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Book part
Publication date: 19 December 2013

Commentary on “Health Care Organizations as Complex Systems: New Perspectives on Design and Management” By Reuben R. Mcdaniel, Dean J. Driebe, and Holly Jordan Lanham

Ruth A. Anderson

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…

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Abstract

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.

Details

Annual Review of Health Care Management: Revisiting The Evolution of Health Systems Organization
Type: Book
DOI: https://doi.org/10.1108/S1474-8231(2013)0000015008
ISBN: 978-1-78350-715-3

Keywords

  • Complexity science guided management practices
  • complex adaptive systems
  • improving patient outcomes
  • adaptive leadership

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Book part
Publication date: 19 December 2013

Health care organizations as complex systems: New Perspectives on Design and Management

Reuben R. McDaniel, Dean J. Driebe and Holly Jordan Lanham

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…

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Abstract

Purpose

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.

Approach

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.

Findings

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.

Originality/value

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.

Details

Annual Review of Health Care Management: Revisiting The Evolution of Health Systems Organization
Type: Book
DOI: https://doi.org/10.1108/S1474-8231(2013)0000015007
ISBN: 978-1-78350-715-3

Keywords

  • Complexity science
  • complex adaptive system
  • HCO design
  • HCO management
  • HCO interdependencies
  • HCO information systems

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Book part
Publication date: 31 July 2013

Exploring interpersonal behavior and team sensemaking during health information technology implementation

Rebecca R. Kitzmiller, Reuben R. McDaniel, Constance M. Johnson, E. Allan Lind and Ruth A. Anderson

We examine how interpersonal behavior and social interaction influence team sensemaking and subsequent team actions during a hospital-based health information technology…

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Abstract

Purpose

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.

Design/methodology/approach

Over the course of 18 months, we directly observed the interpersonal interactions of HIT implementation teams using a sensemaking lens.

Findings

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.

Practical implications

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.

Social implications

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.

Research implications

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.

Value/originality

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.

Details

Leading in Health Care Organizations: Improving Safety, Satisfaction and Financial Performance
Type: Book
DOI: https://doi.org/10.1108/S1474-8231(2013)00000140010
ISBN: 978-1-78190-633-0

Keywords

  • Sensemaking
  • health information technology
  • hospital
  • team
  • implementation

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Book part
Publication date: 1 June 2004

CHAOS AND COMPLEXITY IN A BIOTERRORISM FUTURE

Reuben R McDaniel

Preparing for a potential bioterroism is a difficult task for health care leaders because of the fundamental unpredictability of bioterroist acts. Complexity science…

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Abstract

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.

Details

Bioterrorism Preparedness, Attack and Response
Type: Book
DOI: https://doi.org/10.1016/S1474-8231(04)04005-4
ISBN: 978-1-84950-268-9

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Article
Publication date: 1 December 2000

Organizational responses to complexity: the effect on organizational performance

Donde P. Ashmos, Dennis Duchon and Reuben R. McDaniel

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…

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Abstract

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.

Details

Journal of Organizational Change Management, vol. 13 no. 6
Type: Research Article
DOI: https://doi.org/10.1108/09534810010378597
ISSN: 0953-4814

Keywords

  • Contingency Theory
  • Organizational performance

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Book part
Publication date: 12 September 2001

Complexity science and health care management

Reuben R. McDaniel and Dean J. Driebe

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Details

Advances in Health Care Management
Type: Book
DOI: https://doi.org/10.1016/S1474-8231(01)02021-3
ISBN: 978-1-84950-112-5

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Book part
Publication date: 1 June 2004

List of Contributors

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Abstract

Details

Bioterrorism Preparedness, Attack and Response
Type: Book
DOI: https://doi.org/10.1016/S1474-8231(04)04016-9
ISBN: 978-1-84950-268-9

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Book part
Publication date: 1 June 2004

Table of contents

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Abstract

Details

Bioterrorism Preparedness, Attack and Response
Type: Book
DOI: https://doi.org/10.1016/S1474-8231(04)04015-7
ISBN: 978-1-84950-268-9

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Book part
Publication date: 31 July 2013

List of contributors

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Abstract

Details

Leading in Health Care Organizations: Improving Safety, Satisfaction and Financial Performance
Type: Book
DOI: https://doi.org/10.1108/S1474-8231(2013)0000014002
ISBN: 978-1-78190-633-0

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Book part
Publication date: 12 September 2001

List of contributors

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Abstract

Details

Advances in Health Care Management
Type: Book
DOI: https://doi.org/10.1016/S1474-8231(01)02017-1
ISBN: 978-1-84950-112-5

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