Harbour of Hope: An interactive card game to teach System Thinking, Integrated Care, and Population Health Management

Background: Research shows that a major tenet of successful management and leadership of integrated care is system understanding. Unfortunately, system thinking is not a skill that is commonly taught in health-related educational programs, nor is it universally applied in day-to-day operations. Applying the concepts of adult learning, we’ve established an interactive card game that can be adapted for use by groups from 5 to 100+ participants to learn the concepts of system thinking, integrated care, and population health management in a fun environment.

Audience:This educational game is designed for training of patients/caregivers, front-line workers, administrators and/or policy makers. It works best when the audience includes representatives from several, or all, of these groups.

Approach: The interactive session begins with an introduction to system thinking. Brought to life by a series of thought experiments, participants are introduced to the concepts of simple, complicated, and complex systems at the micro, meso, and macro levels. The group is then introduced to Harbour of Hope, a fictitious town for which a health system needs to be designed. Using specially designed playing cards and placemats, participants will work from a pre-defined global budget to design a health system for the people of Harbour of Hope that includes self-management, community services, primary care, specialty services, and hospitals. Participants then test to see how effectively their system meets the needs of the population of Harbour of Hope and are provided several iterations to improve performance.

The game has been designed to offer flexibility in the rules that allow for adaptation to different contexts. Through iteration, participants are offered an opportunity to tailor solutions to the needs and context set by the facilitators. As such, there is no pre-defined ‘ideal’ approach.

Participants are encouraged to work together to identify challenges and design creative solutions.

In this workshop, participants will be introduced to the System Thinking thought experiments (approximately 20 mins). The group will then be invited to play a version of the game that focuses on population identification, segmentation based on medical and social needs, and adaptation to health equity considerations (40 mins). The session will conclude with a brainstorming session on the applicability of the game to teaching the nine pillars of Integrated Care and the five steps of Population Health Management. Participants will be invited to discuss if/how the game could be adapted for use within their health system and offered support to do so.

Outcomes: Participants will leave the workshop with an understanding of System Thinking and how to teach it, insights into the relationship between Integrated Care and Population Health Management to Health System Design, and an introduction to an interactive game that they can use to teach these principles within their system. Participants will be free to use any, and all, of the concepts shared in the meeting free of charge after the workshop (including the Harbour of Hope game concept).