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In this commentary, I highlight a few of the assertions made by McDaniel et al. (2013) about the importance of complexity science guided management practices, and extend…
In this commentary, I highlight a few of the assertions made by McDaniel et al. (2013) about the importance of complexity science guided management practices, and extend these ideas specifically to how we might think about reducing seemingly intractable problems in health care such as patient safety, patient falls, hospital acquired infection, and the rise of chronic illness and obesity. I suggest that such changes will require managers and providers to view health care organizations and patients as complex adaptive systems and include patients as full participants in co-producing their health care.
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…
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.
Research and practice implications
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.
We examine how interpersonal behavior and social interaction influence team sensemaking and subsequent team actions during a hospital-based health information technology…
We examine how interpersonal behavior and social interaction influence team sensemaking and subsequent team actions during a hospital-based health information technology (HIT) implementation project.
Over the course of 18 months, we directly observed the interpersonal interactions of HIT implementation teams using a sensemaking lens.
We identified three voice-promoting strategies enacted by team leaders that fostered team member voice and sensemaking; communicating a vision; connecting goals to team member values; and seeking team member input. However, infrequent leader expressions of anger quickly undermined team sensemaking, halting dialog essential to problem solving. By seeking team member opinions, team leaders overcame the negative effects of anger.
Leaders must enact voice-promoting behaviors and use them throughout a team’s engagement. Further, training teams in how to use conflict to achieve greater innovation may improve sensemaking essential to project risk mitigation.
Health care work processes are complex; teams involved in implementing improvements must be prepared to deal with conflicting, contentious issues, which will arise during change. Therefore, team conflict training may be essential to sustaining sensemaking.
Future research should seek to identify team interactions that foster sensemaking, especially when topics are difficult or unwelcome, then determine the association between staff sensemaking and the impact on HIT implementation outcomes.
We are among the first to focus on project teams tasked with HIT implementation. This research extends our understanding of how leaders’ behaviors might facilitate or impeded speaking up among project teams in health care settings.
Preparing for a potential bioterroism is a difficult task for health care leaders because of the fundamental unpredictability of bioterroist acts. Complexity science thinking is presented as an approach that can help in this task. Basic concepts from complexity science, especially the role of relationships, are presented. Specific recommendations for action including sensemaking, learning, and improvisation are made. A case study is used to illustrate the power of complexity science thinking in assisting health care leaders addressing potential bioterroism. Questions for further research are presented.
This paper uses a complex adaptive systems view to examine two different organizational responses to turbulent, complex environments. We examined the internal make‐up of…
This paper uses a complex adaptive systems view to examine two different organizational responses to turbulent, complex environments. We examined the internal make‐up of eight organizations that saw their environment the same way – as rapidly changing, complex and requiring aggressive change strategies. Half of these organizations chose a complexity absorption response to environmental turbulence, and half chose a complexity reduction response to environmental turbulence and complexity. The organizations pursuing a complexity absorption response outperformed those organizations with complexity reduction responses.