Using system science to reveal and strengthen prevention in the Queensland public health system

The Making prevention a health system priority – systems analysis project is using a co-design process with stakeholders across the state to identify the successes, gaps and opportunities for prevention.

The Prevention Centre is providing system science expertise to guide the analysis.

The project aligns with Queensland and national health reforms that recognise the importance of prevention to reduce the burden of chronic conditions and build sustainability in the health system.

Executive Director of the Queensland Health Preventive Health Branch, Mr Mark West, said system science could reveal prevention opportunities and solutions that might otherwise remain invisible.

“It’s complex and we don’t know what we don’t know. We know that there is a desire, or a hope, to do more prevention, but we’re concerned that there’s not sufficient dose of primary or secondary prevention happening in the system,” Mr West said.

“With system science, we can look at the characteristics, the drivers and the culture of prevention in the Queensland public health system and the issues that are holding back progress in prevention.”

The team is using a range of methods to engage with stakeholders, including broad communication with the Queensland Health workforce and executive structures, online engagement tools, participatory workshops and semi-structured interviews.

The key outcome of the project is to identify high-value opportunities to expand and sustainably embed chronic disease prevention as a core function of quality clinical care.  

Mr West hopes the project will achieve outcomes in terms of both the “means and ends”.

“In terms of means, we can develop capacity here locally to keep going with new ways of investigating and determining and exploring the system, and how we can influence change,” he said.

“When it comes to the ends, or some results from this project, I want options for prevention to take forward to decision makers and a rationale for that, and a package or a couple of sure things that will help make a difference.”

Prevention Centre Co-Director Professor Lucie Rychetnik welcomed the opportunity to support the project.

“The focus on systems change is really exciting,” she said. “It’s not about describing a problem, or developing a theory, it’s actually creating change on the ground.”

Professor Rychetnik said the Prevention Centre’s remit from its launch in 2013 was to build capacity around systems thinking and systems approaches for chronic disease prevention.

The project is an opportunity to apply the lessons of the Prevention Centre’s work over the past eight or nine years, Professor Rychetnik said.

“There will be value for the Queensland health system, but there will also be lessons that, with Queensland Health’s approval, we can synthesise and share with other jurisdictions.”

Professor Rychetnik said a particular appeal of the project was that Queensland Health was leading it, and had invited the Prevention Centre “to help Queensland Health to identify opportunities to transform the system”.

Mr West said it was important for the Queensland Health team to lead the project as they were part of the system and had to be part of the solution.

“We can’t stand back as a separate policy entity, and just beat the drum or be concerned that not enough is happening. We have to learn, and we have to develop the capabilities around system science so we can be aware of our own role in the system.”

Mr West said the project was a “double-edged process” in that it was exciting and innovative but also a little daunting. “When all those things are happening, we know we’re onto something,” he said.

This project is funded by the Commonwealth Government’s Health Innovation Fund and Queensland Health.