Nonlinear analysis can improve the adaptive ability of clinical paths and aid in providing improved continuity of care. This article continues our exploration of the ways "chaos theory" can be applied in health care by focusing on clinical applications. It describes a specific application of nonlinear techniques to knee arthroplasty, but the generalized nature of the technique suggests it can be applied in many other settings. The approach offers an innovative means for both improved patient care and cost savings.

If you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation.Abstract In today's competitive business environment, organizations are being challenged to improve performance by improving processes, minimizing costs, and increasing output. Such changes can only be made by looking beyond traditional management systems. Continuous improvement (CI) and total quality management (TQM) have been the focus of recent quality improvement initiatives. However, in many ways, the results have not been as dramatic as desired. Business process reengineering (BPR) focuses on innovation and creativity in redesigning processes in an effort to meet customers' needs and expectations. Experience using nonlinear systems theory in applied health care settings has revealed that nonlinear science does offer a practical new frame of reference for BPR initiatives. This article describes why radically different approaches are necessary to sustain continued quality improvement, provides the key practical insights offered by nonlinear systems theory, and provides a clinical example of multidimensional thinking as applied in an acute care setting.The current issue and full text archive of this journal is available at

Chaos theory, also called nonlinear systems theory, provides new insights into processes previously thought to be unpredictable and random. It also provides a new set of tools that can be used to analyze common administrative and clinical data. This tutorial provides an introduction to chaos theory. Subsequent articles will address applications of those principles to the administrative activities of health care organizations, implications of those principles for clinical data, and application of chaos theory concepts to our understanding of organizational dynamics.

With a distinguished 27-year history of continuous publication, Quality Management in Health Care (QMHC) is an essential peer-reviewed journal on the theoretical, technical, and strategic elements of health care quality management. The Journal is included in many important bibliographic databases like PubMed, Medline, Scopus, and Web of Science.

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