Complex adaptive systems for management of integrated care

Abstract

Purpose -The purpose of this paper is to examine how a complex adaptive systems (CAS) approach can be used to promote the integration of health and social care for the benefit of the user. Design/methodology/approach -This paper is a research review and a conceptual analysis of key issues identified in the growing literature on CAS. An application of the CAS approach to the field of integrated care is presented. The paper identifies crucial issues, notably: bringing together different providers and the place of the user as a co-producer of care. Findings -The benefits of the CAS approach to integrated care are distilled. Above all CAS provides managers of health and social care with an alternative mindset. Guiding principles are offered to these managers to facilitate development towards a more integrated system of health and social care. The possibility to benefit from the user's own resources is increased when organizations are viewed from a CAS perspective. CAS promotes emergent ways of working. Practical implications -The CAS approach makes possible a significant improvement in relationships between providers and users and managers and providers; a possibility of more productive relationships and better care outcomes, not least in terms of user satisfaction. Originality/value -The paper shows that CAS literature applied to the health and social care field points the way for managers to rethink the functioning of the field, specifically to go beyond the present dominant but outdated machine model to one which encourages the cooperation of providers and users for better outcomes.

Leading implementation of the management innovation value-based healthcare at a Swedish University Hospital

“…[40,41] Transformational leadership has earlier been found to be favourable in large and complex organizations [17] and one cannot deny that healthcare organizations are complex. [42] The hospital in question here is without doubt a large organization. Further explanation might be that the participants themselves did not see their leading role within the professional role.…”

Implementation of Integrated Care in Singapore: A Complex Adaptive System Perspective

“…The CAS presents as a new perspective to guide the design, development and evaluation of integrated care systems through understanding key focus areas to allocate resources so as to achieve best possible outcomes [4572223]. …”

“…Given the complexity of healthcare systems in general and models of integrated care in particular, except for a few [4567], it is surprising to find that the journey towards integrated healthcare systems has hardly been examined through the lens of complex adaptive systems (CAS). In this descriptive paper, we applied the CAS perspective to two different initiatives that exemplify approaches towards integrating care in Singapore: the Regional Health System (RHS) model, implemented across healthcare institutions at the national level, and CARITAS Integrated Dementia Care implemented in the northern region of Singapore.…”

Acreditação hospitalar: uma complementaridade proveitosa para a gestão da produção

“…A concepção das organizações de saúde como um sistema complexo adaptativo é uma tendência emergente e foi estudada por Edgren et Barnard (2012), que relataram entre as vantagens observadas a criação de novas formas de trabalho baseadas na cooperação entre seus agentes e no aprendizado e melhoria das relações entre os gestores e trabalhadores, resultando em uma maior produtividade e satisfação do usuário. Contudo, Trusko et al (2007) observaram que um dos fatores contribuintes para o erro profissional é justamente a complexidade dos processos de trabalho em um hospital, por isso, erros grosseiros ocorrem no mesmo ambiente onde se desempenham tarefas baseadas em conhecimento altamente especializado.…”