Powell & Associates
Solving complex health care challenges through human-centered design.

Health Care Quality Improvement

Designing at the System Level


designing at the system level

Designing systems is about balancing the complexity of many different stakeholders' needs with the need of the business enterprise. Systems design involves setting high level strategy, such as establishing aim, vision, priorities, policies, and key communications to inform what we call system level requirements. 

system level requirements 

System level requirements are a list of attributes or components needed as we design new models, approaches, and interventions. Examples of system requirements are improved clinical management and patient experience, integration across organizations, accelerated research, transparent and accessible data, and shared responsibility for the system across all stakeholder groups.



Creating a mindset for human-centered design is critical to success. All too often stakeholders can see only through the lens of their own perspective. Human-centered designers develop mindsets enabling them to see how processes are interdependent so that they can more effectively problem solve. Mindsets and skills of designers include: curiosity, the ability to learn from failure, a "make it" mentality, creative confidence, empathy, embrace ambiguity, and be optimistic with an eagerness to iterate.

System Level Measures

In systems that have processes and interface across multiple organizations, measures will be expanded to include the effectiveness of collective impact, including system infrastructure, such as a data repository or a system level data dashboard. Developing a set of system level measures is part of the human-centered design journey; as we refine system requirements and identify intervention packages, we will refine and test a metric set to know whether the system is operating at the level we seek.