Increasing Health System Resilience During Times of Crisis: Application of Systems Thinking & Creative Problem-Solving Methodologies

Abstract

Disease outbreaks and health emergencies cause substantial human suffering, death and economic loss and often test the responsiveness and resilience of health systems. It is therefore necessary to shift the current paradigm of managing outbreaks to include health system strengthening as a critical component of the response. Yet, this is not systematically being done as there is limited evidence on how to do so effectively. Using methodologies that allow for the acute challenges in outbreak response to be addressed while identifying and supporting the strengthening of components of health systems and enabling optimization of resources (both human and financial) is critical. My research aims to lay the foundation for future work in this area through the piloting of systems thinking (process mapping) and creative problem-solving methodologies (design thinking). Process mapping and design thinking are particularly useful methodologies as they can be applied to any country that has an outbreak during any timepoint. These approaches were chosen as they have proven success in other industries, have documented use-cases in healthcare and public health, have a low-cost of implementation, have a low barrier to entry requiring minimal training, and are collaborative methodologies. By using these methods in three settings with three different emerging pathogen outbreaks I was able to show that despite the chaos and complexities associated with them, process mapping can address immediate response priorities while simultaneously strengthening components of a health system. Further, the design thinking principles were used to develop a data collection and reporting system which contains all laboratory data from one of the most complicated multi-country outbreaks to date demonstrating both short and long-term benefits to the response and information management systems Process mapping and design thinking are effective methods to strengthen components of a health system while responding to disease outbreaks. Testing and piloting additional systems thinking and critical problem-solving methodologies is recommended. It is through trying novel approaches, working together and remaining in a growth mind-set that we will be able to address acute and long-term challenges that impact the health of our populations.