Purpose: The purpose of this paper is to highlight how systems thinking contributes to decision making in uncertain contexts that are characteristic of service systems. Based on the assumption that service systems face complex conditions, the paper posits that systems thinking may support the understanding of key issues in service management.Design/methodology/approach: This paper proposes an interpretation of complexity in the context of service systems, which highlights the perspective change that occurs when a systems approach is adopted. The offered conceptual perspective is then brought to an operational level, in spite of the complexity of the decisions driving a viable system, by modelling a service system as a network of agents, resources, processes and decisions through the use of fuzzy logic. The paper reviews service management research streams, and takes a deeper look at the concepts of service systems and complex service systems. The paper then proceeds to discuss how systems thinking contributes to service management by proposing a systems interpretation of complexity.Findings: Service management theories and models may be enhanced by integrating prevailing approaches, based on a quantitative and mechanistic view of service systems dynamics, with systems thinking‐based meta‐models that can be used in better understanding service exchanges. The findings of the paper also show how the integration of an engineering approach can be insightful to the understanding of service systems; adopting a Viable Systems Approach (VSA) as a meta‐model can be useful in fully comprehending market behaviour in uncertain conditions.Originality/value: The originality of this paper lies in exploring the contribution of systems thinking, in particular of the Viable Systems Approach (VSA), to service management and decision making.

The paper aims to advocate the incorporating of the sustainability perspective into the management control system of healthcare organizations. The study is based on two main premises: (1) the evolution of business models towards a wide perspective of the sustainability approach; (2) the evolution of control systems in healthcare organizations towards a control-based approach to monitor the effectiveness and efficiency of the service targeted primarily to cut costs and expenses. Our methodology is developed at theoretical and conceptual level starting from: (1) a literature review on the issue, highlighting main trends and gaps and (2) the adoption of the Viable Systems Approach (VSA) as a conceptual framework oriented to integrate a wide variety of stakeholder perspectives and interests into the business model. Our findings lead us to introduce the Systems Viability Monitoring Model for Sustainability as a potential reference framework to build healthcare management control systems in which the notion of ‘systems viability,’ as defined by VSA, becomes a bridging concept by means of which the sustainability perspective can be incorporated into the management control system of healthcare organizations.