Complexity And Healthcare: An Introduction: An Introduction by Kieran SweeneyThis book illustrates the relevance of chaos and complexity theory to healthcare organisations, public health, clinical governance and the consultation. It explains the terms and ideas at the heart of complexity, the unfamiliar science behind it, and how it applies to the real world. In healthcare, the NHS is a complex adaptive system. So are hospitals, general practices, diseases and patients. The book describes how insights from complexity can help us better understand how organisations, patients or disease develop over time, in an often unpredictable manner. Contributors set out the benefits of applying complexity to their own particular areas of healthcare. Complexity and Healthcare will be of special interest to clinicians and managers in primary and secondary care, researchers and academics, and in particular, general practitioners and public health professionals.
Health Care as a Complex Adaptive System
Chaos Theory, Complexity Theory, and Health Care Quality Management
Complexity theory offers an alternative approach to quantifying the degree of physiological derangement in multi-system disorders such as sepsis. The normal, healthy human heart rate displays fractal variation which is lost in numerous disease states. Statistical techniques, such as approximate entropy, allow us to quantify the degree to which this variation is lost. Large, multi-faceted organizations such as the NHS frequently behave as complex systems and as such may benefit from alternative management strategies, informed by complexity theory. Medicine, like many other scientific fields, is founded upon the classical Cartesian method of reductionism, where a problem is broken down into its smallest components, examined, and then the information gleaned used to draw conclusions about the nature of the larger reality. When this is the case, the reductionist approach is a great success and the clinician may rightly feel confident in predicting the outcome of an intervention.
PURPOSE Over the past 7 decades, theories in the systems and complexity sciences have had a major influence on academic thinking and research. Hand searches and snowballing retrieved another Between and , articles described the complex adaptive nature of this discipline. Those published between and focused on describing the system dynamics of medical practice. After , articles increasingly applied the breadth of complex science theories to health care, health care reform, and the future of medicine.
Written by: Heather Henry Published: 03 November
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Pick a pen up off of your desk, hold it about a foot above the flat surface, and then let it drop. It hits the surface, and despite the fact that quantum mechanics suggest that there is a very small chance that it might fly out the door of the room instead - if you pick up the pen again, and again, and drop it each time - the same thing happens. What you have just created and tested is a simple system. All systems are comprised of three basic components - a structure , a process and a practice. The structure of this simple system was your hand holding a pen. The process was letting go of it, and the practice result was the pen falling and striking the desk.
Previous observational research confirms abundant variation in primary care practice. While variation is sometimes viewed as problematic, its presence may also be highly informative in uncovering ways to enhance health care delivery when it represents unique adaptations to the values and needs of people within the practice and interactions with the local community and health care system. We describe a theoretical perspective for use in developing interventions to improve care that acknowledges the uniqueness of primary care practices and encourages flexibility in the form of intervention implementation, while maintaining fidelity to its essential functions. The Veterans Health Administration VHA , the largest integrated health care system in the United States, provides care to more than 6 million veterans. Each veteran is assigned a primary care provider who is responsible for coordinating access to services, meeting specific health care needs, and providing services that promote wellness and reduce risk for preventable illness. Past initiatives to enhance care in VHA and elsewhere have been based, to a significant extent, on the continuous quality improvement CQI model.