International Journal of Health Policy and Management

International Journal of Health Policy and Management

Why Systems Thinking is Needed to Center Trust in Health Policy and Systems; Comment on “Placing Trust at the Heart of Health Policy and Systems”

Document Type : Commentary

Authors
Diane T. Finegood 1
Chris Yakimov 2
1 Morris J. Wosk Centre for Dialogue and Department Kinesiology and Biomedical Physiology, Simon Fraser University, Vancouver, BC, Canada
2 Faculty of Education, Simon Fraser University, Vancouver, BC, Canada
10.34172/ijhpm.8706
Abstract
The editorial by McKee and colleagues is an important call to action to put a spotlight on trust and its role in the function of health systems. The authors make a good case for this focus considering how trust in health systems seems to have eroded in recent years, an erosion accelerated by the COVID-19 pandemic. They recognize that trust is complex given the many forms of trust, the importance of context, and its dynamic and unpredictable nature. However, the solutions they offer including learning how to measure trust and figuring out the causes and consequences of trust are just simple or complicated solutions to this complex challenge. Instead, we need to approach building trust in healthcare by embracing and harnessing complexity. This starts by understanding the difference between complicated and complex challenges and then by applying complex systems frameworks that offer insight into new ways forward.
Keywords
Complexity
Collaboration
Patient Centred
Emergence
  1. Adam MB, Donelson A. Trust is the engine of change: a conceptual model for trust building in health systems. Syst Res Behav Sci. 2022;39(1):116-127. doi:1002/sres.2766
  2. McKee M, van Schalkwyk MC, Greenley R, Permanand G. Placing trust at the heart of health policy and systems. Int J Health Policy Manag. 2024;13:8410. doi:34172/ijhpm.2024.8410
  3. Solomon RC, Flores F. Building Trust: In Business, Politics, Relationships, and Life. Oxford University Press; 2003.
  4. Shanka MS, Menebo MM. When and how trust in government leads to compliance with COVID-19 precautionary measures. J Bus Res. 2022;139:1275-1283. doi:1016/j.jbusres.2021.10.036
  5. Boyer Y. Healing racism in Canadian health care. CMAJ. 2017;189(46):E1408-E1409. doi:1503/cmaj.171234
  6. Kiran T, Daneshvarfard M, Wang R, et al. Public experiences and perspectives of primary care in Canada: results from a cross-sectional survey. CMAJ. 2024;196(19):E646-E656. doi:1503/cmaj.231372
  7. Finegood DT. Complex Systems Frameworks Collection. Simon Fraser University. https://www.sfu.ca/complex-systems-frameworks.html. Accessed July 6, 2024.
  8. Robinson TN, Sirard JR. Preventing childhood obesity: a solution-oriented research paradigm. Am J Prev Med. 2005;28(2 Suppl 2):194-201. doi:1016/j.amepre.2004.10.030
  9. Rittel HW, Webber MM. Dilemmas in a general theory of planning. Policy Sci. 1973;4(2):155-169. doi:1007/bf01405730
  10. Glouberman S, Zimmerman B. Complicated and Complex Systems: What Would Successful Reform of Medicare Look Like? Discussion Paper No. 8. Toronto: Commission on the Future of Health Care in Canada; 2002.
  11. Brborović O, Brborović H, Nola IA, Milošević M. Culture of blame-an ongoing burden for doctors and patient safety. Int J Environ Res Public Health. 2019;16(23):4826. doi:3390/ijerph16234826
  12. Gilson L. Trust and the development of health care as a social institution. Soc Sci Med. 2003;56(7):1453-1468. doi:1016/s0277-9536(02)00142-9
  13. Bar-Yam Y, Bar-Yam S, Bertrand KZ, et al. A complexity science approach to healthcare costs and quality. In: Sturmberg JP, Martin CM, eds. Handbook of Systems and Complexity in Health. New York, NY: Springer; 2013:855-877. doi:1007/978-1-4614-4998-0_48
  14. French M, Hesselgreaves H, Wilson R, Hawkins M, Lowe T. Harnessing Complexity for Better Outcomes in Public and Non-Profit Services. Bristol: Policy Press; 2023. doi:47674/9781447364139
  15. Kramer M, Parkhurst M, Vaidyanathan L. Breakthroughs in Shared Measurement and Social Impact. FSG Social Impact Advisors; 2009.
International Journal of Health Policy and Management
Volume 13, Issue 1
2024
Pages 1-4

  • Received Date 16 July 2024
  • Revised Date 22 August 2024
  • Accepted Date 24 August 2024
  • First Published Date 28 August 2024
  • Published Date 01 December 2024