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40946Healthcare Systems

Keynote

Healthcare in the 21st century is complex; thus, the theory of complexity science is applicable to this new age. The mechanistic mind-set of the industrial years, still in place in many organizations today, is no longer an appropriate thinking for addressing contemporary problems. Complexity science recognizes the many self-adapting mini-systems within each larger system. Nelson, Batalden, and Nelson (2007) describe healthcare systems as consisting of microsystems, mesosystems, and macrosystems. I suggest you do a little reading for yourself to see how the smaller systems fit into the larger and how each system influences the behavior of the others. Because system pieces are dynamic and constantly adapting, outcomes are unpredictable. Most of us, growing up in an industrialized society, are probably more comfortable with linear thinking (where cause and effect provides explanation and predictability); however, the reality is life is “messy”. Plesk and Greenhalgh (2001) state that unpredictability and paradox is inherent in complex systems; consequently, some things are simply unknowable. However, the unknown should not serve as a deterrent to understanding and improvement efforts. We are not victims of systems, we are co-creators.

References:

Nelson, E.C., Batalden, P.B., & Godfrey, M.M. (2007). Quality by design: A clinical microsystems
approach. San Francisco, CA: Josey-Bass.

Plsek, P.E., & Greehalgh, T. (2001). Complexity Science: The challenge of complexity in healthcare. British
Medical Journal 323, 625-628.

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