Abstract
Background: Healthcare organisations often find themselves ensnared in pilots that fail to scale, and/or developmental projects that are incoherent systemically, which delays and stifle meaningful whole system transformation, necessitating new approaches such as a systemic design lab, to manage whole system complexity and foster cross-functional collaboration to develop coherent integrated care strategies and innovations.
Approach: The Khoo Teck Puat Hospital's Systemic Design Lab (SDL) was conceptualised based on principles from the Health System Transformation Playbook (HSTP), which emphasises system-thinking and design-thinking as methods to address complex healthcare issues. The lab's aims to promote collaboration across multidisciplinary teams, enabling participants to rethink the way they deliver care and develop strategic solutions that are both innovative and aligned with goals of the Khoo Teck Puat Hospital System, across the subsystems and through time.
An initial prototype of the SDL was implemented at various discussion platforms with healthcare teams from the service delivery, and governance and leadership subsystems to test its capacity for enhancing cross-team collaboration and foster innovative solutions. Observations on how the prototype lab facilitated discussions and collaboration informed refinements in the lab's design, leading to the final development of the SDL.
Results: Participants in the SDL engage in five experiential zones: Preamble, Storytelling, Model Building, Pathfinding, and Case Studies. These zones guide participants through a journey that begins with understanding the broader system context (Preamble), identifying and sharing personal and professional experiences related to healthcare challenges (Storytelling), and progressing to collaboratively building models that represent their current state and desired future state (Model Building). Pathfinding provides a structured approach for developing action plans based on insights gathered in the earlier zones. Finally, the Case Studies zone presents real-world examples of implemented care strategies, further inspiring participants to implement their solutions.
Designed to be self-facilitative, three specialised working zones (Storytelling, Model Building, Pathfinding) will allow teams to explore their healthcare challenges, visualise where they situate in the Khoo Teck Puat Hospital System, and co-create solutions using a series of curated tools and frameworks in each zone, such as system visualisation maps, patient journey maps, and scenario planning exercises. The collaborative and iterative nature of the SDL ensures that all voices are heard, and solutions generated are grounded in real-world insights and system needs.
Implications: The SDL, underpinned by the HSTP, offers a novel and systemic approach to addressing healthcare’s wicked problems by leveraging on systemic visualisation and systemic design methodologies. Through its participatory design and collaborative structure, the lab fosters cross-functional innovation, enabling teams to co-create integrated care solutions that are aligned with broader health system goals.
Moving forward, the lab will be further developed and scaled up for cross-subsystem, whole of system, and public collaboration. By broadening the scope of the lab, we aim to create a sustainable model for health system transformation that can effectively address challenges on a larger scale. Further refinements based on user feedback will be implemented, ensuring that the lab continues to meet the evolving needs of healthcare teams as they navigate complex health challenges.