SystemsThinking Mod6

accelerating
community
transformation

A five-year applied research project
conducted by Health Forum
in conjunction with Disney Corporation and Florida Hospital
Funded by AstraZeneca

Module 6

Systems Thinking for
Community Improvement

Accelerating
Community
Transformation

Module 6
Systems Thinking for
Community
Improvement
TABLE OF CONTENTS
1. Introduction .............................................................................................1
2. Timeline ...................................................................................................3
3. Learning Objectives ................................................................................4
4. Overview: Systems Thinking for Community Improvement ................5
What Is Systems Thinking?................................................................7
Health, Quality-Of-Life, And Community As Systems .................13
How Can Systems Thinking Help Us In Our Community Work?.....17
5. Reading Guide (Readings listed below are available by calling 415 356 4385)

Reading #1: New visions for communities, by Carol Schwinn, 1994.
Reading #2: Creating circles of health: Integrating enhanced social environments with responsible
behavior to achieve improved population health profiles, by Paul Lee, 1996.
Reading #3: The laws of the fifth discipline, by Peter Senge, 1990.
Reading #4: Creating sustainable organizations: Meeting the economic, ecological, and social
challenges of the 21
st
century, by Sara Schley and Joe Laur, 1998.
Reading #5: Building shared visions and strategies for action: combining systems thinking and
dialogue, by Gary Hirsch, 1994.
Reading #6: How to see structure, by Richard Karash, 1997.
Reading #7: Welfare reform efforts, by James Rieley and Don Seville, 1997.

6. Community Exercises ..............................................................................29
Exercise # 1:. Moving from Events Thinking to Systems Thinking .................... 29
Storytelling from Multiple Perspectives
Exercise # 2: Finding Leverage: Measures And Behavior Over Time ... ............ 35
7. Resources..................................................................................................40
Computer Conference Guide
Glossary of Systems Thinking Language
Bibliography
Faculty Biography
Systems Archetype Basics, From Story to Structure
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ACT Module 6 Systems Thinking for Community Improvement Page 1
INTRODUCTION
Systems thinking challenges us to put on some new glasses and
consider a different kind of vision one into our
thinking, actions and learning.
Your ACT community teams are well under way in a performance-based planning mindset,
having defined:
Mission and vision (for your initiatives and your community)
Key issues (that you wish to address)
Outcomes (statements of what you specifically want to achieve)
Indicators (measures of your results)
Potential interventions (continually improved best practices for achieving your outcomes)
The purpose of this module is to provide ACT community members with an overview and
some practice with systems-thinking principles and tools to deepen and accelerate your
community work. Specifically, we hope to illustrate and encourage you to experiment with:
Building a shared understanding of the community as a system;
Gaining deeper insights into the underlying system dynamics and determinants of health and
quality-of-life in the initiatives and issues you are supporting;
Enhancing the work you are currently doing with the Outcomes community improvement
software, by understanding potential systemic relationships among outcome statements and
indicators;
Anticipating systemic relationships and unintended consequences as you create more detailed
action plans for your initiatives; and
Building community, learning capability, and social capital, within your community team,
through the practice and use of systems-thinking skills.
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This module is designed to help you and your community teams continue to build and strengthen
your capability for performance-based planning and sustainable results, building on all your
history and all you have accomplished. The discipline of systems thinking offers us some
practical tools and ways of seeing the world that acknowledge the often overwhelming
complexity and interdependencies we sense in our communities. Systems-thinking tools help us,
individually and collectively, to gain a clear picture of our current realities and of our desired
community future. Given our emphasis on evidenced-based and performance-based healthier
communities work, systems thinking offers tools for deepening our understanding of the
evidence as well as the performance in our initiatives. And, we will be surprised how
systems-thinking principles and tools help us to build community, learning capability, and social
capital.
The module is organized as follows:
Timeline to help you plan your individual and community activities
Learning Objectives to guide your expectations
Overview an overview of systems thinking and its application to our community work
Reading Guide recommended resources to prepare you and your teams for further work
together
Community Exercises practices designed to support your current community work and
to use often!
Resources a glossary; illustrations of systems thinking tools; resource listings of web
sites, books, and journal articles about systems thinking and its application to sustainability
and healthy community initiatives
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TIMELINE
Date Activity
September 28 Module mailed to ACT Teams
September 28-
October 5
Read Overview and Readings
Preview Community Exercises # 1 and 2
October 5-16 Participate in Computer Conference
October 12-27 Complete Exercises 1 and 2
October 29-30 Learning Collaborative in Aiken, SC
Continue Learning after Module and Learning Collaborative
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LEARNING OBJECTIVES
By participating in the Learning Module activities, community teams will:
1. Learn the basics of systems-thinking within a healthier communities framework.

2. Apply systems-thinking tools to deepen understanding of the community as a system
and the determinants of health and quality-of-life.

3. Practice using systems thinking tools to leverage collaborative planning, action, and
evaluation activities.

4. Extend current work with the Outcomes community improvement software, through
better understanding of the community as a system and experience with systems
thinking tools; align specific project and overall community outcome statements and
measures with your communitys vision.

5. Increase capacity for team learning and sustained community action, through the
practice and use of systems-thinking skills.
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OVERVIEW
Rather than thinking of the world in parts that form wholes,
we start by recognizing that we live in a world of wholes within wholes.
Rather than trying to put the pieces together to make the whole,
we recognize that the world is already whole.
Koffman and Senge (1993)
Introduction
Farm children seem to learn naturally about the cycles of cause and effect that make up systems.
They see the links among the milk the cow gives, the grass the cow eats, and the
droppings which fertilize the fields. When a thunderstorm is on the horizon, even a small child
knows to turn off the floodgate on a spring-water well, for fear that runoff carried downstream
by the rains will foul it. They know that if they forget to turn off the gate, theyll have to boil
their water, or carry it by bucket from far away. They easily accept the counter-intuitive fact of
life: the greatest floods represent a time when you must be most careful about conserving water.
Similar paradoxes perplex us daily in our organizational and community life. Yet as a
community seeking change, it is very difficult to be collectively aware of these counter-intuitive
dynamics amidst our social, economic, political, organizational, and human systems. Times of
your greatest progress and success in a community initiative may be the best moment to plan for
harder times, anticipating some limit to your success. The policies and decisions which seem to
gain the most for your community priorities may ultimately drain your common community
resources most quickly. The harder you strive for what you want, the more you may undermine
your chances of achieving it, as unexpected, unintended consequences begin to emerge.
As we progress further into our healthy community work, we recognize the complex web of
deeply persistent socio-economic patterns which lie in the way of major gains in health status
and quality-of-life. While we know that health and quality-of-life are determined by a complex
interaction of social, economic, educational, psychological, behavioral, genetic, medical, and
environmental variables it is the potential unique mix of these determinants as a system,
embedded in a community as a system, that give us so much challenge.
Our work needs to address this complexity while not being overwhelmed by it. Our
interventions must address the root cause and not simply symptoms, in order to create
sustainable change. Our impatient quest for improvement (action) all too often results in
superficial changes that leave deeper community problems untouched, or worse yet, creates new
problems.
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The discipline of systems thinking offers us some practical tools and ways of seeing the world
and these paradoxes a way of dealing with the complexity and interdependencies in our
communities a way to find leverage for sustainable change. Systems thinking offers us a way
to individually and collectively gain a clear picture of our current realities and of our desired
community future. Systems thinking challenges us to put on some new glasses and consider a
different kind of vision one into our thinking, actions and learning.
Given our emphasis on evidenced-based and performance-based healthy community work,
systems thinking offers tools for deepening our understanding of the evidence as well as the
performance in our initiatives. It offers us practical tools as well to build community, learning
capability, and social capital.
The purpose of this module is to provide ACT community members with an overview and
some practice with systems thinking principles and tools to deepen and accelerate your
community work. Specifically, we hope to illustrate and encourage you to experiment with:
Building a shared understanding of the community as a system;

Gaining deeper insights into the underlying system dynamics and determinants of
health and quality-of-life in the initiatives and issues you are supporting;

Enhancing the work you are currently doing with the Outcomes community
improvement software by understanding the potential systemic relationships among
outcome statements and indicators;

Anticipating systemic relationships and unintended consequences as you create more
detailed action plans for your initiatives; and

Building community, learning capability, and social capital, within your community
team, through the practice and use of systems-thinking skills.
This Overview is organized as follows:
What Is Systems Thinking?
Health, Quality-Of-Life, And Community As Systems
How Can Systems Thinking Help Us In Our Community Work?
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What is Systems Thinking?
Based on Systems Dynamics
Events in our lives and in our communities are rarely as simple and direct as they appear.
Systems thinking is the practical application of systems dynamics an intricate field of study
that examines the patterns and structures that govern nature, families, the economy, our bodies,
companies, communities, and all other systems. In the broadest sense, systems thinking
encompasses a larger body of methods, tools and principles. The field includes cybernetics and
chaos theory, gestalt therapy; the work of Gregory Bateson, Russell Ackoff, Eric Twist, Ludwig
von Bertallanfy, and the Santa Fe Institute; and the dozen or so practical techniques for process
mapping systems and structures. All of these diverse approaches have one guiding idea in
common: the behavior of all systems follows certain common principles, which continue to be
discovered and articulated.
Systems thinking has become more mainstream with the recent publication of The Fifth
Discipline: The Art and Practice of the Learning Organization by Peter Senge (1990). This
work is primarily based on the field of systems dynamics, developed by Professor Jay Forrestor
and his colleagues at Massachusetts Institute of Technology, over the past forty years.
Numerous tools have evolved for practical use in organizational and community change, each
based on a systems dynamics understanding of how complex feedback processes generate often
problematic patterns of behavior within organizational, social, and human systems. When the
system is better understood, teams can find leverage in changing or re-shaping the system and in
designing interventions to avoid these recurring patterns of behavior.
Of special interest, Senges efforts began with the focus on building learning organizations as
a foundation for management and leadership. As the work has progressed, it has shifted to
encompass what many discovered as a missing link the essential glue for sustainable and
enduring efforts building community, specifically building learning communities. This shift is
primarily in response to the growing recognition of the deep fragmentation in our own
organizations and communities; one we often take as a given. The process of building
community itself, as a prerequisite for learning and performance, is now recognized for its own
significance. An interesting learning for us as we consider how this work can help us as ACT
communities.
One of five disciplines
Senges work defines a set of five inter-related disciplines that are the foundation for a culture of
continuous learning.
Shared Vision is building a sense of commitment in a group by developing a shared
understanding of the future they seek to create and the guiding principles, values and
practices by which to get there. This building process is an ongoing one, whereby people
can articulate their common stories - around vision, purpose and values, why their work
matters and how it fits into the larger world.
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Mental Models are the deeply held images, assumptions, and stories which we carry in
our mind about ourselves, other people, institutions, and every aspect of the world.
Mental models shape our decisions and actions. This discipline builds capacity to surface
your own mental models and try on new ones, while continually clarifying and
improving upon them. It helps us think about our thinking.
Personal Mastery is learning to expand our personal capacity to create the results we
desire most, with an economy of means. People and communities without personal
mastery are doomed to be the victims of the world around them. Personal mastery is the
first step towards being a part of and creating a shared vision.
Team Learning is the transforming of conversational and collective thinking skills, so
that groups can reliably develop intelligence and ability that is exponentially greater than
the sum of the individual members talents. When teams are truly learning, not only are
they producing extraordinary results, but individual members are growing more rapidly
than could have occurred otherwise. The discipline starts with dialogue thinking
together.
Systems Thinking is a way of thinking about and a language for describing the forces
and interrelationships that shape the behavior of systems. This discipline, termed the
fifth discipline, helps us see how to change systems more effectively, and to act more
in tune with the larger processes of the natural and economic world.
The word discipline has been carefully chosen, with the belief that in order to practice a
discipline, you must be a lifelong learner. Each discipline has to do with improving how we
think, what we truly want, and how we interact and learn with one another. And, this learning
occurs best in the context of community, a community of learners.
Key Principles of Systems Thinking
1. A system is more than the sum of the parts
Our cultural, educational, and work environments have often promoted and been defined by the
analytic method, which supports a three-step process: (1) break the system into its component
parts, (2) study each part in isolation, and (3) assemble an understanding of the whole from an
understanding of the parts. The assumption in this thinking is that the parts interact in a
relatively weak and linear, cause-and-effect pattern, with the belief that optimizing one of the
parts (or each of the parts) will optimize the whole.
In systems thinking, we apply the reverse. We identify the whole to explain the parts only as
they relate to the whole. The defining characteristic of a system is that it cannot be understood
as a function of isolated components. The behavior of the system does not depend on what each
part is doing, but rather on how each part is interacting with the rest. A cars engine may be
working just fine, but if the transmission column is detached from it, the car wont move.
Furthermore, to understand a system, we need to understand how it fits into the larger system of
which it is a part. And most importantly, the parts should not be taken as primary, but rather we
need to support and understand the primacy of the whole.
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For example, behavioral factors have been the dominant focus of many prevention and healthy
community strategies. However, two shortcomings, or limits to success seem to be apparent in
most of these initiatives.
First, behavioral interventions get overwhelmed by the surrounding social context of
people's lives. This is especially evident in distressed urban settings. Behavioral
interventions without simultaneous improvements in the social environment are like an
experiment designed with the proper reagents, that are then set into a medium of
inhibitors. Second, preventing disease by modifying a specific behavior without building
up the mechanisms of sustaining healthiness leaves a vacuum. The individual remains
susceptible to the 'opportunistic effect' of other high risk behavior. The ingredients
necessary for sustaining healthiness go far beyond behavioral factors like good nutrition
and exercise and involve specific social processes and characteristics. (Lee,1996)
At the same time, the systems view recognizes that while the whole is fundamental, it is
unmanageable. The discipline of systems thinking is a set of tools and practices which support
us to acknowledge the whole, understand our work in the context of the whole, and yet find
leverage in understanding key relationships in the system which drive the behavior of the system.
2. We shape the world by how we see it
We shape the world by how we see it. We act in the world by how we see it. And, we can re-
shape it, depending on our individual or shared viewpoint. A key foundation for us to
appreciate, especially in our communities, is that we have many viewpoints (mental models) of
the world (our community, our project) and yet desire shared understanding, the capability for
common action and alignment so we can move forward to create sustainable solutions.
Yet why is building common understanding so difficult? We have all experienced the dawn of
the best idea which never comes to fruition. Brilliant strategies that fail to get translated into
action. A successful pilot project that never moves further into our community. As Senge
describes:
We are coming to believe that this slip twixt cup and lip stems from not our weak
intentions, wavering will, or even nonsystemic understanding, but from mental models.
More specifically, new insights fail to get put into practice because they conflict with the
deeply held internal images of how the world works, images that limit us to familiar ways
of thinking and acting. That is why the discipline of managing mental models
surfacing, testing, and improving our internal pictures of how the world works
promises to be a major breakthrough for building learning organizations.
Systems thinking is about making our thinking (mental models) more explicit and rigorous in
order to build shared understanding and find leverage for fundamental solutions. We cannot
navigate through the complex environments of our world without cognitive or mental maps;
and all of these, by definition, are flawed and incomplete in some way. They are only made
whole as we understand others mental models. Because mental models are usually tacit
(implicit), existing below our level of awareness, they are often untested and unexamined. And,
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they are generally invisible to us unless we look for them, or we bump up against others
differing mental models. Differences in each of our mental models explains how two people can
observe the same event and describe it so differently. They are paying attention to different
details and using different filters.
Two skills are primary to this discipline:
Reflection slowing down our thinking processes to become aware of how we form our
mental models and what they are
Advocacy and Inquiry holding conversations where we are open to sharing our
views and surfacing our own mental models, while seeking to understand those of others
During our on-site meeting in Aiken, South Carolina, we will be working with TheCommunity
Builder Learning Lab. This will be an exciting way for you to practice your skills in surfacing
and exploring our own mental models, as well as those of your community team. You will have
a chance to manage and improve the health and quality-of-life of a prototypical community, via
an interactive computer simulation game, over twenty years. The simulation tool is designed to
illustrate key principles of systems thinking and team learning, as it provides us with a practice
field to test our thinking, assumptions, and multiple scenarios of intervention. And, it will be a
way for us to explore the next principle outlined, how the structure of the system influences the
behavior of the system.
3. Structure influences the behavior of the system
A true and profound insight is the way you begin to see
that the system causes its own behavior.
(Senge, 1990)
The systems perspective tells us that we must look beyond individual mistakes or bad luck to
understand important problems. We must look beyond personalities and events. We must look
into the underlying structures which shape individual actions and create the conditions where
types of events become likely.
Without a deeper understanding of why something happened or is happening seeing the
underlying structure the most we can do is find ways to react faster to similar events in the
future. Our goal as systems thinkers, is not to be simply reactive, but to understand the core
structure he forces and pressures that shape trends, patterns, and events close to us, but are often
far removed in time and space. In our community work, we want to create opportunities for our
teams to progressively deepen their ability to move through all the levels of exploration and
work with multiple levels simultaneously. (We will practice this principle in Community
Exercise #1.)
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Structures can be any number of explicit or implicit
relationships in a system. Elements of structure may
include a broad array of elements: physical structures,
reporting structures, information systems, communication
systems, determinants of health and quality-of-life,
geography, demographics, financial structures and
incentives, reward systems, policies and procedures,
habits, norms, and values. If you get stuck understanding
what is structure, simply ask: What underlying forces
(structures) are shaping the behavior of the system?
Structure is difficult to see and, especially in our community work, there may be a number of
different views. The nature of structures in human systems is subtle because we are a part of the
structure. And, it is difficult to see how we contribute to structures which run counter to our
desired outcomes. This is a powerful step though, because if we can recognize and alter the
structures we are a part of, we can create the kind of sustainable outcomes we desire in our
communities. If you get stuck understanding what is structure, simply ask: What underlying
forces (structures) are shaping the behavior of the system?
Another difficulty in understanding and seeing these core structures is that while they often
generate events close to us, the actual structure is often far removed in time and space from the
events we are experiencing today. The most important consequences of our actions seem to
occur elsewhere in the system, eventually coming back to create the very problems we often
blame others or the system for creating. Systems thinking shows us that there is no outside,
and that it is not productive to blame some external force. We and the cause of our problems are
part of a single system. Some timeless wisdom:
We have met the enemy and he is us.
Pogo, Walt Kelly
4. Well-intended actions can produce considerable negative consequences for the system as
a whole
As Senge points out, some have called systems thinking the new dismal science because it
teaches that the most obvious solutions dont work at best, they improve matters in the short
run, only to make matters worse in the long run. But, the good new is, small, well-focused
actions can sometimes produce significant and sustainable improvements, if they are in the right
place. This is the principle of leverage. Tackling a difficult, long-lasting problem is often a
matter of seeing where the high leverage lies, a change which with a minimum of effort
would lead to lasting, significant improvement. The real problem is that high-leverage changes
are usually not obvious to most participants in the system.
To find leverage, we must develop our capability to see structure and find ways to shape or
create structures to support the outcomes we desire. For example, the obvious symptoms that
we have in our communities drug abuse, unemployment, crime, teen pregnancies, and
diminished community resources have significant and complex root causes. The causes
Levels of Exploration
Events
Trends and
Patterns
Structure
(Forces/pressures at play)
Increased Leverage
(Deepened Learning)
React
Anticipate/Adapt
Modify/Redesign
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constitute the underlying structures and systems which are most responsible for generating the
effects; which if recognized, could lead to changes producing lasting improvements. Todays
issues may be the result of policies or actions taken five to ten years ago, or even decades ago,
often by others. We certainly cannot fully see and understand all the dynamics which started
these dynamics in motion.
A set of visual systems thinking tools can help teams find these points of leverage. They are
designed to help groups collectively understand the core relationships and feedback loops of the
system(s), understand its boundaries (or new boundaries), and then work through potential
leverage points. The basic building blocks of this visual language are links and loops which
form feedback loops and make up causal loop diagrams. There are two types of feedback loops
which can make up many types of causal loop diagrams. Balancing loops help maintain
equilibrium in a system by resisting change, sometimes making problems more persistent.
Reinforcing loops amplify and compound change. They either produce growth or accelerate
decline, and are often referred to by the vicious or virtuous cycles they produce.
You will see many examples and representations of these links, loops and causal loop diagrams
throughout this module and in the recommended readings. We will also explore these in a
hands-on way during our Learning Collaborative meeting, while experiencing The
Community Builder Learning Lab.
The language of links & loops
Indicates a causal link between two variables
Placed next to an arrowhead, indicates a causal
change in the same direction
Indicates a causal change in the opposite direction
A reinforcing feedback loop that amplifies
change
A balancing feedback loop that seeks
equilibrium
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B
s
o
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B
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Health, Quality-of-Life, and Community as a System
Systemic Definitions
The word health has the same roots as whole (the old English hal, as in hale and hearty).
In our healthier communities work, we have come to recognize a broad perspective emphasizing
the systemic relationships of health, community, and quality-of-life. Paul Lee, in the white
paper, Creating Circles of Health (1996), offers some interesting definitions of health. These
definitions speak well to the systemic relationships between individuals and community, between
health and quality-of-life, and to the need to focus our attention on the interaction of these
elements, not simply the elements themselves.
Health grows out of a continuum of society, community, organizational behavior, lifestyle,
human function, medical interventions, environment, and self.

Health and quality-of-life, of the system as a whole, is defined by the relationship and
connection of each of these elements. All of these elements feed back into the health of the
individual and the health of the community. Aggregate effects of the whole, while not
determining any individual outcomes, pattern and shape the communitys health and quality-
of-life.

Health is not just an absence of disease. Health is more than our physiologic balance with a
hostile world of germs. It is a measure of an individual's ability to move toward potentials in
all levels, including participating in and contributing to the world around them. Health, in
short, expresses how fully we are living. Health is circular because the health of each
individual contributes materially and poignantly to improvement in the health status of the
groups to which they belong. In other words, determinants of health are multi-directional.
This is not a two-way street but a five-way intersection.
Seeing Structures - Significant Leverage or Barriers in Our Communities
As we learn and practice with systems thinking, we are challenged to look closer at the structures
in our communities and consider which structural elements reinforce and support our dealing
with the whole and which structures may have the unintended consequence of strengthening the
parts and not whole. While there are many elements of structure in our communities, two
examples offer insight into how these structures can offer leverage or a become significant
barriers to our work: (1) our methods for collaboration, planning and strategy development, and
(2) the measurement systems we use to guide and evaluate our efforts.
First, lets consider the structures which support collaboration and the design of strategy and
interventions. Paul Lee (1996) suggests that we look at the linkages between the socio-economic
factors, urban collaborative processes, and empowering behavior that together foster
collaboration and strategy for improved health and quality-of-life in our communities? Are there
structures in place to support these linkages? Lee contends that historically, in our attempt to
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make community change, we have often isolated our interventions into one of these factors, and
have not challenged ourselves to understand the root of the interconnections. For example,
social health is often viewed as so broad and complex, that strategies are often split into those
which address social conditions and into others which address health outcomes. Individual or
multiple sectors in the community may sponsor initiatives for only one part of the equation.
Our methods for planning, organizing and implementing initiatives (each elements of structure)
significantly impacts the individual and community outcomes we experience.
During our Learning Collaborative meeting, we will explore The Community Builder Learning
Lab, and have a chance to consider some of these significant elements of structure. For
example, we can explore how investments and interventions made within a single sector or
among multiple sectors in our community enhance or inhibit the kind of community outcomes
we desire. We will also explore how the strategy of involving multiple sectors can contribute to
building overall social capital in our community, and how this social capital influences the
effectiveness of our strategies. And, we will consider how various key measures that we choose
to evaluate our progress actually reinforce our strategies and decisions - another interesting
element of structure.
Here is one example from the Learning Lab, which illustrates linkages and feedback
relationships of investing in education, health, and public safety. A number of interesting
interdependent dynamics (structures) are shown in the diagram on the next page:
Average Well Being, Crime Rates, and % Risky Behaviors are interdependent. They
each influence the other.
Improving Crime Rates depends in part on Employment levels which, in turn, are
dependent on both Jobs available and Employable People available. This means that
Investing in Education will lower Crime Rates only if there are Jobs available for the
increased % Graduates who become Employable People.
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Key Effects of Education, Health and Public Safety
The Community Builder Learning Lab
A second element of structure we should consider in our community is the kind of health
information and measurement systems we are familiar with and/or are developing. The design of
these systems is a significant element of structure which can be a point of leverage or a barrier
for community change. Historically, many of these measurement systems have taken a
categorical, linear cause-and-effect approach, not a systemic one.
For example, Healthy People 2000 includes 21 priority areas, 10 special target groups, and 10
sectors bearing shared responsibility. The product of this scope, range, and complexity is 2100
essential information groups or focal perspectives. Analysis of these factors typically measures
statistical correspondence between a singular determinant and a singular indicator or condition
which sets the boundary of analysis within a single sector or discipline. Furthermore, the
research focus is often on proximate causes that are tangible and easily measured, such as
specific behaviors or genetic and medical risk factors, rather than the more intangible role and
relationships of the community, environment, social, cultural, social, psychological, and
economic factors as determinants of health.
A strength of our current surveillance capability lies in the large amount of
categorical information available. A corresponding weakness of our current
approach to information lies in our inability to connect these discrete data together
to reflect the behavior of complex real-world systemsour ability to represent
these cross-cutting influences in useful, pragmatic ways is in its infancy.
Lee (1996).
Key Effects of Education, Health & Public Safety
leads to results in
enables
produces
reduces
supports
enable
contributes to
influence
influence
influence
leads to
influences
lessens
influences
lessens
adds to
leads to
affect
Investing in
Education
%
Graduates
Employable
People
Employment
Income
Subsidy
Requirements
from Govt
Ability to
Purchase
Goods &
Services
Business
Attractiveness
Jobs
Average
Well
Being
% Risky
Behaviors
Crime
Rates
Resident
Attractiveness
Investing in
Health
Investing in
Public Safety
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Another important consequence of our current structures is that the design of the measurement
systems often drives the planning processes that community members undertake. For example,
most measurement systems, including Healthy People 2000, attempt to bridge the gap between
data (knowledge) and solutions by articulating objectives for each priority area and population
sub-group and create measurements with single indicators. While this may assist in planning
efforts, it does not support the kind of systemic pattern analysis amongst priorities, populations,
and sectors which can leverage sustainable change.
With an improved understanding of system dynamics principles, we can either use our current
measurement systems in new ways, or design new ones with these principles in mind. The
organizing structure of the information system needs to identify the patterns of interdependence
and collaboration that have the highest leverage for enhancing outcomes. The Outcomes
community improvement software is an excellent opportunity to create a systemic method for
measurement design and dissemination of results. Challenge your team(s) to consider how the
measures and systems you are designing will impact your communitys capability for creating
sustainable interventions which are holistic and systemic in nature.
Sustainability Another Systems View
The sustainability movement offers an excellent example of focusing on the community as a
system. With the impetus of the growing awareness of the predicted ecological disaster we will
face as a result of a massive breakdown of the earths natural systems, there is growing
awareness and desire to discover how to leverage new levels of prosperity economically,
ecologically, and socially.
Sara Schley and Joseph Laur are two leaders in the field of sustainability, basing their work on
the principles of organizational learning, systems thinking, and basic science. See the
monograph titled Creating Sustainable Organizations: Meeting the Economic, Ecological, and
Social Challenges of the 21
st
Century (1998), reading #3 in this module. The kind of questions
they are encouraging communities and businesses to explore are very relevant for our work:
How can we expand our perspective to see that our economic systems are embedded
within and defined by the broader ecosystem, and how might that awareness inform our
business strategies?

How can we use the concepts, tools, and methods of systems thinking and organizational
learning to expand our capacity for sustainable development in both our businesses and
communities?

How can we align our technologies with scientific principles for sustainability as we
create products and services that will benefit society long term?

How can we use the concept of the triple bottom line a measurement tool for
meeting financial, ecological, and social needs for the present and the future as
leverage for designing measurement and planning systems that will support sustainable
solutions?
________________________________________________________________________________________________________________
How Can Systems Thinking Help Us In Our Community Work?

In summary, the Overview of this learning module has provided an introduction to systems
thinking and consideration of the community as a system, highlighting many implications to
consider in our healthy community work. With our emphasis on evidenced-based and
performance-based planning and action, there are numerous ways we can leverage the concepts,
methods, and tools of systems thinking. The tools of systems thinking are diverse, some simple
to use, and some more complex to master. Consider how you might begin to experiment with
some of them. (See A Palette of Systems Thinking Tools in the Resource section of this module)
Some beginning suggestions:
Practice, Patience, and A Shift in Mind
The way of a systems thinker calls for lifelong practice, a lot of patience, and continued
awareness for a shift in mind. Systems thinking, as a discipline, involves lifelong practice.
While this practice is challenging to us as individuals, there is great opportunity in the collective
and collaborative learning with others in our communities, that can actually accelerate our
individual and groups perspective and capabilities.

The Way Of A Systems Thinker Calls For A Shift I n Mind

From: To:

Assuming that cause and effect are linear Recognizing that cause and effect are circular

Seeing things as parts and isolated events Seeing things as whole, interdependent, and
dynamically changing

Routinely considering just the first-order
consequences of our actions
Anticipating multiple-order ripple effects

Being overwhelmed with complexity

Seeing people as victims and reactors

Seeing chaos as a time for restructuring and
growth

Becoming an active participant in shaping
your reality

________________________________________________________________________________________________________________
Building shared understanding of issues and relationships
With their emphasis on making our thinking explicit and visual, the tools of systems thinking
offer wonderful support in creating shared understanding of a communitys vision, assets,
measures, and actions. These steps are circular, not linear, and ones which you continually build
your efforts around. Consider these tools in your performance-based planning efforts:

Surface mental models using advocacy and inquiry while building ongoing
capacity for meaningful dialogue. Each of the systems thinking tools (see resources
section) involves surfacing assumptions and mental models about how we think the
system works, what our desired future and current reality is, and then discovering
where the leverage points for change might be. Meaningful dialogue, to gain common
understanding and new insights, takes patience, practice, and discipline. Our
challenge is to balance the time we invest in action, with an adequate investment in
dialogue to ensure we are not creating unintended consequences that will further
compromise the goals we are seeking. Consider ways to strengthen your teams
learning and capability with dialogue. How well do you practice reflection, advocacy
and inquiry?

Construct visual maps, describing relationships and interactions of key elements
or core dynamics of the systems. Systems thinking gives us a language that
allows us to see and understand the underlying causal forces that produce the
behavior of systems and their interrelationships. It is necessary to understand
interrelationships that produce growth, decline, and resistance to change as we try to
fix problems. Practice making your thinking visual by experimenting and drawing
core relationships which drive the performance of the system(s) you are working
with. There is no wrong way to do it. Make it better with the input of your team.
See Community Exercise # 1 and # 2 for some focused practice.

Explore the match of your communitys or an initiatives story with some of the
common system archetypes. Limits to success, Fixes that Fail, Tragedy of the
Commons are frequently recurring patterns (system archetypes) in our community
efforts. See if your stories match and what might be the leverage and learning from
studying these archetypes. See a brief description of each Archetype in the Resource
section of this module.

Consider delays and interdependencies as your team moves from planning to
action. Shared understanding of the vision you are trying to create and the systems
and underlying structures you are dealing with is the fundamental basis for effective
planning. Teams need a clear understanding of the conditions necessary to enable
the system(s) to perform optimally, while gaining a sense of the leverage points in the
system to create those conditions or vision. One point teams often overlook is the
need to plan and sequence interventions over time, recognizing the delays and
interdependencies which are inherent. In our planning then, we need to anticipate
how our actions today may not demonstrate effects until some distant future and how
our actions one year from now will have effects in another time horizon. We will
________________________________________________________________________________________________________________
practice this skill while using The Community Builder Learning Lab, with the
support of the computer to compress time and space so we can experiment with
multiple strategies and combinations of strategies over time. Consider how you can
integrate the dynamics of time sequencing, delays, and interdependencies in
your current planning efforts.
Selecting outcome statements and indicators
It is essential to align the outcome statements and indicators you are selecting (for an initiative,
or at a community level) with your communitys vision, to promote optimization of the whole
and not the parts. Consider how it might be possible to improve individual outcomes and
indicators, while not impacting the whole. How do the current outcome statements you have
chosen tell a story about your communitys vision? How can you link multiple outcome
statements within an initiative, to create a more comprehensive view of the whole?
Constructing behavior-over-time graphs, with multiple combinations of 2 to 3 indicators,
(described in the Community Exercise # 2) is an excellent way to begin to see the relationships
among underlying structures, and among multiple indicators. You will also want to consider
how to link multiple outcome statements across numerous initiatives, and how best to represent
their relationship.
It is also significant to recognize that the organizing structure of the measurement and
information systems will contribute to the outcomes we experience from these systems. How
does our current approach help us to identify the patterns of interdependence and collaboration
that have the highest leverage for enhancing outcomes?
Building community, learning capability and social capital
One of the key concepts you are exploring in your communities, and a foundation element in
The Community Builder Learning Lab, is that of social capital, popularized by Robert D.
Putnam, Ph.D., Director of the Center for International Affairs at Harvard University. Dr.
Putnam believes that the health of Americans and our communities depends on rebuilding the
social connectedness and civic engagement that have been declining over the past generation.
The willingness and capacity of community members to engage in voluntary activities comprises
a community's social capital. Consider how you are integrating the building of social capital in
your initiatives.
________________________________________________________________________________________________________________
Social Capital, as described in the following diagram from the Learning Lab, is represented as
an index of the amount of Leadership, Trust and Collaboration in the community. Social Capital
is directly influenced by the amount of Cross-Sector Investments and Collaborative Planning
teams can choose, as well as the levels of Trust and Leadership in the community. Social Capital
has an impact on the effectiveness of new program investments. As Social Capital grows, it
shortens the time to see results of investments and it strengthens the results of investments. A
number of interesting interdependent dynamics are shown in this diagram:
Investing Time and making Cross-Sector Investments builds the communitys Social Capital.
As Social Capital grows, it both shortens the Time to See Results from new community
programs and enables programs to have greater Effectiveness or yield.
Note, however, that increasing %Time to Collaborative Planning decreases %Time Available
for Implementation perhaps an unintended consequence of a well-intended action.
Realizing such consequences heightens our awareness about our actions and their likely
results.
Good luck, have fun enjoying and practicing
the discipline of systems thinking
for your own growth and for that of your community!
Building Social Capital and its Effects
leads to
leads to
produces
reinforces influences
builds
builds & prevents
losses of
adds
enables
buffers
losses of
adds
shortens boosts
affects
% Time to
Leadership
Cross-Sector
Investing
Shared
Vision
Collaborative
Leadership
Community
Leaders
% Time to
Collaborative
Planning
Social Capital
Trust
Time to
See Results
Effectiveness of
Investments
Resident
Attractiveness
________________________________________________________________________________________________________________
READING GUIDE
Introduction
The suggested readings for this module are designed to support you and your community
team by:
Providing an overall context for systems thinking as a discipline and foundation for
your community improvement work.

Stimulating your thinking and preparation for the recommended Community
Exercises.

Offering a point of departure and inquiry for the dialogue we will develop in the
computer conference, scheduled for October 516.

Preparing you for our Learning Collaborative meeting, scheduled for October 2930,
in Aiken, South Carolina.

While the readings are suggested in order, they can be read in any order. It is highly
recommended that all readings be done prior to beginning the two Community Exercises which
are part of this learning module.

Reading #1
Schwinn Carol. New visions for communities, Healthier
Communities Action Kit, Module 3, Chapter 3. San Francisco: The
Healthcare Forum, 1994. (6 pages)

This short essay gives us a broad perspective of the opportunity to create learning communities
in order to sustain our healthy community work, using the framework of learning and systems
thinking. Schwinn challenges us to consider how the vision we have developed (or are
developing) in our communities can drive and shape a more natural systems perspective. She
describes quite vividly what people in a learning community might value and how they might
approach community improvement. For example:

The people see the community as a natural system made up of its land and air, plants and
animals and natural assets, as well as its people, its organization, and its institutions.

The people see learning and growing, and helping others learn and grow, as the primary
task of community participation.
The essay concludes with suggestions of ways we can get from here to there. This is an
excellent, easy-to-read, context setting piece for the other readings in this module.
Reading #2:
Lee, Paul. Creating Circles of Health: Integrating enhanced social
environments with responsible behavior to achieve improved
population health profiles, White Paper, published in Faulkner and
Greys Annual Guide to Healthcare Resources, 1996. (32 Pages)
In this white paper, Paul Lee describes the linkages between socio-economic factors, urban
collaborative processes, and empowering behavior that together foster improved health and
quality-of-life. He contends that historically, in our attempt to make community change, we
have often isolated our interventions into one of these factors, and have not challenged ourselves
to understand the root of the interconnections.
Lee emphasizes the systemic relationships of health, community, and quality-of-life:
Health and quality-of-life, of the system as a whole, is defined by the relationship and
connection of each of these elements, not the elements themselves. All of these elements
feed back into the health of the individual and the health of the community. Aggregate
effects of the whole, while not determining any individual outcomes, pattern and shape
the communitys health and quality-of-life.
Additionally Lee describes health as a set of positive and circular processes which link the
individual to the community:
Health is not just an absence of disease. Health is more than our physiologic balance
with a hostile world of germs. It is a measure of an individual's ability to move toward
potentials in all levels, including participating in and contributing to the world around
them. Health, in short, expresses how fully we are living Health is 'circular' because
the health of each individual contributes materially and poignantly to improvement in the
health status of the groups to which they belong. In other words, determinants of health
are multi-directional. This is not a two way street but a five way intersection.
Although this white paper is based primarily from a public health model, it outlines a significant
number of systemic relationships and perspectives which need to be considered in designing
community-level interventions. It is an excellent backdrop to systems thinking principles and
finding leverage in the complex systems that challenge us.
If you find this reading interesting, see the companion white paper by the same author,
Modeling Health in the Information Age which is listed in the References section. This paper
describes a systemic model for the measurement of health and quality-of-life outcomes, using a
multi-sector approach in data gathering, analysis, and deployment. Lee focuses on the potential
use of data such as Healthy People 2000 and how we can accelerate and leverage more
comprehensive systemic change and community benefit with a dramatically new information
infrastructure, which he terms dimensional informatics.
Reading #3
Senge, Peter M. The Laws of the Fifth Discipline, Chapter 4,
excerpted from The Fifth Discipline: The Art and Practice of the
Learning Organization. New York, Doubleday/Currency, 1990.
(11 pages)
Excerpted from the classic text, this easy-to-read chapter outlines eleven key principles of
systems thinking, illustrating how our thinking and actions can actually create or limit our ability
to find and create sustainable, enduring solutions. Senge encourages us to begin to understand
these universal principles as a backdrop for approaching any complex system intervention. You
will find the long-term social and economic dilemmas he uses as examples especially interesting
in relation to the web of community issues you are dealing with in your healthy community
efforts.
The principles (laws) he considers and describes include:
1. Todays problems come from yesterdays solutions.
2. The harder you push, the harder the system pushes back.
3. Behavior grows better before it gets worse.
4. The easy way out usually leads back in.
5. The cure can be worse than the disease.
6. Faster is slower.
7. Cause and effect are not closely related in time and space.
8. Small changes can produce big resultsbut the areas of highest leverage are often the least
obvious.
9. You can have your cake and eat it toobut not at once.
10. Dividing an elephant in half does not produce two small elephants.
11. There is no blame.
Reading #4
Schley Sara, Laur Joe. Creating Sustainable Organizations: Meeting
the Economic, Ecological, and Social Challenges of the 21
st
Century.
Cambridge, MA. Pegasus Communications, Innovations in
Management Series # IMS008, 1998. (20 pages)
Sustainability is an excellent framework for our healthier communities work and for focusing the
design of our interventions. This monograph challenges us to consider how we can conduct our
business (and community strategies) in a way that will ensure a safe future for our children and
for the planet as a whole. Building on the work of The Natural Step, the authors define
sustainability principles and scenarios for our potential future, with multiple examples and
descriptions of systemic (and non-systemic) solutions to the kind of challenges we are facing in
our communities.
Case examples illustrate how systems thinking tools, such as systems archetypes, the tragedy of
the commons and limits to success can be a way to leverage community understanding of the
issue and to design sustainable intervention strategies. The Triple Bottom Line for sustainable
development is introduced as a measurement tool for meeting financial, ecological, and social
needs for the present and the future.
The authors are co-founders of SEED Systems, a company dedicated to promoting sustainable
development in business through the principles of organizational learning, systems thinking, and
basic science.
Reading #5:
Hirsch Gary B. Building shared visions and strategies for action:
combining systems thinking and dialogue, Healthier Communities
Action Kit, Module 3, Chapter 3. San Francisco: The Healthcare Forum,
1994. (16 pages)
This article provides an excellent, well-written case example of using systems thinking tools in a
community setting. Given the dilemma and often conflicting community views about how to
improve health insurance coverage (the case), Hirsch works through multiple systems-thinking
tools to illustrate their usage and applicability.
Hirsch considers how to build shared understanding of the issue through surfacing individual
mental models and then engaging in dialogue. He skillfully outlines how the identification of
causal relationships, feedback loops, and then applicable systems archetypes helps move the
community team from understanding to planning.
The shared understanding that emerges from dialogue can help people see beyond their
immediate interests and perceive those interests in the context of the larger community.
He then helps the case example team move from planning to action, by identifying leverage
points in the system they now better understand, evaluating potential strategies, and then
communicating potential strategies. Hirsch illustrates the power of well-defined strategies in our
communities:
Typically, well-designed combinations of strategies are required to deal with the multi-
faceted problems they are directed at. Single strategies may simply produce fixes that fail
because they create new problems or the system pushes back and renders the strategy
ineffective. The sequence with which strategies are implemented is important. Some may
set the stage for others, perhaps creating capabilities needed for the later ones to succeed.
Trying to do everything at once is a recipe for failurewhile planning, do not forget that
even successful strategies have unintended consequences. Devise combinations of
strategies that realize the community vision and deal with the side-effects of that
realization.
________________________________________________________________________________________________________________
Reading #6:
Karash, Richard. How to see structure,
The Systems Thinker, Volume 8(4), May 1997, page 6-7. (2 pages)
This short, two-page article is an excellent foundation for the two Community Exercises included
in this module. It provides a well written and simple illustration of the classic systems thinking
principle structure influences behavior. Our key challenge as community teams is to
collectively see the underlying structures (and their interrelationships) in the complex systems
we are improving. When we can better see this structure and how it influences the behavior of
the system, we can find ways to intervene in modifying the structures to create the outcomes we
desire.
Richard Karash skillfully illustrates this principle using an example from our physical
environment, a bad stretch of highway. He demonstrates the power to leverage sustainable
change by seeing more than the simple events of this bad stretch of highway. By also seeing
the patterns and trends, and then the underlying structures, which caused the events, Karash
illustrates the movement from events to systems thinking. A great example we can all relate to,
and a key issue in most of our communities.
Reading #7:
Rieley James B. and Seville Don. Welfare reform efforts,
The Systems Thinker, Volume 8(2), March 1997, page 9-11. (3 pages)
Reiley and Seville provide an excellent demonstration of the power of using systems-thinking
tools in tackling a chronic, complex social problem welfare reform. Using visual-thinking
and mapping skills, they demonstrate two potential views and scenarios of Clintons 1996
welfare reform programs, which transferred control of and funding for welfare from the federal
to the state level. The examples come from the state of Wisconsins proposed reform program,
scheduled to go into effect in 1998, known as Wisconsin Works (W2).
While the purpose of the welfare system is simple, the set of forces surrounding the issue are
quite complex. You will find this to be a superb illustration of a number of systems principles,
as well as an opportunity to see a practical, live application of structural tension, delays,
mapping system linkages, and feedback loops. Most importantly, Reiley and Seville
demonstrate the power of selecting outcome measures in respect to overall system performance,
and the danger of selecting measures which actually may foster actions with unintended
consequences to the system.
This is another easy to understand, thoughtful, and practical application of systems thinking.
COMMUNITY EXERCISES
Community Exercise # 1
Moving from Events Thinking to Systems Thinking
A true and profound insight is the way you begin to see
that the system causes its own behavior
(Senge, 1990).
Purpose
This exercise is designed to offer your community team a set of questions and a framework
which can be used for any initiative or issue. The exercise should help your community team
further define your understanding of an issue or initiative from a systems and structure
perspective. It also will assist you in your capability for current and future action planning.
Without a deeper understanding of why something happened or is happening seeing the
underlying structurethe most we can do is find ways to react faster to similar events in the
future. Our goal, as systems thinkers, is not to be simply reactive, but to anticipate and create
the kind of systems and structures which will support our community vision.
Structure is difficult to see and, especially in our community work, there may be a number of
desired outcomes. This is a powerful step, because if we can recognize and alter the structures
we are a part of, we can create the sustainable outcomes we desire in our communities. Our
views shape our actions. Common understanding of structures will go a long way to aligning
teams into common action and evaluation of their efforts.
Exercise # 1 is one way in to practice systems thinkingtelling stories about an event, its
pattern and its underlying structures. In contrast, Exercise # 2 has a similar goal, yet the way
in is by looking at measures and their relationships to tell a deeper story about the underlying
structure of the system(s) you are trying to improve. Both exercises are designed to prepare you
and your team for more effective action planning and interventions. Experiment with both of
these exercises and hopefully you will find multiple opportunities to use them in your
community work. Good luck!
________________________________________________________________________________________________________________
Levels of Exploration
Events
Trends and
Patterns
Structure
(Forces/pressures at play)
Increased Leverage
(Deepened Learning)
React
Anticipate/Adapt
Modify/Redesign
Why? Storytelling from Multiple Perspectives
Stories can be a powerful tool for engaging a groups
interest in a problem or issue and certainly are one of the
routines in the kind of community engagement in which
we are involved. The specific events and details of a
well-told story make it easy for most people to relate and
they often provide a firm grounding to the reality of the
situation. But storytellings greatest strength is also its
Achilles heel when we remain at the event level in
storytelling, it is difficult to generalize the insights into
other situations and the solutions are often situation specific. Furthermore, they tend to be
reactive, short-term solutions, which do not take into account the underlying structure which
produced the event or issue or symptom at hand.
Our goal is to move our communities through all three levels of exploration when defining or
analyzing an issue or when creating action plans to move an initiative forward:
The events level What happened? What is happening?

The pattern or trend level What has been happening over time? What trends
or patterns caused the event?

The structural level What structures explain the patterns? Why are we getting
these patterns? How are we getting these patterns?
Remember, structures can be any number of explicit or implicit relationships in a system.
Consider a broad array of elements of structure, such as: physical structures, reporting
structures, information systems, communication systems, determinants of health and quality-of-
life, geography, demographics, financial structures and incentives, reward systems, policies and
procedures, habits, norms, and values.
________________________________________________________________________________________________________________
Steps To Take With Your Community Team
1. Consider a current initiative or project your team is working on. Ideally, choose a long-
standing one, which seems to be resistant to community change interventions. You might
consider one for which you already have identified outcomes statements and indicators as
part of the Outcomes community improvement software.

2. Review the list of questions in the model below: Finding LeverageStorytelling from
Multiple Perspectives

3. Decide how to use the matrix model and with whom. The questions in the model can be
asked in any order, although generally teams start with the Events level in the Current
Reality column (working their way up from the bottom).
If your team is just beginning to gain understanding into the nature of the problem or
issue, you might begin at the Events level in the Current Reality column.

If your team believes you already have a good understanding of the problem or
issuein terms of understand many of the systemic issues which are a part of it,
begin at the Vision level in the Desired Future Reality column (work your way
down from the top).

When using the matrix, it is likely your teams conversation will bounce all over
the place. The main point is to capture your conversation in a useful framework.
4. This exercise may be an iterative process. As your team begins to uncover and discover
the underlying structures, with a shared view, you will then be able design more effective
interventions, or in some cases, re-design the structures to support the kind of outcomes you
are seeking. Once some structures are surfaced, the boundaries of your problem may change
or expand. Encourage the use of advocacy and inquiry skills, essential to surfacing and
challenging individual and team mental modelsand be patient.

5. Use a blank matrix to record your groups conversation.

6. Conclude this exercise by capturing overall learnings and implications for next steps in
your teams work. These questions might be helpful:
What are our key insights and learnings? What new understandings have emerged
regarding the issue or initiative we are working on?

What are the implications for:
our vision on a community level and for this initiative
other key issues we are working on
outcome statements we are developing using Outcomes software
indicators we are developing using Outcomes
________________________________________________________________________________________________________________
(implications, continued)
Does moving from event to systems thinking help us see any new leverage points for
our action planning or in designing sustainable interventions?

What questions do we have of other community initiatives, to learn about their
stories, and to deepen our story? What questions are still unanswered?
________________________________________________________________________________________________________________
Finding Leverage:
Level of Perspective
Story Telling
Current Reality Desired Future Reality
Vision
What is the current vision
in use (our community
vision, our project goals)?
Is this vision consistent
with the structures in
place?
What is our vision for the future
(for our community, or for this
project/initiative?)
Mental Models
What mental models do we
hold that led us to put such
structures in place? What
are the current
assumptions, beliefs, and
values that sustain these
structures?
What assumptions, beliefs, and
values will help realize this
vision?
Systemic Structures
Are there systemic
structures in place that are
responsible for the pattern
of behavior? Which
systemic structures are
producing the most
dominant pattern in the
current system?
What kinds of systemic
structures (either invented or re-
designed) are required to
operationalize our mental
models, achieve our vision, to
produce our desired results?
Patterns
Do other stories
corroborate the same
pattern? Are these
individual events part of a
pattern of events which has
been unfolding over time?
What is the behavior over
time of key indicators in
the current system?
What would be the behavior
patterns over time of key
indicators that would tell us the
vision is becoming a reality?
Events
What are some specific
events that characterize the
current reality?
What are some specific events
that would illustrate how the
vision is operating on a day-to-
day basis? What are the new
stories we would share?
(WellSpring, 1998. Adopted from Daniel Kims Vision Deployment Matrix and From Events
to Vision: Structured Problem Solving Matrix, and other publications, Pegasus
Communications, Inc.)
________________________________________________________________________________________________________________
Finding Leverage:
Level of Perspective
Story Telling
Current Reality Desired Future Reality
Vision
Mental Models
Systemic Structures
Patterns
Events
(WellSpring, 1998. Adopted from Daniel Kims Vision Deployment Matrix and From Events
to Vision: Structured Problem Solving Matrix, and other publications, Pegasus
Communications, Inc.)
________________________________________________________________________________________________________________
Community Exercise # 2
Finding Leverage - Measures And Behavior Over Time
Purpose
This exercise is designed to offer your community team set of questions and a framework
which can be used for any initiative or issue. The exercise should help your community team
further define your understanding of an issue or initiativefrom a systems and structure
perspective. The exercise will deepen your ability to identify key measures, their relationships,
and the behavior of a system over time.
Without a deeper understanding of why something happened or is happeningseeing the
underlying structurethe most we can do is find ways to react faster to similar events in the
future. Our goal, as systems thinkers, is not to be simply reactive, but to anticipate and create
the kind of systems and structures which will support our community vision. One of the most
important aspects of this skill is to be able to see how a system behaves over time, how its
performance is dynamic and ever changing.
Structure is difficult to see, and especially in our community work, there may be a number of
desired outcomes. This is a powerful step though, because if we can then recognize and alter the
structures we are a part of, we can create the kind of sustainable outcomes we desire in our
communities. Our views shape our actions. Common understanding of structures will go a long
way to aligning teams into common action and evaluation of their efforts.
Time and delays are also difficult to see and appreciate in systems. Cause and effect are circular,
and not close in time and space. For example, the effects are the obvious symptoms that we
have in our communities drug abuse, unemployment, crime, teen pregnancies, diminished
community resources. The causes are the underlying structure(s) most responsible for
generating the behavior of the system which, if recognized, could lead to changes producing
lasting improvements. The time delay is difficult to appreciate, because most of us assume that
cause and effect are closely related in time and space, or, because we are not able to experience
both cause and effect directly. Todays issues may be the result of actions taken five or ten years
ago, or even decades ago.
Exercise # 2 is one way in to practice systems thinking - looking at measures and their
relationships to tell a deeper story about the underlying structure of the system(s) you are trying
to improve. In contrast, Exercise # 1 has a similar goal, yet the way in is by telling stories
about an event, its pattern, and its underlying structures. Both exercises are designed to prepare
you and your team for more effective action planning and interventions. Experiment with both
of these exercises and hopefully you will find multiple opportunities to use them in your
community work. Good luck!
________________________________________________________________________________________________________________
BOT Graphs - A simple to use tool
Behavior over time (BOT) graphs are one of the most powerful, yet simple-to-use systems
thinking tools. BOT graphs can help you and your team to:
1. See beyond one-time events to patterns of behavior over time;
2. Consider how a problems parts might be connected;
3. Create working hypotheses about the systemic structures that are driving your
problems and the current performance of the system; and
4. Anticipate more systemic and sustainable interventions.
In short, BOT graphs are another bridge from event thinking to systems and structural thinking.
A typical BOT graph has a horizontal and vertical axis, with behavior along the vertical axis and
time along the horizontal. It also contains one or more (preferably 2 or 3) variables plotted over
time, demonstrating the dynamic interrelationships of the variables. The graph may be more
free-form than you are used to. The lines are intended to emphasize the pattern of relationship
over time, rather than the precise values. In practice, most BOT graphs have a mix of variables
that have different units of measure. Since the plot is not scaled, but rather a general trend line,
this difference in scaling is not significant for this purpose. And finally, BOT graphs often have
a mix of easy-to-measure variables, such as teen pregnancies, as well as those which are not
generally considered measurable, attitudes about health or community involvement.
Behavior over time diagrams
Time
C
A
B
Behavior over time diagrams
Time
C
A
B
B
e
h
a
v
i
o
r
________________________________________________________________________________________________________________
Steps To Take With Your Community Team
1. Consider a current initiative or project your team is working on. Ideally, choose a long-
standing one which seems to be resistant to community change interventions. You might
consider one for which you already have identified outcome statements and indicators as part
of the Outcomes community improvement software.

2. Ask one of your team members to tell their story of the issue, from the perspective of your
community teams interest and your work to date. Include working hypotheses about why
this has been such a stubborn problem to solve and which questions remain unanswered. (If
you have the time, try to also tell the story from multiple perspectives such as civic leader,
businessperson, grass-roots citizen or other groups which would be relevant).

3. Now, list all the key variables which make up the definition of this problem. Ask your team
questions like these: Are there variables we have missed, that might not be obvious? Are
there soft variables which we dont traditionally measure which we might quantify - for
this purpose? Have we considered all variables, especially those which might tell us about
the underlying structure of this problem? How do the variables relate? Are there any
clusters of variables which seem to tell a story? Can I divide one by another to get a new
picture?

4. Create BOT graphs of variables. Ideally, you want to graph clusters of variables together,
in multiple combinations, with multiple BOT graphs, to begin to peel the onion.
Remember, the graph is designed to emphasize a pattern over time, not exact values. Select a
common time frame for all of the graphs (ideally 1 to 4 years). Ask your team questions like
these: What is the behavior over time of each variable, of multiple variables? What do we see
as we group different variables together? What will happen (or has happened) to key
variables over time?

5. Use a blank flip chart or other means to record your groups conversation and work.

6. Conclude this exercise by capturing overall learnings and implications for next steps in
your teams work. These questions might be helpful:
What are our key insights and learnings?

What is the relationship among the key variables which impact the system, or which
drive the behavior of the system?

What are the implications for:
our visionon a community level and for this initiative

other key issues we are working on

________________________________________________________________________________________________________________
outcome statements we are developing using Outcomes community
improvement software

indicators we are developing using Outcomes community improvement
software

our action planning or design of sustainable interventions

How can we apply the skill of looking at measures over time (BOT graphs), as part of
our work with the Outcomes community improvement software?

What questions do we have of other communities and their initiatives, to learn about
their stories, and to deepen our story? What questions are still unanswered?

________________________________________________________________________________________________________________
Follow-up Exercise

Creating BOT graphs is often the first step teams use to create other visual maps, such as causal
loop diagrams and system archetypes. If you have an interest, you may want to consider how
your BOT graphs might tell a story similar to the system archetypes.

System archetypes are classic stories in systems thinking, common patterns and structures
which tend to recur in different social, organizational, business and community settings. An
overview of the system archetypes is included in the readings and resources which are part of
this module. You will be surprised how the leverage point in most of these archetypes is not
obvious as first. (See the reference section for examples of other archetypes.)

Common archetypes that may recur in our community work include:

Fixes that Fail
In a Fixes that Fail situation, a problem symptom cries out for resolution. A
solution is quickly implemented, which alleviates the symptoms and has immediate
positive results. However, the fix also has unforeseen long-term consequences that
eventually worsen the problem, which leads us often to apply the same of similar
fix again, perpetuating a reinforcing cycle.
Limits to Success
In a Limits to Success scenario, an effort, organization, or product grows rapidly
at first, but eventually begins to slow or even decline. The reason is that the system
has hit some limit - capacity constraints, resource limits, market saturation - which
is inhibiting further growth.
Shifting the Burden
In a Shifting the Burden situation, a short-term solution is tried that successfully
solves an ongoing problem. As the solution is used over and over again, it takes
attention away from more fundamental, enduring solutions. Over time, the ability
to apply a fundamental solution may decrease, resulting in more and more reliance
on the symptomatic solutions.
Tragedy of the Commons
In a Tragedy of the Commons scenario, a shared resource becomes overburdened
as each person in the system uses more and more of the resource for individual
gain, without concern for the collective impact of everyones actions. Eventually,
the sum of the individual activity overloads the commons, the resource dwindles
or is wiped out, resulting in lower gains for everyone involved.
RESOURCES
Computer Conference Discussion Questions
The following questions will help guide our computer conference discussion, scheduled for
October 5-19, 1998. These questions will be posted intermittently as the basis for our dialogue,
and provide an opportunity for reflection and exploration with other ACT members.
1. Community as a System
The focus in this module is to heighten our awareness of the community as a system, and to
make this awareness explicit in our healthy community initiatives. As our community begins to
collectively see and recognize the systemic relationships between individuals, community,
health and quality-of-life, our attention begins to shift more toward the interaction of these
elements, not simply the elements themselves. While there are many aspects to consider when
viewing the community as a system, consider the following questions:
In the collaborative community work you are involved with, how are you and your
teams viewing the community as a system? What examples do you have from your
planning or actions?
Which structures or relationships in your communities reinforce your dealing with the
whole? Which have the unintended consequence of strengthening the parts and not
whole? Are there examples you can share?
2. Measurement and Outcomes
. Measurement and OutcomesAnother focus we have considered in this module is the
systemic nature of the assessment and measurement systems you are currently using and/or are
developing for your communities. The design of these systems is a significant element of
structure which can be a point of leverage or a barrier for community change. The organizing
structure of these systems will contribute to the outcomes we experience from these systems.
For example, the design of the assessment and measurement systems often drives the planning
processes that your community members undertake. You are beginning to experience this as you
identify collaborative partners who will participate with you in building and supporting the
Outcomes community improvement software.
What are some of the elements of structure in your current measurement and
assessment system which support a whole systems view? Which elements of
structure are barriers to this view?
Consider how it might be possible to achieve individual outcomes, while not
________________________________________________________________________________________________________________
impacting the whole. Think of instances where this has happened. Why has it
happened?
Consider how it might be possible to achieve outcomes that have an effect on the
entire community and its overall vision. How do the current outcome statements you
have chosen tell a story about your communitys vision? Think of instances where
this has happened. Why has it happened?
What strategies have you considered or used for disseminating the results you
achieve? Does your current system allow you to anticipate for delays in the system?
How? Does your dissemination strategy reflect a whole systems perspective or
highlight only the individual parts? How? What examples can you share?
How can we use the concept of the triple bottom line - a measurement tool for
meeting financial, ecological and social needs for the present and the future - as
leverage for designing measurement and planning systems that will support
sustainable solutions? (See Reading # 4)
Glossary of Systems Thinking Language

Balancing Process/Loop: Combined with reinforcing loops, balancing processes form the
building blocks of dynamic systems. Balancing processes seek equilibrium: they try to bring
things to a desired state and keep them there. They also limit and constrain change generated by
reinforcing processes. A balancing loop in a causal loop diagram depicts a balancing process.

Behavior Over Time (BOT) Graph: One of the 10 tools of systems thinking. BOT graphs
capture the history or trend of one or more variables over time. By sketching several variables on
one graph, you can gain an explicit understanding of how they interact over time. Also called
Reference Mode.

Causal Loop Diagram (CLD): One of the 10 tools of systems thinking. Causal loop diagrams
capture how variables in a system are interrelated. A CLD takes the form of a closed loop that
depicts cause-and-effect linkages.

Feedback: The return of information about the status of a process. Example: annual performance
review return information to an employee about the quality of his or her work.

Learning Laboratory: One of the 10 tools of systems thinking. A learning laboratory embeds a
management flight simulator in a learning environment. Groups of managers use a combination
of systems thinking tools to explore the dynamics of a particular system and inquire into their
own understanding of that system. Learning labs serve as a managers practice field.

Leverage Point: An area where small change can yield large improvements in a system.

Management Flight Simulator (MFS): One of the 10 tools of systems thinking. Similar to a
pilots flight simulator, an MFS allows managers to test the outcome of different policies and
decisions without crashing and burning real companies. An MFS is based on a system
dynamics computer model that has been changed into an interactive decision-making simulator
through the use of a user interface.

Reinforcing Process/Loop: Along with balancing loops, reinforcing loops form the building
blocks of dynamic systems. Reinforcing processes compound change in one direction with even
more change in that same direction. As such, they generate both growth and collapse. A
reinforcing loop is a causal loop diagram depicts a reinforcing process. Also known as vicious
cycles or virtuous cycles.

Simulation Model: One of the 10 tools of systems thinking. A computer model that lets you
map the relationships that are important to a problem or an issue and then simulate the
interaction of those variables over time.

Structure: The manner in which a systems elements are organized or interrelated. The structure
of an organization, for example, could include not only the organizational chart but also
incentive systems, information flows, and interpersonal interactions.
________________________________________________________________________________________________________________

System: A group of interacting, interrelated or interdependent elements forming a complex
whole. Almost always defined with respect to a specific purpose. The terms system and
structure are sometimes used interchangeably.

Systems Thinking: A school of thought which focuses on recognizing the interconnections
between the parts of a system and synthesizing them into a unified view of the whole. It emerged
in the 1940s as a response to the failure of mechanistic thinking to explain biological
phenomena. Over the years it has proved useful for explaining not only complex biological
phenomena, but also social phenomena. There are numerous approaches to systems thinking,
including systems dynamics and interactive planning.

Systems Dynamics: A field of study which includes a methodology for constructing
computer simulation models to achieve better understanding and control of social and
corporate systems. It draws on organizational studies, behavioral decision theory, and
engineering to provide a theoretical and empirical base for structuring the relationships in
complex systems. Systems dynamics was pioneered by Jay Forrester at MIT and has been
further refined by Peter Senge.

Interactive Planning: A methodology rooted in management science, that assists
participants of an organization to design a desirable future for themselves and to invent
ways of bringing it about. Interactive planning is based on three operating principles:
planning requires participation from all stakeholders; planning is continuous; and planning
should occur simultaneously and interdependently for as many parts and levels of the
system as possible. Russell Ackoff is credited with developing this methodology.

Systems Archetypes: One of the 10 tools of systems thinking. Systems archetypes are the
classic stories in systems thinkingcommon patterns and structures that occur repeatedly in
different settings
Adapted from Kim DH, Anderson V. Systems Archetype Basics: From Story to Structure. Waltham, MA.
Pegasus Communications, Workbook Series, 1998.

Bibliography
Web Sites
Circle of Health
This site provides links to documents which have been created by the Circle of Health
consortium, a voluntary alliance of people and organizations collaborating to improve the health
of their communities. The theory behind the Circle of Health is based on a complex systems
view of health dynamics, with the intent to support organizations and communities in improving
health in more rationale and systematic ways. Founder: Paul Lee.
www.netcom.com/~/pbl/circle_of_health.html
Learning-org
An ongoing dialogue group on organizational learning and the learning disciplines, over the web.
For more information, contact host: Richard Karash, rkarash@karash.com
Pegasus Communications, Inc.
This site provides a rich resource designed to support managers, leaders and educators to apply
the ideas, principles, and tools of systems thinking and organizational learning to complex social
and business issues. Founded in 1989, Pegasus has worked to build a world-wide community of
organizational learning practitioners through conferences, newsletters and other publications.
Telephone 1-800-272-0945 for ordering information.
www.pegasuscom.com
SEED Systems
This site is dedicated to promoting collaboration among organizations and associations
committed to sustainable development in business, using the principles of organizational
learning, systems thinking, and basic science. Founded by Joe Laur and Sara Schley, SEED
Systems is a charter member of the Society for Organizational Learning and The Natural Step
U.S.
www.seedsys.com
Systems Primer
This site features writings by John J. Shibley on how organizations can learn, and how they can
learn to learn. There is an emphasis on making ideas simple enough to make sense, but real
enough to be relevant. The site also includes a page of related organizational learning and system
thinking links.
www.systemsprimer.com
________________________________________________________________________________________________________________
Readings:
Anderson V. and Johnson L. Four steps to graphing behavior over time. The Systems Thinker,
Volume 8(3), 8, April 1997.
Berger, Peter and Neuhaus, John. To Empower People: The Role of Mediating Structures in
Public Policy. Washington D.C., American Enterprise Institute, 1977.
Best Practices in Collaboration to Improve Health: Creating Community Jazz. The California
Wellness Foundation and The Healthcare Forum, 1996.
Billings J, et al. Group support therapy in The Lifestyle Heart Trial. In Scheit S and Allan R
(eds), Heart and Mind: The Emergence of Cardiac Psychology. Washington, D.C., American
Psychological Association, 1996.
Brown J and Issacs D. Conversation as a core business process, The Systems Thinker, Volume
7(10), 1-6, December/January 1997.
Cisneros, Henry. Building Better Communities: The Housing/Health Care Connection,
Hospitals & Health Networks, Volume 68(15), August 5, 1994.
Evans R, et al. Why are Some People Healthy and Others Not? The Determinants of Health of
Populations. New York, Aldine de Gruyter, 1994.
Flower, J. Why some people get sick and others dont: A conversation with J. Fraser Mustard,
M.D., Healthcare Forum Journal, 40(6), 12-18, November-December 1997.
Hagland, M. Accelerating Community Transformation: Moving Health to the Community
Level, Healthcare Forum Journal, 40(6), 24-30, November/December 1997.
Hirsh GB. Building shared visions and strategies for action: combining systems thinking and
dialogue, Healthier Communities Action Kit, Module 3, Chapter 3. San Francisco: The
Healthcare Forum, 1994.
House JS, et al. Social relationships and health, Science, Volume 241, 540-5, 1988.
Hutchens D. Outlearning the Wolves: Surviving and Thriving in a Learning Organization.
Waltham, MA. Pegasus Communications, Inc. 1998.
Indicators of Sustainable Community: Sustainable Seattle, 1993.
Isham, G. Population health and the health plan: The partners for better health experience,
Healthcare Forum Journal, 40(6), 36-39, November/December, 1997.
________________________________________________________________________________________________________________
Johnson, Lauren. Organizations as living systems, The Systems Thinker, Volume 7(10), 9-11,
December/January 1997.
Kaplan FA, et al. Social connections and mortality from all causes and from cardiovascular
disease: prospective evidence from eastern Finland, American Journal of Epidemiology,
Volume 128(2), 370-80, 1988.
Kim DH. From event thinking to systems thinking, The Systems Thinker, Volume 7(4), 6-7,
May 1996.
Kim DH and Anderson V. System Archetype Basics: From Story to Structure. Waltham, MA.
Pegasus Communications, Inc., 1998.
Kim DH and Lannon CP. Applying System Archetypes. Cambridge, MA., Pegasus
Communications, Inc., Innovations in Management Series # IMS002, 1997.
Koffman F and Senge P. Communities of commitment: the heart of learning organizations,
Organizational Dynamics, 5-23, Autumn 1993.
Kretzmann, John and John L. McKnight. Building Communities from the Inside Out: A Path
Toward Finding and Mobilizing A Community's Assets, Chicago, IL, Center for Urban Affairs
and Policy Research, Northwestern University, 1993.
Lee P. Creating Circles of Health: Integrating Enhanced Social Environments with
Responsible Behavior to Achieve Improved Population Health Profiles, Faulkner and Greys
Annual Guide to Healthcare Resources, 1996.
Lee P. Modeling Health in the Information Age: Advancing Public Benefit with Dimensional
Informatics, Faulkner and Greys Annual Guide to Healthcare Resources, 1996.
McKnight J. The Careless Society: Community and its Counterfeits, Basic Books, 1995.
Mulligan, Richard K. Catalyst for Community Capacity-Building: A Role for Public Sector
Practitioners, Economic Development Review, Volume 13, (4), Fall 1995.
Pellitier KR. A review and analysis of the health and cost-effective outcome studies of
comprehensive health promotion and disease prevention programs at the work site, American
Journal of Health Promotion, Volume 8, 50-62, 1993.
Robert, Karl-Henrik. The Natural Step: A Framework for Achieving Sustainability in our
Organizations. Cambridge, MA. Pegasus Communications, Inc., Innovations in Management
Series # IMS005, 1997.
Schley S and Laur J. Creating Sustainable Organizations: Meeting the Economic, Ecological,
and Social Challenges of the 21
st
Century. Waltham, MA., Pegasus Communications, Inc.,
Innovations in Management Series # IMS008, 1998.
________________________________________________________________________________________________________________
Schley S and Laur J. The sustainability challenge: Ecological and economic development,
The Systems Thinker, Volume 7(7), 1-6, September 1996.
Schwinn C. New visions for communities, Healthier Communities Action Kit, Module 3,
Chapter 3. San Francisco, The Healthcare Forum, 1994.
Senge, Peter M. The Fifth Discipline: The Art and Practice of the Learning Organization. New
York, Doubleday/Currency, 1990.
Senge, Peter M. The leaders new work: Building learning organizations, Sloan Management
Review, Fall 1990, Volume 32(1), 7-22.
Senge PM and Kim D. From fragmentation to integration: Building learning communities,
The Systems Thinker, Volume 8(4), 1-5, May 1997.
Senge PM et al. The Fifth Discipline Fieldbook: Strategies and Tools for Building a Learning
Organization. New York, Doubleday/Currency, 1994.
Sweeney LB and Meadows D. The Systems Thinking Playbook: Exercises to Stretch and Build
Learning and Systems Thinking Capabilities. Framingham, MA, Turning Point Foundation,
1996.
Tang, Shui-Yan. Building Community Organizations: Credible Commitment and the New
Institutional Economics, Human Systems Management, Volume 13, Number 3, 1994.
Waterhouse D. "Building Viable Communities: The Essence of Economic Development,"
Economic Development Review, Volume 9, Number 3, Summer 1991.
Wheatley M and Kellner-Rogers M. A Simpler Way. San Francisco: Berret Koehler, 1996.
________________________________________________________________________________________________________________
Faculty Biography: SUSAN HAECKER
Susan C. Haecker is the founder and principal of WellSpring. She specializes in organizational
design, interactive planning, leadership development, primarily to create innovative systems and
leadership solutions for health improvement. WellSpring helps organizations align values,
purpose, culture, strategy and systems to build and sustain their capacity for renewal and success.
WellSprings mission is to offer tools and resources which enliven, encourage, and re-inspire the
focus of health and quality-of-life within organizations and communities.
Susan is one of the principal authors of The Healthcare Forums Learning Advantage, a tool
designed to build capacity for team and organizational learning. She has been a part of the
development team and a lead facilitator for The Healthcare Forums Strategic Simulations
Series: Managing the Transition to Capitation, Risky Business: The New Business of Health, and
The Community Builder.
Susan has over twenty years of experience in healthcare operations, strategy deployment,
organizational development, program design, quality improvement, and community health
planning within health systems and across communities. Susan is a registered nurse and holds a
master's degree in nursing practice, administration, and education. She has a special interest in
spirituality and leadership, and in how to create the consciousness of health within organizations
in order to promote health and healing among those served.

425 Market Street, 34
th
floor
San Francisco, CA 94105

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