What’s Outside the Box?! Thinking About Big “S” System Factors in Your Change Initiative
By Dr. Sobia Khan, Director of Implementation
8-min read
Implementation frameworks that describe context have shed incredible light on determinants of change, particularly when it comes to factors that affect change within the implementation setting. When it comes to systems however, these factors seem to have been left in the dark. Have you ever seen the cartoon “Complexity and policy making” by Virpi Oinonen? In the cartoon, three people are developing a plan inside their box; on their chart paper, they have written: A -> B. Their backs are turned to a door that one of their colleagues has courageously opened, revealing chaos outside of the box. The brave colleague says, “um”… an utterance of realization that there is something incredibly important being overlooked.
I think this cartoon describes a lot of what is happening in implementation (which is why I have started using it so much in my talks and workshops). It very accurately depicts how we treat system factors in our implementation planning. We know they exist and that they profoundly impact our initiatives, but we choose to only peer at them through the door (“um….”) rather than walk outside and embrace them, in fear that we can’t possibly account for them in our plans.
Embracing system factors in implementation science and practice
Luckily, it feels that things are shifting in both implementation science and practice to emphasize systems thinking. We are now starting to crack the surface of what we need to pay attention to in multiple embedded levels of implementation. In fact, to develop our new Context Compass Framework, we looked at 13 different determinant frameworks that describe context and included some that explicitly describe systems. This was a fruitful exercise that clarified the need for more expansive determinant frameworks to describe systems.
When compiling the system factors, the usual suspects came up time and time again – outer setting resources, policies and laws, and social norms/values and beliefs. Other system factors gave us food for thought about how certain factors could be specified or expanded upon to really focus on key issues that impact multiple system levels, affect system readiness, and that are pertinent to specific contexts. Here are a few of the key factors that haven’t typically been described in widely used frameworks, but might resonate with many who are implementing in practice.
Stability
While many systems theorists would encourage people to embrace the “edge of chaos” (i.e., the sweet spot between order and disorder, where innovation is most likely to emerge), many systems tend to not to live in that space. We are either too rigid and too stable systemically to embrace system transformation, or we are way too chaotic to make sense of change in the first place. An example of a too-stable system is academia, where traditional structures of knowledge productions and trajectories for career growth/ security have been maintained to such a degree that it does a disservice to the field and perpetuates inequities. The most common and profound examples of unstable systems are those that are constantly undergoing political or environmental turmoil. In my parents’ home county of Pakistan, implementers there have cited political instability as a huge barrier to getting anything done (some version of “I connected with these officials to see if we could get XYZ started but 3 months later they were out and a new person was in” often rings true for many people). It should be mentioned that sometimes in chaos there is opportunity, and sometimes stability positively serves the needs of a system at that moment in time – so living on the ends of the spectrum can also have certain advantages, depending on what you are trying to achieve.
System characteristics
This is actually a factor that consists of multiple subfactors, but the point is that mapping out what a system looks like and understanding why it looks that way can give you a sense of what large scale change efforts must overcome or leverage. Some subfactors here include system architecture and distribution of power. A very concrete example is trying to build support hubs for implementation across an entire state education system. This might involve understanding power in the system (i.e., who has power to influence or motivate change? Who has power to mandate change? Where does this power come from?) and also involves understanding the architecture of the education system to see where natural support hubs might occur, and at what level. Using existing systems architecture and changing power dynamics across a system could help to better sustain and embed a support mechanism.
Equity and justice orientation
While values, beliefs, and social norms are often cited in determinant frameworks, it is important to specifically draw out equity and justice as outer setting factors. Inequities are structurally built into so many of our systems (e.g., structural racism), and belief systems that perpetuate these inequities are unfortunately still so influential in determining what is funded, de-funded and implemented that this needs to be called out explicitly and clearly so that we can advocate and collectively act for change.
System supports
This again is a factor that consists of many subfactors and is rarely referred to in determinant frameworks. As we continue to uncover how important support systems are to implementation, it is imperative to draw this out as a pertinent system factor so that we can bring attention to support systems where they exist and build them where they don’t. For example, building a cadre of skilled workers who understand how to support implementation; ensuring that leaders have competencies and skills in system leadership (which is different from traditional models of leadership), and having dedicated organizations that can provide support to implementation settings are all forms of system capacity building for change that can stimulate transformational and large-scale change in the future.
Many of the factors and subfactors in the Context Compass Framework may resonate with you, and we encourage you to look at the system factors in particular to see what is applicable to your context and initiative. You can learn more about the Context Compass Framework by viewing the recording of our event that happened on June 6. We are also making the Context Compass Framework and an associated tool that helps implementation teams select contextual strategies (note that this is a beta version of the tool!) available in our Embracing Complexity course, which is open for enrollment until July 18.
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