Why Get Operational?
When tackling a challenging problem, typical thinking processes use “factor thinking” to reach a solution. Factor thinking is when you think about the causes or associations related to a various problem. For example, what causes people to develop Type 2 diabetes? While we could come up with a long list that would help us identify factors associated with diabetes, it wouldn’t get us any closer to figuring out how to focus time and limited resources on the highest impact strategies.
But when you are thinking in systems you might ask “what is really causing the issue I’m concerned about?” A systems thinking technique utilizes “stock and flow diagrams” to help you understand how the system works. Using stocks and flows to map the system you care about can help you identify levers for improving performance in the system.
Stocks and flows can be used to create systems maps that illustrate the connections between different elements of a system.
Stocks represent accumulations. Think about water in a bathtub as accumulating. Stocks, at any point in time, can be counted or measured. At any point in time, you can measure the amount of water in a bathtub, the number of open beds in a hospital, the number of people with the flu, etc.
Flows are actions or activities that fill or drain accumulations over time. In this case, a flow into the bathtub increases the stock of water or an outflow from the drain subtracts water from the bathtub. Think of flows as adding to or taking away from stocks. They are actions. You can drain water from the tub, admit or discharge patients from a hospital, or recover from the flu.
Example from the Field
The public health example above is for illustration and demonstrates the concept of getting operational. It can be used for a variety of health topics.
Using the example of Type 2 diabetes, we can sketch out a simple map of how this system starts to work, not just the factors associated with it but how the system operates. In this map, the “Type 2 diabetic population” is the stock of concern. People will flow into that stock by developing Type 2 diabetes. This is represented as the thin line that looks like a pipe. In this example, the way people leave the stock of the “Type 2 diabetic population” is by dying, which is represented as the outflow to the right of the stock.
Note: On this map, you see little clouds at the head end of the inflow and the tail end of the outflow. These clouds represent the boundary of your map—your map doesn’t care about what’s happening in the clouds. When you create your map, you can decide what your outflow will be and what is outside the scope of your map.
How Can You Use This with the CDC Policy Process?
The Policy Analysis domain is when you identify different policy options to address the problem or issue. This is the perfect time to get operational because thinking in systems can help you find higher leverage solutions.