Applying systems thinking to commissioning: remember Donella Meadows

What are the elements in your system of interest? Can you see them? Do you know what they are? In all likelihood, you can see them and you do know what they are. But, do you know how they are interconnected and what the purpose or function of your system is?

Donella Meadows, in her book Thinking in Systems, reminds us that a system must consist of three things: elements, interconnections and a function or purpose. We could say, then, that it is surprising that we can often see the elements more easily than we can identify the interconnections or define the function or purpose, for it is the purpose of the system that defines its behaviour and it is its behaviour that can often give us some cause for concern.

So, what about when we want to use different providers or different types of providers or different departments or teams etc. in our systems when we are commissioning? What happens then? Well, you can change the elements in a system quite easily and the system will remain the same. Just like the cells in the body are replaced on an ongoing basis but we still remain a human being, we don’t completely change. However, there is a BUT. The but is that the system will remain the same when elements are replaced IF the interconnections and purpose(s) remain the same.

This is something that I see being forgotten during times of change and transformation all the time. Elements – be they providers, services, teams, departments or any other element of the system – are changed and yet the interconnections and purpose of the system are not considered. This is especially true regarding interconnections. By interconnections I am talking about the relationships that hold the elements together. This can be anything from a chain of communication to a set of rules, a protocol or a timetable, for example. Imagine a football game. You can change the players (the elements) and it will still be a football game. Change the rules (interconnections) and you may have some sort of ball game, but it may not be football. Those rules might change the purpose or functions of the game and so you might no longer have a football game. You can completely change the elements and the ‘thing’ will remain the same, as long as the interconnections and purpose remains the same.

Donella also reminds us that, as systems practitioners, our focus is on stocks (accumulations of material or information that has built up in a system over time) and flows (material or information that enters or leaves a stock over time) and the operating unit of our system, which is the feedback loop (the mechanism that allows a change in stock to affect a flow into or out of that same stock). The dynamics of our stocks and flows gives us a picture of the behaviour over time of our system. This behaviour over time gives us clues about the underlying structure of our system, which can help us to identify what action we need to take to reinforce or change that behaviour. Yet, in commissioning, we are not always driven to taking action in response to how the system is structured and behaving as a result of that structure. I think this is partly due to pressures which force quick decisions to what is assumed to be an obvious cause and effect. This assumed cause and effect, as we know, is rarely a proven cause and effect and is exactly as described – as ‘assumed’ cause and effect. I also think it is down to there being a lack of general awareness of how systems, with their elements, interconnections and purposes actually work.

Do we always remember that ‘stock’ takes time to change because ‘flow’ takes time to flow? Even if a lot of money is available, it might still be difficult to change ‘stock’ instantly.

What is an example of stock? Well, Donella explains to us that the population can be considered a stock. It has a ‘reinforcing loop causing it to grow through its birth rate, and a balancing loop causing it to die off through its death rate. As long as fertility and mortality are constant (which in real systems they rarely are), this system has a simple behaviour. It grows exponentially or dies off, depending on whether its reinforcing feedback loop determining births is stronger than its balancing feedback loop determining deaths.’ Births and deaths do not usually happen at the same rate, so we need to be aware that there is a time lag when considering our stock. In commissioning,  we shouldn’t be giving up on our improvement or change efforts too soon, having thought they were a failure, when it might be that they just haven’t had the time they need to make a difference.

It might be useful to remember that inflows and outflows are independent and will, of course, happen at different rates. We tend to focus on stocks more than flows, and inflows more than outflows………….don’t just focus on hiring new staff (inflow) but also give some attention to preventing people from quitting or going elsewhere (outflow) – stem the outflow as well as increasing the inflow to increase the stock (number of staff).

This is but a brief snippet of the messages of Donella Meadows that we can apply to our commissioning practice – look for the history of the system, identify its long-term behaviour because this will provide clues about the system’s underlying structure. Identify the structure (the stocks, flows, feedback) which is determining the resulting behaviour. Try and identify your most important input – this is the one that is likely to be most limiting. Remember, overall, aim to enhance total systems properties like growth, stability, diversity, resilience and sustainability rather than focussing on short term ‘fixes that fail’ because they are implemented without knowledge of how the system works as a whole.

‘Systems of information-feedback control are fundamental to all life and human endeavour, from the slow pace of biological evolution to the launching of the latest space satellite….Everything we do as individuals, as an industry, or as a society is done in the context of an information-feedback system’ Jay W Forrester

(Donella H Meadows, Thinking in Systems, 2008)

 

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