Health system modelling for policy development and evaluation: Using qualitative methods to capture the whole-system perspective

This research is motivated by the desire to incorporate system-modelling tools in the policy-making process to facilitate a better understanding of the system-wide effects of patient flow related interventions. We discuss the development and use of a whole-system qualitative model for the Ontario Ministry of Health and Long-term care aimed to design patient flow policies, and to generate hypotheses on their intended and unintended consequences. We present a multi-panel expert knowledge elicitation approach based on group model building principles. A use case concerning changes to rehabilitation patient flows in the hospital and community settings is discussed. It is concluded that qualitative whole-system modelling is a highly valuable but resource intensive approach to facilitate systems thinking for policy development.