Operationalizing systems thinking approach to sustain public health rehabilitation programs: a rapid review and strategic synthesis.
Zanib Nafees, Mahmoud AboAlfa, Mohammed Alkhaldi
PMID 41069591WHAT IT FOUND
Sustaining rehabilitation programs relies on three practical strategies: using real-time data to spot problems, engaging stakeholders to fix referral gaps, and making small, low-cost changes like adjusting protocols.
These approaches improved coordination and efficiency in diverse settings, but the evidence is descriptive rather than causal.
Key findings
01Feedback loops, such as real-time dashboards and patient-reported outcomes, helped programs detect bottlenecks and adjust resources quickly.
02Stakeholder engagement and systems mapping revealed service duplication and referral gaps, leading to improved continuity of care.
03Leverage points, defined as small strategic changes like adjusting referral protocols or travel routes, yielded significant improvements in service reach with minimal additional resources.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The review was a rapid review with a short timeframe (January-March 2025), prioritizing timeliness over exhaustiveness. No formal quality appraisal of the included studies was conducted. The search was restricted to English-language publications, potentially missing relevant evidence from non-English sources. The included studies were largely descriptive, limiting the ability to assess causal relationships between systems thinking application and sustainability outcomes. The review did not include speech-language pathology-specific outcomes or interventions.
Declared interests
The authors declare that no financial support was received for the research and/or publication of this article.
The easy way to misread this
Do not interpret the reported improvements in coordination and efficiency as proof that systems thinking causes better patient clinical outcomes. The review synthesized descriptive studies and policy reports, not controlled trials, so it cannot establish a causal link between these strategies and reduced disability or improved function.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →