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Table 6 Ways of using SSM

From: Change and improvement 50 years in the making: a scoping review of the use of soft systems methodology in healthcare

  Number of studies %
Purpose of using SSM
 Problem structuring and proposing improvements 20 40.8
 Problem structuring 8 16.3
 Evaluation 6 12.2
 Problem structuring, proposing and implementing improvements 5 10.2
 Describing or understanding models of care or processes in healthcare 4 8.2
 Determine objectives for a simulation study 2 4.1
 Other 4 8.2
Problem situation/reason for using SSM
 Health system improvement 9 18.4
 Care process improvement 8 16.3
 Policy improvement 7 14.3
 Information system development/improvement 6 12.3
 Describe/improve knowledge management system 3 6.1
 Intervention/program/care model evaluation 3 6.1
 Analyse/improve practice development 3 6.1
 Analyse/improve teamwork 2 4.1
 Other 8 16.3
Type of SSM used
 Seven stage 13 26.5
 Four activity 6 12.3
 Combined with other method 11 22.5
 Part of the method 6 12.3
 New adapted version 3 6.1
 Two strands 1 2
 Nine stage 1 2
 Not clear/not stated 8 16.3
SSM tools applieda
 PAM 33 67.3
 Root definition 29 59.2
 CATWOE 28 57.1
 Rich picture 20 40.1
 Comparison of real world and PAM 17 34.7
 Three Es 4b 8.2
 PQR-formula 2 4.1
 Five Es 1 2
  1. aPercentage exceeds 100 because some studies applied multiple SSM tools
  2. bOne study used an adapted version of the Three Es [30]