Strategizing towards the future hospital: a systems thinking approach
Abstract Background The complex systemic nature of Future Hospital design in the rapidly ageing city-state of Singapore calls for systems thinking. We apply this approach to answer two research questions: (i) What are the variables that drive the present and future dynamics of the Future Hospital sy...
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| Format: | Article |
| Language: | English |
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BMC
2025-05-01
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| Series: | Health Research Policy and Systems |
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| Online Access: | https://doi.org/10.1186/s12961-025-01333-9 |
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| author | Ashish Kumar Sean Shao Wei Lam Sze Ling Chan Yingqi Xu Yao Ge Geoffrey Kah Tack Gui Hiang Khoon Tan |
| author_facet | Ashish Kumar Sean Shao Wei Lam Sze Ling Chan Yingqi Xu Yao Ge Geoffrey Kah Tack Gui Hiang Khoon Tan |
| author_sort | Ashish Kumar |
| collection | DOAJ |
| description | Abstract Background The complex systemic nature of Future Hospital design in the rapidly ageing city-state of Singapore calls for systems thinking. We apply this approach to answer two research questions: (i) What are the variables that drive the present and future dynamics of the Future Hospital system? (ii) How are these driving variables related? Methods Causal loop diagrams (CLDs) were developed collaboratively by a cross-functional system modelling team through group modelling discussions and reviews, totalling 20 sessions. Network analysis of the resulting CLDs was used to identify dominant variables. Results Seven interlocking CLDs (national view, cluster view, and study hospital top level, outpatient, emergency department, inpatient and surgeries and procedures views) were created to serve as “boundary objects” for different Future Hospital stakeholders, as well as researchers and planners of other Future Hospital systems. Important feedback loops and 15 interventions for redesign were identified. In all the modelled services (outpatient, emergency, inpatient and surgeries and procedures), capacities are subject to positive feedback loops. Alternative models of care are needed to restrain ever-increasing demand. Need for agility (the need for ability to quickly deploy and pivot capacity in responses to crises) is the variable with the highest betweenness centrality in the combined network of seven CLDs. Conclusions We address the need for greater openness on Future Hospital initiatives by making our resulting logic maps public. Due to their qualitative nature, the CLDs are insightful for Future Hospital strategic planning exercises globally. |
| format | Article |
| id | doaj-art-244f479abc3949d88e4166d42d3e3512 |
| institution | DOAJ |
| issn | 1478-4505 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Health Research Policy and Systems |
| spelling | doaj-art-244f479abc3949d88e4166d42d3e35122025-08-20T03:16:42ZengBMCHealth Research Policy and Systems1478-45052025-05-0123111210.1186/s12961-025-01333-9Strategizing towards the future hospital: a systems thinking approachAshish Kumar0Sean Shao Wei Lam1Sze Ling Chan2Yingqi Xu3Yao Ge4Geoffrey Kah Tack Gui5Hiang Khoon Tan6Duke-NUS Medical School, National University of SingaporeDuke-NUS Medical School, National University of SingaporeDuke-NUS Medical School, National University of SingaporeDuke-NUS Medical School, National University of SingaporeSingapore Health ServicesSingapore Health ServicesDuke-NUS Medical School, National University of SingaporeAbstract Background The complex systemic nature of Future Hospital design in the rapidly ageing city-state of Singapore calls for systems thinking. We apply this approach to answer two research questions: (i) What are the variables that drive the present and future dynamics of the Future Hospital system? (ii) How are these driving variables related? Methods Causal loop diagrams (CLDs) were developed collaboratively by a cross-functional system modelling team through group modelling discussions and reviews, totalling 20 sessions. Network analysis of the resulting CLDs was used to identify dominant variables. Results Seven interlocking CLDs (national view, cluster view, and study hospital top level, outpatient, emergency department, inpatient and surgeries and procedures views) were created to serve as “boundary objects” for different Future Hospital stakeholders, as well as researchers and planners of other Future Hospital systems. Important feedback loops and 15 interventions for redesign were identified. In all the modelled services (outpatient, emergency, inpatient and surgeries and procedures), capacities are subject to positive feedback loops. Alternative models of care are needed to restrain ever-increasing demand. Need for agility (the need for ability to quickly deploy and pivot capacity in responses to crises) is the variable with the highest betweenness centrality in the combined network of seven CLDs. Conclusions We address the need for greater openness on Future Hospital initiatives by making our resulting logic maps public. Due to their qualitative nature, the CLDs are insightful for Future Hospital strategic planning exercises globally.https://doi.org/10.1186/s12961-025-01333-9Strategic planningComputer simulationHospital of the futureComplex systemsSystems thinkingNetwork analysis |
| spellingShingle | Ashish Kumar Sean Shao Wei Lam Sze Ling Chan Yingqi Xu Yao Ge Geoffrey Kah Tack Gui Hiang Khoon Tan Strategizing towards the future hospital: a systems thinking approach Health Research Policy and Systems Strategic planning Computer simulation Hospital of the future Complex systems Systems thinking Network analysis |
| title | Strategizing towards the future hospital: a systems thinking approach |
| title_full | Strategizing towards the future hospital: a systems thinking approach |
| title_fullStr | Strategizing towards the future hospital: a systems thinking approach |
| title_full_unstemmed | Strategizing towards the future hospital: a systems thinking approach |
| title_short | Strategizing towards the future hospital: a systems thinking approach |
| title_sort | strategizing towards the future hospital a systems thinking approach |
| topic | Strategic planning Computer simulation Hospital of the future Complex systems Systems thinking Network analysis |
| url | https://doi.org/10.1186/s12961-025-01333-9 |
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