Bridging complexity : a systemic design approach to policy in the BC Ministry of Health

Abstract

As the reach of complexity accelerates and characterizes health systems, there is an increasing need for government and health sector policymakers to move from siloed to systemic approaches to designing, implementing, and evaluating health policy. However, public-sector conventions inherited from the 20th century were designed for stability and remain resistant to change. This research explores what prevents or enables a complexity-informed, systemic design-led policy approach in the Population Public Health (PPH) Division, BC Ministry of Health. Engaging an action research framework facilitated reflective application of systemic design-led methods to map PPH policymakers’ experiences and organizational mental models and tested ways for policy teams to be more iterative, networked/collaborative, and supported to bridge conventional and innovative, design-led policy approaches. Study recommendations include designing a PPH policy hub with aligned policy tools and resources, enhancing staff-level networks, and shifting from top-down to a more adaptive, distributed leadership and decision-making model.