Health Services Management Research > Volume 22, Number 2 > Pp. 71-80

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Systems thinking, complexity and managerial decision-making: an analytical review

D G Cramp ^* and E R Carson  

* School of Management, University of Surrey, Guildford; Centre for Health Informatics, City University, London, UK

E-mail: e.r.carson{at}city.ac.uk

One feature that characterizes the organization and delivery of health care is its inherent complexity. All too often, with so much information and so many activities involved, it is difficult for decision-makers to determine in an objective fashion an appropriate course of action. It would appear that a holistic rather than a reductionist approach would be advantageous. The aim of this paper is to review how formal systems thinking can aid decision-making in complex situations. Consideration is given as to how the use of a number of systems modelling methodologies can help in gaining an understanding of a complex decision situation. This in turn can enhance the possibility of a decision being made in a more rational, explicit and transparent fashion. The arguments and approaches are illustrated using examples taken from the public health arena.

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