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We discuss the impact of complexity science on the design and management of health care organizations over the past decade. We provide an overview of complexity science issues and their impact on thinking about health care systems, particularly with the rising importance of information systems. We also present a complexity science perspective on current issues in today’s health care organizations and suggest ways that this perspective might help in approaching these issues.

We review selected research, focusing on work in which we participated, to identify specific examples of applications of complexity science. We then take a look at information systems in health care organizations from a complexity viewpoint.

Complexity science is a fundamentally different way of understanding nature and has influenced the thinking of scholars and practitioners as they have attempted to understand health care organizations. Many scholars study health care organizations as complex adaptive systems and through this perspective develop new management strategies. Most important, perhaps, is the understanding that attention to relationships and interdependencies is critical for developing effective management strategies.

Increased understanding of complexity science can enhance the ability of researchers and practitioners to develop new ways of understanding and improving health care organizations.

This analysis opens new vistas for scholars and practitioners attempting to understand health care organizations as complex adaptive systems. The analysis holds value for those already familiar with this approach as well as those who may not be as familiar.

While uncertainty has always been a feature of the healthcare environment, its pace and scope are rapidly increasing, fueled by myriad factors such as technological advancements, the threat and frequency of disruptive events, global economic developments, and increasing complexity. Contemporary healthcare organizations thus persistently face what is known as “deep uncertainty,” which obscures their ability to predict outcomes of strategic action and decision-making, presenting them with novel challenges and threatening their survival. Persistent, deep uncertainty challenges us to revisit and reconsider how we think about uncertainty and the strategic actions needed by organizations to thrive under these circumstances. Simply put, how can healthcare organizations thrive in the face of deeply uncertain environments? We argue that healthcare organizations need to employ both adaptive and creative strategic approaches in order to effectively meet patients' needs and capture value in the long-term future. The chapter concludes by offering two ways organizations can build the dynamic capabilities needed to employ such approaches.

This paper aims to predict the localized corrosion resistance by the application of artificial neural networks. It emphasizes the importance to take into account the relationships between the physical parameters before presenting them to the network.

The work was conducted in two phases. At the beginning, the authors executed an experimental program to measure pitting corrosion resistance of carbon steel in an aqueous environment. More than 900 electrochemical experiments were conducted in chemical solutions containing different concentrations of pitting agents, corrosion inhibitors and oxidant reagents. The obtained results were collected in a table where for a combination of the experimental parameters corresponds a pitting potential Epit obtained from the corresponding electrochemical experiment. In the second step, the authors used the experimental data to train different artificial neuron networks for predicting pitting potentials.

In this step, the authors considered the relationships that the chemical parameters are likely to have between them. Two types of relationships were taken into account: chemical equilibria which are controlled by the pH and the synergistic relationships that some corrosion inhibitors may have when they are in the presence of a chemical oxidant.

This comparative study shows that adjusting the input data by considering the physical relationships between them allows a better prediction of the pitting potential. The quality of the prediction, quantified by a regression factor, is qualitatively confirmed by a statistical distribution of the gap between experimental and calculated pitting potentials.

Workplace voice is well-established and encompasses behaviors such as prosocial voice, informal complaints, grievance filing, and whistleblowing, and it focuses on interactions between the employee and supervisor or the employee and the organizational collective. In contrast, our chapter focuses on employee prosocial advocacy voice (PAV), which the authors define as prosocial voice behaviors aimed at preventing harm or promoting constructive changes by advocating on behalf of others. In the context of a healthcare organization, low quality and unsafe patient care are salient and objectionable states in which voice can motivate actions on behalf of the patient to improve information exchanges, governance, and outreach activities for safer outcomes. The authors draw from the theory and research on responsibility to intersect with theories on information processing, accountability, and stakeholders that operate through voice between the employee-patient, employee-coworker, and employee-profession, respectively, to propose a model of PAV in patient-centered healthcare. The authors complete the model by suggesting intervening influences and barriers to PAV that may affect patient-centered outcomes.

In the last decade, greater attention has been paid to the role of management accounting and control (MAC) in making professional organizations more horizontal. The authors argue that earlier research has not shown how the interrelatedness between professional identities and MAC influences attempts to make organizations more horizontal. In this paper the authors respond to the call for more research on the relationship between horizontalization and accounting and control. The purpose of this paper is to contribute to the emerging literature on the relationship between accountability arrangements and professional identities.

Theoretically the authors have an actor-network theory (ANT) approach. Empirically, the authors followed two episodes where actors at top management levels in two Swedish health care organizations introduced horizontalization.

The two episodes support the view that the role of MAC when making professional organizations more horizontal is limited. Professionals dominate what happens at the operational level and they do not act on MAC rules and performance targets in opposition of their professional identity. However, in alliance with other interessement devices MAC may have a role in creating overflows, that is, pointing out imperfections in the existing frame. The authors noticed no signs that professionals developed hybrid identities as in previous research.

The authors apply ANT to move beyond the commonly used contingency and new institutional sociology perspectives.

The aim of the present paper is to examine how the introduction of information and communication technologies (ICTs) can have positive implications in a territorial context, where healthcare organizations are characterized by limited organizational independence and lack of individual statutory autonomy, with limited level of integration between the involved parties (healthcare operators, managers, and patients) and an uneven management of data and of information‐sharing.

The approach taken was an investigation based on a combination of quantitative and qualitative methods for information‐gathering and data‐analysis in the context of diabetes care. A case study approach was adopted with the aim of enhancing general practitioners' (GPs') performance levels through an evaluation monitoring and by controlling care paths dynamics.

The realization of the target care path for chronic–degenerative pathologies in the Local Health Trust “Naples 4” in Campania Region (Italy) led to the identification of a suitable framework that modifies, through the implementation of ICT tools, the communications dynamics and the interaction/integration for those actors involved in a patient's care path.

Healthcare markets are currently experiencing an acceleration of technological developments; the study tries to show how the appropriate adoption of new technologies can lead to improvements for the quality of care, managing at the same time the consequent rising costs in the sector.

The purpose of this paper is to provide a framework for analyzing stakeholder‐management strategies in supply chain collaboration. The authors aim to show how prior dyadic relations with a stakeholder and perception of situational demands on the relationship determine the choice of aggressive vs cooperative strategies in managing stakeholder relationships.

To develop a blueprint for predicting collaboration strategies, literature on stakeholder theory, stakeholder management strategies, field theory, and organizational mental models was surveyed. From the literature, 31 predictors of eight stakeholder management strategies were identified. To operationalize the study's constructs, results of a national survey were analyzed to determine the significant predictors of stakeholder management strategies.

Factor analysis identified two groups of stakeholder strategies: aggressive strategies and cooperative strategies. Aggressive strategies feature some form of forceful attitude or behavior toward stakeholders in an attempt to alter other stakeholders' behavior. Cooperative strategies feature supportive attitudes or behaviors towards its stakeholders. Models were developed for these two types of stakeholder management strategies. When the level of trust among stakeholders is low, a firm that presses to complete the collaboration activity may choose aggressive strategies in dealing with its trading partners. On the other hand, a sense of interdependence, a perception that its trading partners share the urgency to collaborate, plus awareness that the collaboration activity benefits all will lead the organization to adopt cooperative strategies.

By examining the factors contributing to an organization's decision to pursue aggressive (e.g. the radio frequency identification – RFID Mandate), rather than cooperative stakeholder management strategies, this study has important implications to advocates of change (e.g. firms mandating RFID compliance), and firms at the receiving end of aggressive stakeholder strategies.

The findings have important implications for advocates of change (e.g. firms mandating RFID compliance). For trading partners to cooperate, the trading partners must be convinced of the urgency of change, that it is appropriate and right to comply with the call for change, and that they have the ability to do it correctly. To firms at the receiving end of aggressive stakeholder strategies, the approach taken by their trading partners may seem like “bullying tactics” exercised by firms in a position of power. Instead, this research suggests that firms use aggressive stakeholder management strategies because of a heightened sense of urgency, difficulty in conveying legitimacy in carrying out the collaborative undertaking to the trading partners, and lack of faith that all stakeholders will do their share to make the collaborative undertaking work.

This study aims to empirically validate five propositions about the benefits of three-dimensional (3D) visualizations for the management of subsurface utility projects. Specifically, the authors validate whether benefits from 3D in the literature of building construction project management also apply to subsurface utility projects and map them using a taxonomy of project complexity levels.

A multiple case study of three utility construction projects was carried out during which the first author was involved in the daily work practices at a utility contractor. 3D visualizations of existing project models were developed, and design and construction meetings were conducted. Practitioners' interactions with and reflections on these 3D visualizations were noted. Observational data from the three project types were matched with the five propositions to determine where benefits of 3D visualizations manifested themselves.

Practitioners found that 3D visualizations had most merit in crowded urban environments when constructing rigid pipelines. All propositions were validated and evaluated as beneficial in subsurface utility projects of complexity level C3. It is shown that in urban projects with rigid pipelines (project with the highest complexity level), 3D visualization prevents misunderstanding or misinterpretations and increases efficiency of coordination. It is recommended to implement 3D visualization approaches in such complex projects

There is only limited evidence on the value 3D visualizations in managing utility projects. This study contributes rich empirical evidence on this value based on a six-month observation period at a subsurface contractor. Their merit was assessed by associating 3D approaches with project complexity levels, which may help utility contractors in strategically implementing 3D applications.