A critical systems evaluation of the introduction of a ‘discharge to assess’ service in Kent

Discharge to Assess (D2A) models of care have been developed to expedite the process of discharging hospital patients as soon as they are medically fit to leave, thereby improving the efficiency and effectiveness of the healthcare system. This article focuses on the implementation of a D2A model in Kent, England, which formed a case study for a European research programme of improvements in integrated care for older people. It uses the Critical Systems Heuristics framework to examine the implementation process and focuses in particular on why this improvement project proved to be so difficult to implement and why the anticipated outcomes were so elusive. The analysis highlights the value in using critical systems thinking to better evaluate integrated care initiatives, in particular by identifying more explicitly different stakeholder perspectives and power relationships within the system and its decision environment.

The role of evaluation in supporting action on a hazardous world, a call for critical systems thinking

A commentary on “Confronting storms, fires and pestilence: Meaningful evaluation for a hazardous world” by Juha I. Uitto

Furthering systems theory towards social theory by revisiting critical systems thinking: connecting problem-solving and theory-building

PurposeThe purpose is to forward systems theory one more step towards social theory and integrate problem-solving and theory-building, and search for the integration and unity of science by revealing the nature and role of critical systems thinking (CST).Design/methodology/approachThis article describes relations between systems theory and social theory in three parts. First, it examines the links of systems methodologies with three social science approaches as well as the role of CST. Second, the focus of theory and the form of explanation are discussed from critical social science (CSS) perspective. Third, the direction of theorizing of a CST-based systems theory is investigated.FindingsFirst, CST is a hidden assumption of system dynamics (SD)/systems thinking (ST). Second, systems theory is positioned in CSS. Third, CST integrates traditional and soft systems methodologies (SSM), and connects systems science and social science. Fourth, this article reveals hidden links between systems approaches and three corresponding social science approaches. Fifth, the theoretical focus of a CST-based systems theory could be formal/structure theory and/or substantive/content theory. Sixth, the form of explanation could be structural/mechanismic explanation combining causal and interpretive explanations. Seventh, a CST-based systems theory may adopt abduction, which complements a defect in deduction and induction in a difficulty of nonlinearity.Originality/valueIt illustrates a graph of the competing approaches in systems science corresponding to paradigms in social science.

Cascading climate change impacts and implications

Climate change is expected to have adverse impacts and implications for a range of human-environment systems. However, our understanding of the extent to which these impacts may propagate as cascades, compounding to form multiple impacts across sectors, is limited. Cascades result from interdependencies between systems and sub-systems of coupled natural and socio-economic systems in response to changes and feedback loops. The combined effects of interacting stressors may affect the ability of individuals, governments, and the private sector to adapt in time, before widespread damage occurs. We discuss the origins of cascading impacts thinking and present the results of an investigation of cascading impacts and implications in New Zealand. A participatory and collaborative approach was used through workshops and semi-structured interviews with sector informants, including engineers, local government staff, and financial risk managers and analysts from the financial services sectors. Qualitative data collection was combined with network and systems analysis to examine increased frequency of high-intensity rainfall events, sea-level rise and drought, across urban water infrastructure and the financial services, and the implications of cascading climate change impacts for governance. Results demonstrate that closer consideration of the combined effects of linked stressors can facilitate a better understanding of the scope and scale of climate change impacts. By using critical systems thinking in characterising and assessing how climate change impacts cascade across domains, we show the implications of cascades for their governance and reveal where climate change adaptation interventions might be focused. The research methods and insights into cascades provide a conceptual and practical basis for further development, which can inform the design of additional studies in other domains and jurisdictions.

Cascading climate change impacts and implications

Climate change is expected to have adverse impacts and implications for a range of human-environment systems. However, our understanding of the extent to which these impacts may propagate as cascades, compounding to form multiple impacts across sectors, is limited. Cascades result from interdependencies between systems and sub-systems of coupled natural and socio-economic systems in response to changes and feedback loops. The combined effects of interacting stressors may affect the ability of individuals, governments, and the private sector to adapt in time, before widespread damage occurs. We discuss the origins of cascading impacts thinking and present the results of an investigation of cascading impacts and implications in New Zealand. A participatory and collaborative approach was used through workshops and semi-structured interviews with sector informants, including engineers, local government staff, and financial risk managers and analysts from the financial services sectors. Qualitative data collection was combined with network and systems analysis to examine increased frequency of high-intensity rainfall events, sea-level rise and drought, across urban water infrastructure and the financial services, and the implications of cascading climate change impacts for governance. Results demonstrate that closer consideration of the combined effects of linked stressors can facilitate a better understanding of the scope and scale of climate change impacts. By using critical systems thinking in characterising and assessing how climate change impacts cascade across domains, we show the implications of cascades for their governance and reveal where climate change adaptation interventions might be focused. The research methods and insights into cascades provide a conceptual and practical basis for further development, which can inform the design of additional studies in other domains and jurisdictions.