Implications of complexity theory for clinical practice and healthcare organization

Abstract

• Non-linear systems are not amenable to investigation by reductionist methods.

Embracing the Complexity of Primary Health Care: System-Based Tools and Strategies for Researching the Case Management Process

“…28 It has been noted that there is generally limited research, education, and implementation of complexity approaches within the health care domain. 24,25 While the diagnosis of pathology using syndromic patterning reduces some of the complexity involved in clinical health care provision, it also reduces the capacity to individualise disease assessment and treatment, and to identify susceptibility and preclinical manifestations of disease. 29,30 Movement towards a systems mindset is not a call for the abolition of reductionist methods and knowledge -understanding the parts is a valuable adjunct to working with the whole.…”

“… 23 These indivisible elements are considered to be the key to deducing and explaining high-level function and, as a result, the best and most logical manner to investigate a system is considered to be at the lowest level possible. 21 , 24 However, essential to this reductionist approach is the condition that a linear system is being explored, 24 a flawed assumption when considering the health of a CAS, such as the human organism.…”

Knowledge development, technology and questions of nursing ethics

“…For example, Multiple Organ Dysfunction Syndrome (MODS) represents a condition with features consistent with complexity theory: sensitivity to initial conditions, interdependent elements, and disproportionate response. 26 Traditional ways of knowing might dismiss the difference in patient response to MODS protocols as error; complexity theory tells us that the so-called error could represent fundamental differences in understanding the syndrome’s trajectory because it is a complex response and not a linear one. Complexity theory also elucidates why seemingly small events in MODS and other diseases can result in catastrophic results in patients.…”

“…Complexity theory also elucidates why seemingly small events in MODS and other diseases can result in catastrophic results in patients. 26…”

“…Complexity theory also elucidates why seemingly small events in MODS and other diseases can result in catastrophic results in patients. 26 Although subtle, there are ethical ramifications in the choices of research approaches. First of all, complexity may compel us to revisit the meaning of error.…”