The healthcare environment comprises a series of interconnected components that make it function like a system. Therefore, systems thinking finds great relevance to the healthcare system both in research and clinical practice. Systems thinking in research provides learners with the science, knowledge, and skills that they need to see the interrelationships within a given functional system, the patterns of change, organizational structures, and the processes beneath complex scenarios in relation to managing patients (Plack, Goldman, Scott, & Brundage, 2019). These capabilities make systems thinking particularly important in research aimed at developing evidence-based practices for improving healthcare outcomes when working with patients exhibiting different complex symptoms. According to Plack et al. (2019), systems thinking is appropriate for healthcare research as it provides the relevant tools and strategies for the recognition of multidisciplinary perspectives, questioning personal assumptions, recognizing the implication of environmental and social factors in the patient care process, and identifying functional and structural relationships in healthcare service delivery. All these are necessary for healthcare research and practice for results to be holistic and evidence-based.
The research aimed at answering the research question, “Among elderly long-term care residents with dementia, does use of music therapy compare to no-music therapy reduce depression and agitation”? requires understanding multiple perspectives in healthcare service delivery. Systems thinking can be relevant and appropriate for the study because it gives the researcher the capability to understand complex patient scenarios, such as those around working with patients with dementia. Research generally entails unlearning personal assumptions and adopting an open mind to allow one to learn from the perspectives shared by others through literature and day-to-day communications.
In the research on the treatment of depression and agitation in patients with dementia using music therapy, systems thinking enables the understanding of the contributions of different components to effective healthcare service delivery. Applying systems thinking to the research would entail conducting literature reviews and primary data collection activities to explore the contributions made by components of the healthcare systems to patients’ treatment outcomes and developing treatment approaches aligned to the contribution of each component as recommended by (Chughtai & Blanchet, 2017). Some of the components include service delivery (such as safety and quality, infrastructure, and management); healthcare workforce (advocacy, policies, norms, data, and standards); information; medical products (such as vaccines and technologies); financing; leadership and governance (Jackson & Sambo, 2020). Each of these components contributes to the choice and effectiveness of care delivery processes, and it is only through systems thinking that a researcher can understand the distinct contributions to each and effectively design even the music therapy to be used as an intervention when working with patients who have dementia.
Besides understanding the components of healthcare delivery models, systems thinking can be applied in the treatment of depression and agitation in dementia patients by focusing on the four distinct system levels that comprise the healthcare delivery models. These system levels include the patient level, the care team, the healthcare organization, and the environment, which interact in the care process (Rosas, 2017). Systems thinking can help in understanding the interrelationships that help in the behaviors of systems at the different levels of the healthcare systems as well as how the interactions across the levels of healthcare systems contribute to the overall outcomes in the treatment process (Rosas, 2017). By adopting systems thinking in this research, it will be possible to come to an all-inclusive strategy for implementing music therapy in treating patients with dementia based on the patients’ behaviors within the contexts of different systems.
While systems thinking is generally quite effective in healthcare research, its main limitation is that it complicates research. Systems thinking expands the range of factors and parties to healthcare service delivery, all of which have to be included in the research to ensure that findings are holistic and evidence-based. While this may be good as it increases the depth of research, it is a limitation as it requires significant time input and increases the probability of error and conflicting information. Therefore, it is recommended that the application of systems thinking to healthcare research should be focused on the patient and care systems more than on the environment and organization.
Chughtai, S., & Blanchet, K. (2017). Systems thinking in public health: A bibliographic contribution to a meta-narrative review. Health Policy and Planning, 32(4), 585-594. Retrieved from https://academic.oup.com/heapol/article/32/4/585/2846147
Jackson, M. C., & Sambo, L. G. (2020). Health systems research and critical systems thinking: The case for partnership. Systems Research and Behavioral Science, 37, 3-22. Retrieved from https://onlinelibrary.wiley.com/doi/pdf/10.1002/sres.2638
Plack, M. M., Goldman, E. F., Scott, A. R., & Brundage, S. B. (2019). Systems thinking in the healthcare professions: A guide for educators and clinicians. Health Sciences Research Commons, The George Washington University. Retrieved from https://hsrc.himmelfarb.gwu.edu/cgi/viewcontent.cgi?article=1000&context=educational_resources_teaching
Rosas, S. R. (2017). Systems thinking and complexity: Considerations for health-promoting schools. Health Promotion International, 32, 301-311. doi: 10.1093/heapro/dav109