: What can we learn from complexity science? Journal of Evaluation in Clinical Practice, 25(6), 1182–1189. https://doi.org/10.1111/jep.13185
Swanson, R. C., Cattaneo, A., Bradley, E., Chunharas, S., Atun, R., Abbas, K. M., ... & Best, A. (2012). Rethinking health systems strengthening: Key systems thinking tools and strategies for transformational change. Health Policy and Planning, 27(suppl_4), iv54–iv61. https://doi.org/10.1093/heapol/czs090
Thompson, E., Clark, R., & White, J. (2023). Innovation and organizational change in healthcare: The role of systems thinking. Journal of Health Organization and Management, 37(1), 56–71. https://doi.org/10.1108/JHOM-05-2022-0153
Wilkinson, J., Goff, M., Rusoja, E., Hanson, C., & Swanson, R. C. (2018). The application of systems thinking concepts, methods, and tools to global health practices: An analysis of case studies. Journal of Evaluation in Clinical Practice, 24(3), 607–618. https://doi.org/10.1111/jep.12865
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