A participatory systems approach to design for safer integrated medicine management

Abstract

It is recognised that whole systems approaches are required in the design and development of complex health care services. Application of a systems approach benefits from the involvement of key stakeholders. However, participation in the context of community based health care is particularly challenging due to busy and geographically distributed stakeholders. This study used action research to investigate what processes and methods were needed to successfully employ a participatory systems approach. Three participatory workshops planned and facilitated by method experts were held with 30 representative stakeholders. Various methods were used with them and evaluated through an audit of workshop outputs and a qualitative questionnaire. Findings on the method application and participation are presented and methodological challenges are discussed with reference to further research.

Practitioner Summary: This study provides practical insights on how to apply a participatory systems approach to complex health care service design. Various template-based methods for systems thinking and risk-based thinking were efficiently and effectively applied with stakeholders.

Keywords:

• Health care ergonomics
• participatory ergonomics
• systems approach
• sociotechnical system
• patient safety

Acknowledgements

The authors thank all the participants of the workshops and Professor Graham Martin and colleagues at SAPPHIRE (Social science APPlied to Healthcare Improvement REsearch) for support and advice.