Systems Thinking and Human Resource Management in Healthcare: A Scoping Review of Core Applications Across Health System Levels

Background: Systems thinking (ST) is an approach to problem-solving that views systems through a holistic perspective, focusing on the interconnections and relationships between various elements. In healthcare, the World Health Organization’s 2009 report marked a paradigm shift toward ST, prompting the development and use of ST tools to address complex challenges. Despite this, limited attention has been given to ST’s application in healthcare human resource management (HRM). This paper aims to provide a scoping review of ST application in healthcare HRM to explore its value in workforce management. Methods: Following Arksey and O’Malley’s framework, a scoping review was conducted to map how ST has been applied in healthcare HRM. Peer-reviewed articles published between 1999 and December 2024 were identified through Scopus and PubMed, using search terms such as systems thinking, human resources, and workforce. Data were extracted using a structured tool, and findings were analyzed through the lens of the system level of application. Results: The review identified 19 studies from 15 countries, with the majority using qualitative or mixed methods approaches across diverse settings. Core applications were applied at the macro, meso, and micro system levels to address workforce challenges, map feedback loops, identify leverage points, and strengthen stakeholder collaboration. ST was commonly applied at regional and national levels and supported improved workforce planning, policy development, and service coordination. Most studies employed soft systems modeling. Conclusions: This review highlights ST’s potential to enhance HRM by recognizing interdependencies across workforce functions. Findings suggest that ST enables more integrated strategies, promotes collaboration, and supports systemic decision-making. The adoption of ST in healthcare HRM may address persistent workforce challenges, though implementation remains limited by reductionist perspectives and unfamiliarity with ST tools.