System Thinker and Leadership

Systems are conceptualized at the micro, meso, and macro level (see Figure 3.3 in Armstrong & Sables-Baus, 2019). As we move to embrace patient-centered care and include the patient and their family with the healthcare team, we see the micro systems come together to form a mesosystem. For example, consider what is accomplished through centers that focus on heart failure, stroke, or cancer. The macrosystem (or organization as a whole) is responsible for a seamless, satisfying, and safe experience for the patient and their family. For this discussion, you’ll describe the system that makes up your organization.


  1. Describe the adaptive system that makes up your organization (MACRO- INSURANCE COMPANY), in which you respond to the following:
    • How will you develop your skills to become a system thinker in relation to these 14 habits? (Choose three to focus on for this discussion.)
      • Seek to understand the big picture.
      • Observe how elements within a system change over time, generating patterns and trends.
      • Recognize that a system’s structure generates behavior.
      • Identify the circular nature of complex cause-and-effect relationships.
      • Make meaningful connections within and between systems.
      • Change perspectives to increase understanding.
      • Surface and test assumptions.
      • Consider the issue fully and resist coming to a quick conclusion.
      • Consider how mental models affect current reality and the future.
      • Use understanding of system structure to identify possible leverage actions.
      • Consider short-term, long-term and unintended consequences of actions.
      • Pay attention to accumulations and their rates of change.
      • Recognize the impact of time delays when exploring cause-and-effect relationships.
      • Check results and change actions if needed, a process known as “successive approximation.”
      • Adapted from: Why You Need to be a Systems Thinker in Healthcare
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