Accelerating Health System Change and Transformation with the Health System Transformation Playbook: A Work Shop for Practitioners

Abstract

Introduction: Health systems are complex adaptive systems (CAS) operating within larger socioeconomic contexts. Health system transformation (HST) is a complex endeavour that often results in unintended consequences. Existing methods to drive health system transformation is slow, have intrinsic limitations, and may impede successful implementation in local contexts.
 Yishun Health is a small regional population health system of 320,000 people. In our HST experience, services redesign and transformation projects were initiated continuously through time with transformation actions interacting across all health system sub-systems e.g. governance, manpower, financing, informatics systems, etc. Ensuring synergistic and coherent transformation into a more people-centred, integrated and value-driven health system at scale was extremely challenging.
 We designed a Health System Transformation Playbook (HSTP) as a design-, systems-, and complexity-thinking enabled methodology to systematically design, prioritize and test health system and services transformation actions, anchored on a three-step (1) iterative story-telling, (2) model building and (3) pathfinding process that tackles the scale of socially and technologically complex adaptive systems through time.
 It is hypothesized that the use of HSTP enables stewards of health systems to gain a more systematic and coherent understanding of health systems services planning and organization development, so as to accelerate transformation towards people-centred, integrated and value-driven health systems.
 Workshop: Our experience suggested that any HST method with the hope of accelerating whole system change must address the need to train and gather numerous stakeholders as co-designers, it must enable a continual series of innovations that remain synergistic despite their introduction at different time points and into different sub-systems of a CAS, and it must guard against incremental-only innovations, premature convergence and lock-in into HST paths that are less transformative or with potential negative effects.
 We hope to engage with health system leaders, designers, organization development and change management practitioners across the world through a facilitated workshop that encourages participant sharing and group discussion on how we lead and accelerate HST in our own organizational and cultural contexts. The session aims to co-create new knowledge on HST methodologies that can accelerate whole health systems change and transformation.
 
 Outline of Workshop (90 minutes) 
 
 Introduction to Health System Transformation (5min)
 Presentation on Health System Transformation Playbook (15min)
 Table Discussions (25min):
 
 - Group Story Telling: Each participant to share own experiences in leading and facilitating large scale or whole health systems change and transformation. Highlight valuable lessons, especially what didn’t work, counter-intuitive results and reasons.
 - Pathfinding: Generate questions or recommendations for accelerating HST. 
 
 Table Read Back & Facilitated Q&A (25min)
 Invitation to Share Personal Takeaways (15min)
 Closing (5min)
 
 Facilitators: A/Prof Ng Yeuk Fan & Dr Teo Ken Wah