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BACKGROUND Despite health care advances, artificial intelligence and government interventions aiming to improve the health and wellbeing of citizens, huge disparities and failures in care provision exist. This is demonstrated by the rising number of medical errors, increase in readmission rates and mortality rates, and the failure of many health systems to successfully cope with events, such as pandemics and natural disasters. This shortfall is in part because of the complexity of the health care system, the interconnectedness of various parts of service, funding models, the complexity of patients' conditions, patient and carer needs, and the clinical processes needed for patients via multiple providers. OBJECTIVE The objective of this paper is to describe the use of system thinking methodologies to address complex problems such as those in the public health and health services domains. METHOD A description of the system thinking methodology and its associated methods including causal loop diagrams, social network analysis and soft system methodology are described with examples in the health care setting. RESULTS There are various models of knowledge translation that have been employed including the Joanna Briggs Institute model of implementation of evidence into practice, the triple C, and the Promoting Action on Research Implementation in Health Services. However, many of these models are neither scalable nor sustainable, and are most effective for localized projects implemented by trained clinicians and champions in relevant settings.System thinking is essentially a modelling process, which aims to create opportunities for change via an appreciation of perspective, and recognition that complex problems are a result of interconnected factors. The article argues that systems thinking applications need to move beyond that of addressing complex health issues pertaining to a population, and rather consider complex problems surrounding the delivery of high-quality health care. CONCLUSION It is important that methods to implement systems thinking methodologies in health care settings are developed and tested.

Planning and implementing surge capacity in healthcare services is challenging. The evolving nature of viral transmission makes it difficult to predict the potential impact on the health system and the readiness of healthcare managers and professional staff in responding to system transformation and consequential impacts. This is compounded by sudden increased demands in the types of work required. Guidance for implementing targeted strategies for health systems and services should include evidence that considers the feasibility, appropriateness, meaningfulness and effectiveness of healthcare practices at both the system and organization level. This is consistent with the Joanna Briggs Institute (JBI) model of evidence synthesis and translation. Evidence-based decision-making is a core management competency for health service leadership and the mechanism for improving the quality of management decisions, and hence better service delivery, effectiveness and efficiency. Human resources are the most important asset in crisis management. Health managers must create responsive surge capacity by quantifying existent human and material resources and the shortfall needs required to meet anticipated additional demand. We believe a multifaceted approach is the key to developing systemic surge capacity within the heath sector when faced with the management of crises such as pandemics. We explore and discuss the desirability of strategies based on the JBI model of evidence synthesis and implementation with a view to encouraging the creation of registries and follow-up systems. We believe this will encourage the effective use of human resources including the upskilling in how future crises may be addressed.