Exploring Systems Thinking and Systemic Design: Insights from a Summer School Experiment Addressing Urban Health Crises
Article Sidebar
Main Article Content
Abstract
This paper relates urban healthcare crises to the global challenges of overshoot and collapse and suggests systems thinking as an innovative approach towards addressing these amalgamated crisis situations. We begin by reviewing what systems are and how they are structured and behave, highlighting how systems thinking can identify high-leverage interventions and systemic design to achieve effective change. Subsequently, we illustrate how these system concepts were applied in an international, multidisciplinary summer school between European and Southeast Asian partners in collaboration with the World Health Organization’s (WHO) Technical Science for Health Network (Téchne). Examining how ventilation, temperature, humidity, and daylighting control strategies enhance Infection Prevention and Control (IPC), the initiative developed ideas and designs for a multiple disease treatment center that would provide isolation units and create a safe care environment for patients, families, and communities. The design process was informed through consultation with three physically and socio-economically diverse neighborhoods across the Bangkok Metropolitan Region to gain a richer understanding of the varied experiences and approaches in managing the COVID-19 disruption. Leveraging WHO guidelines, students adopted a systemic design approach to develop innovative solutions that could withstand natural hazards and used local materials and natural ventilation to prevent airborne infection and control indoor temperature. In conclusion, we propose a novel working model linking specific stages of systemic thinking and systemic design into a generalized, iterative urban and healthcare design framework that will be further refined as part of specific electives at the KU Leuven Faculty of Architecture and joint summer schools in 2023, 2024 and beyond.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
All material is licensed under the terms of the Creative Commons Attribution 4.0 International (CC-BY-NC-ND 4.0) License, unless otherwise stated. As such, authors are free to share, copy, and redistribute the material in any medium or format. The authors must give appropriate credit, provide a link to the license, and indicate if changes were made. The authors may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. The authors may not use the material for commercial purposes. If the authors remix, transform, or build upon the material, they may not distribute the modified material, unless permission is obtained from JARS. Final, accepted versions of the paper may be posted on third party repositories, provided appropriate acknowledgement to the original source is clearly noted.
References
Acumen Academy. (n.d.). Systems Practice. An 8-week online training course. Retrieved January 23, 2022, from https://acumenacademy.org/course/systems-practice/
Adam, T., & de Savigny, D. (2012). Systems thinking for strengthening health systems in LMICs: Need for a paradigm shift. Health Policy Plan, 27(Suppl 4), 1–3.
Arnold, R.D., & Wade, J.P. (2015). A definition of systems thinking: A systems approach. Procedia Computer Science, 44, 669-678. https://doi.org/10.1016/j.procs.2015.03.050
Barbero, S., & Pereno, A. (2020). Editorial: Relating systems thinking and design. Systemic design and co-creation processes for territorial enhancement. Strategic Design Research Journal, 13(2). https://doi:10.4013/sdrj.2020.132.01
Bertalanffy, L. von. (1968). General system theory: Foundations, development, applications. Penguin Books.
Boulding, K.E. (1956). General systems theory—The skeleton of science. Management Science, 2(3), 197-208. https://doi.org/10.1287/mnsc.2.3.197
Büscher, M. (2006). Vision in motion. Environ. Plan. A, 38, 281–299.
Catton, W.R., & Udall, S.L. (1982). Foreword to overshoot: The ecological basis of revolutionary change. University of Illinois Press.
Cross, N. (2001). Designerly ways of knowing: Design discipline versus design science. Design Issues, 17(3), 49-55.
Damabi, R. (2016). Follow the rabbit: A field guide to systemic design. Government of Alberta CoLab.
De Wandeler, K. (2019, October 16). Overshoot. Why we need systemic approaches when dealing with urban crises [Public lecture]. Faculty of Architecture and Planning, Thammasat University,Thailand.
De Wandeler, K. (2020). Overshoot: System design & practice in aid of urban crises. Master dissertation guidelines, AY 2020-21. KU Leuven Faculty of Architecture. https://www.blog-archkuleuven.be/overshoot/?filter_category=architecture-master-studios
De Wandeler, K., Mendis, R.M., Nanayakkara, S.M., & Vasudevan, M. (2020). Rhythm analysis of life during physical distancing for Covid-19: Sri Lankans in Brussels, Belgium. Cities People Places: An International Journal on Urban Environments,4(2), 1-24.
De Wandeler, K., Gopal, R., Jadhav, A., Madhav, S. M., Mendis, R., Nanayakkara, S., Thoria, P., & Vasudevan, M. (2021). Living lockdown beyond borders How South Asian residents in Brussels dealt with physical distancing. The Architect. Journal of the Sri Lanka Institute of Architects, March 2021, 160-171.
De Wandeler, K., & Lo, A. (2022). International multidisciplinary summer school: Systemic design for health -Infectious diseases prevention and control. Thammasat Design School. https://issuu.com/tds.thammasat/docs/summer_school_2022_booklet_220925
Dodds, W. (2019). The world’s worst problems. Spinger.
Doucet, I., & Janssens, N. (2011). Editorial: Transdisciplinarity, the hybridisation of knowledge production and space-related research. In I. Doucet & N. Jannssens (Eds.), Transdisicplinary knowledge production in architecture and urbanism: Towards hybrid modes of inquiry (urban and landscape perspectives). Springer.
Durizzo, K., Asiedu, E., Van der Merwe, A., Van Niekerk, A., & Günther, I. (2021). Managing the COVID-19 pandemic in poor urban neighborhoods: The case of Accra and Johannesburg. World Development, 137, 105175.
Ellwanger, J.H., Byrne, L.B., & Chies, J.A.B. (2022). Examining the paradox of urban disease ecology by linking the perspectives of urban one health and ecology with cities. Urban Ecosystems, 25, 1735–1744. https://doi.org/10.1007/s11252-022-01260-5
Fejerskov, A. M., & Fetterer, D. (2021). Disrupting development? A situated perspective on technology and innovation in global development. Progress in Development Studies, 21(3), 231-243.
Findeli, A. (1999). Introduction. Design Issues, 15(2), 1-3.
Forrester, J.W. (1961). Industrial dynamics. Pegasus communications.
Forrester, J.W. (1968). Principles of systems (2nd ed.). Pegasus communications.
Forrester, J.W. (1971). World dynamics. Wright-Allen Press.
Hensel, M. U., Hensel, D. S., & Sevaldson, B. (2019). Editorial RSD5: Linking systems-thinking and design-thinking in architecture and urban design. FormAkademisk, 12(2). https://doi.org/10.7577/formakademisk.3406
Hirsch Hadorn, G., Hoffman-Riem, H., Biber-Klemm, S., Grossenbacher-Mansuy, W., Joye,D. Pohl, C.,Wiesmann, U., & Zemp, E.(2008). Handbook of transdisicplinary research. Springer.
Jahn, T., Bergmann, M., & Keil, F. (2012). Transdisciplinarity: between mainstreaming and marginalization. Ecological Economics, 79, 1-10.
Jones, P. (2014). Systemic design principles for complex social systems. In G. Metcalf (Ed.), Social systems and design (Vol.1 of the Translational Systems Science Series, pp. 91-128). Springer Verlag. https://doi.org/10.1007/978-4-431-54478-4_4
Jones, P., & Van Ael, K. (2022). Design journeys through complex systems. Practice tools for systemic design. BIS Publishers.
Khan, A. (2021). Thinking tools for systems thinking, technology. Architecture + Design, 5(2), 134-139. https://doi.org/10.1080/24751448.2021.1967051
LeCompte, M. D., Schensul, J. J., Singer, M., Trotter, R. T., & Cromley, E. K. (1999). Mapping social networks,spatial data, and hidden populations. Rowman Altamira.
Madhav, N., Oppenheim, B., Gallivan, M., Mulembakani, P., Rubin, E., & Wolfe, N. (2017). Pandemics: risks,impacts, and mitigation. In D. T. Jamison, H. Gelband, S. Horton, P. Jha, R.Laxminarayan, C. N. Mock, & R. Nugent (Eds.), Disease control priorities: improving health and reducing poverty (3rd ed.) The International Bank for Reconstruction and Development / The World Bank, PMID: 30212163.
Meadows, D.H., Meadows, D. L., Randers, J., & Behrens III, W. W. (1972). The limits to growth: a report for the club of rome’s project on the predicament of mankind. Universe Books.
Meadows, D.H. (2008). Thinking in systems: A primer. Chelsea Green Publishing.
Mofijur, M., Fattah, I. R., Alam, M. A., Islam, A. S., Ong, H. C., Rahman, S. A., Najafi, G., Ahmed, S.F. Md.Uddin, A., & Mahlia, T. M. I. (2021). Impact of COVID-19 on the social, economic, environmental and energy domains: Lessons learnt from a global pandemic. Sustainable Production and Consumption, 26, 343-359.
Monat, J. P., & Gannon, T. F. (2015). What is systems thinking? A review of selected literature plus recommendations. American Journal of Systems Science, 4(1), 11-26.
Murphy, R., & Jones, P. (2020). Leverage analysis: A method for locating points of influence in systemic design decisions. FormAkademisk, 13(2). https://doi.org/10.7577/formakademisk.3384
Omidyar Group. (2017). Systems practice workbook. Omidyar Group. https://docs.kumu.io/content/Workbook-012617.pdf
Peters, D. H. (2014). The application of systems thinking in health: why use systems thinking?. Health Research Policy and Systems, 12(51). http://www.health-policy-systems.com/content/12/1/51
Raworth, K. (2017). Doughnut economics. Seven ways to think like a 21st-century economist. Random House Business Books.
Richmond, B. (2000). The “thinking” in systems thinking: Seven essential skills. Pegasus Communications.
Rigolot, C. (2020). Transdisciplinarity as a discipline and a way of being: Complementarities and creative
tensions. Humanities and Social Sciences Communications, 7(1), 1-5.
Roggema, R. (2017). Research by design: Proposition for a methodological approach. Urban Science, 1(1), 2. https://doi.org/10.3390/urbansci1010002.
Rydland, H. T., Friedman, J., Stringhini, S., Link, B. G., & Eikemo, T. A. (2022). The radically unequal distribution of Covid-19 vaccinations: A predictable yet avoidable symptom of the fundamental causes of inequality. Humanities and Social Sciences Communications, 9(1), 1-6.
Savigny, D.de, & Adam, T. (2009). Alliance for health policy and systems research & World Health Organization In D.de Savigny & T. Adam (Eds.), Systems thinking for health systems strengthening. World Health Organization. https://apps.who.int/iris/handle/10665/44204
Škare, M., Soriano, D. R., & Porada-Rochoń, M. (2021). Impact of COVID-19 on the travel and tourism industry. Technological Forecasting and Social Change, 163, 120469.
Strijbos, S. (2017). Systems thinking. In R. Frodeman (Ed.), The Oxford Handbook of Interdisciplinarity (2nd ed., pp. 291-302). Oxford University Press. https://doi.org/10.1093/oxfordhb/9780198733522.001.0001.
Stroh, D.P. (2015). Systems thinking for social change: A practical guide to solving complex problems, avoiding unintended consequences and achieving lasting results. Chelsea Green Publishing.
Tatar, M., Shoorekchali, J. M., Faraji, M. R., & Wilson, F. A. (2021). International COVID-19 vaccine inequality amid the pandemic: Perpetuating a global crisis? Journal of global health, 11.
Tran, B. X., Nguyen, H. T., Le, H. T., Latkin, C. A., Pham, H. Q., Vu, L. G.,Le, X.T.T., Nguyen, T.T., Pham, Q.T., Ta, N.T.K., Nguyen,Q.T., Ho, C.S.H., & Ho, R. C. (2020). Impact of COVID-19 on economic well-being and quality of life of the Vietnamese during the national social distancing. Frontiers in psychology, 11, 565153.
UN-Habitat. (2022). World cities report 2022: Envisaging the future of cities. UN-Habitat.
Van Ael, K., Vandenbroeck, P., Ryan, A., & Jones, P. (2018). Systemic design toolkit guide. Namahn.
Van Doorn, H. R. (2021). The epidemiology of emerging infectious diseases and pandemics. Medicine, 49(10), 659-662.
Westman, L., Patterson, J., Macrorie, R., Orr, C. J., Ashcraft, C. M., CastánBroto, V., Dolan, D., Gupta, M. van der Heijden, J., Hickmann, T. Hobbins, R., Papin, M., Robin, E. Rosan, C. Torrens, J., & Webb, R. (2022).Compound urban crises. Ambio, 51(6), 1402-1415.
World Health Organization. (2007). Everybody’s business: Strengthening health systems to improve health outcomes: WHO’s framework for action. World Health Organization (WHO), Food and Agriculture Organization of the United Nations (FAO) & World Organisation for Animal Health (OIE). (2020). Joint Risk Assessment Operational Tool (JRA OT): An operational tool of the tripartite zoonoses guide. Taking a multisectoral, One health approach: A tripartite guide to addressing zoonotic diseases in countries. https://www.woah.org/fileadmin/Home/eng/Media_Center/docs/pdf/onehealthportal/EN_JointRiskAssessmentOperationalTool_webversion.pdf
World Health Organization. (2020, July 9). Transmission of SARS-CoV-2: implications for infection prevention precautions. Scientific Brief. https://www.who.int/news-room/commentaries/detail/transmission-of-sars-cov-2-implications-for-infection-prevention-precautionshttps://www.who.int/news-room/commentaries/detail/transmission-of-sars-cov-2-implications-for-infection-prevention-precautions
World Health Organization. (2021). Roadmap to improve and ensure good indoor ventilation in the context of COVID-19. https://www.who.int/publications/i/item/9789240021280
World Health Organization, Health Emergencies Programme. (2022). Téchne website. Retrieved January 23, 2023, from https://www.who.int/groups/techne
World Health Organization, Health Emergencies Programme. (2022, August 4). Téchne’s International Multidisciplinary Summer School on “Systemic Design for Health:” responding to needs identified during the COVID-19 pandemic and beyond. WHO’s Monthly Operational Update on COVID-19,10.
Wu, T. (2021). The socioeconomic and environmental drivers of the COVID-19 pandemic: A review. Ambio,50(4), 822-833.