Abstract
Integrating systems thinking and design thinking offers a promising approach to address systemic challenges in healthcare. However, existing studies apply diverse systems thinking theories and methods across different healthcare contexts, and design also shows methodological pluralism. Such diversity has created conceptual fragmentation and uncertainty about how designers can meaningfully apply systems thinking. This paper presents a scoping review of 44 empirical studies that apply both design approaches and systems thinking theories or methods in healthcare service systems. The analysis examines where systems thinking is positioned within studies and identifies four relationship types: (1) design as systemic practice, (2) systems thinking informing design, (3) design–systems thinking integration, (4) design supporting systems thinking. It also highlights the practical challenges that emerge from the integration. The study clarifies the current landscape of how design engages with systems thinking and outlines research opportunities for advancing systems thinking to address healthcare complexity.
Keywords
Healthcare Complexity, Systems Thinking, Systemic design, Service Design
DOI
https://doi.org/10.21606/drs.2026.1551
Citation
Guo, Y., Wang, Z., Kettley, S., and Roesch-Marsh, A. (2026) Mapping How Design Engages with Systems Thinking in Complex Healthcare Systems: A Scoping Review, in Simeone, L., Gray, C. M., Verhoeven, A., de Götzen, A., Bakırlıoğlu, Y., Zohar, H., Stead, M., and Buwert, P. (eds.), DRS2026: Edinburgh, 8–12 June, Edinburgh, United Kingdom. https://doi.org/10.21606/drs.2026.1551
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Included in
Mapping How Design Engages with Systems Thinking in Complex Healthcare Systems: A Scoping Review
Integrating systems thinking and design thinking offers a promising approach to address systemic challenges in healthcare. However, existing studies apply diverse systems thinking theories and methods across different healthcare contexts, and design also shows methodological pluralism. Such diversity has created conceptual fragmentation and uncertainty about how designers can meaningfully apply systems thinking. This paper presents a scoping review of 44 empirical studies that apply both design approaches and systems thinking theories or methods in healthcare service systems. The analysis examines where systems thinking is positioned within studies and identifies four relationship types: (1) design as systemic practice, (2) systems thinking informing design, (3) design–systems thinking integration, (4) design supporting systems thinking. It also highlights the practical challenges that emerge from the integration. The study clarifies the current landscape of how design engages with systems thinking and outlines research opportunities for advancing systems thinking to address healthcare complexity.