Leadership and transitions: maintaining the science in complexity and complex systems

Background: Nowadays, health systems are generally acknowledged to be complex social systems. Consequently, scholars, academics, practitioners, and policy-makers are exploring how to adopt a complexity perspective in health policy and system research. While leadership and complexity has been studied extensively outside health, the implications of complexity theories for the study of leadership in healthcare have received limited attention. We carried out a scoping review of complex leadership (CL) in healthcare to investigate how CL in healthcare has been defined, theorised and conceptualised and to explore how ‘CL’ has been applied in healthcare settings. Methods: We followed the methodological steps proposed by (Arksey and O’Malley, 2005): (1) specifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, (5) collating and summarizing the findings, and (6) reporting the results. We searched using Medline, Psychinfo, Wiley online library, and Google Scholar. Our inclusion criteria were: publication type (peer reviewed articles, theses, and book chapters); phenomenon of interest: complex leadership; context: healthcare and period of publication: between 2000 and 2016. Results: Our search and selection resulted in 37 papers (16 conceptual papers, 14 empirical studies and 7 advocacy papers). We note that empirical studies on CL are few and almost all research reported by these papers was carried out in the North (mainly in USA and UK). We found that there is some variation in definitions of CL. Furthermore, the research papers adopt mostly an explorative or explanatory approach and do not focus on assessing effectiveness of CL approaches. Finally, we found that the majority of researchers seem to adhere to the mathematical complexity perspective. Conclusion: Complexity concepts derived from natural sciences may not automatically fit management of health services. Further research into how social complexity theories may offer researchers useful grounds to empirically test CL theories in health settings is warranted. Specific attention should be paid to the multi-layered nature of leadership.

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“…Other authors use similar narrow definitions of CL 29,32,34,35,41,43,45,48,56,58-61,63 (see Figure 4).…”

Section: Resultsmentioning

confidence: 99%

Complex Leadership in Healthcare: A Scoping Review

Belrhiti

Giralt

Marchal

2018

Int J Health Policy Manag

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“…In a 2011 article, of the 56 publications cited by Sturmberg as the Forum's contribution the pair was found to have co-authored a combined 21 (37.5%) (Sturmberg and Martin 2012). In keeping with its late editor's specialism, the Forum's work is characterized by an extensive use of metaphors and analogies adapting abstract Systems ideas and principles from other disciplines to public health.…”

Section: Forum On Systems and Complexity In Medicine And Healthcarementioning

confidence: 99%

Systems thinking in public health: a bibliographic contribution to a meta-narrative review

Chughtai¹,

Blanchet

2017

Health Policy Plan.

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Background Research across the formal, natural and social sciences has greatly expanded our knowledge about complex systems in recent decades, informing a broadly inclusive, crossdisciplinary conceptual framework referred to as Systems Thinking (ST). Its use in public health is rapidly increasing, although there remains a poor understanding of how these ideas have been imported, adapted and elaborated by public health research networks worldwide. Method This review employed a mixed methods approach to narrate the development of ST in public health. Tabulated results from a literature search of the Web of Science Core Collection database were used to perform a bibliometric analysis and literature review. Annual publication counts and citation scores were used to analyse trends and identify popular and potential 'landmark' publications. Citation network and co-authorship network diagrams were analysed to identify groups of articles and researchers in various network roles. Results Our search string related to 763 publications. Filtering excluded 208 publications while citation tracing identified 2 texts. The final 557 publications were analysed, revealing a nearexponential growth in literature over recent years. Half of all articles were published after 2010 with almost a fifth (17.8%) published in 2014. Bibliographic analysis identified five distinct citation and co-authorship groups homophilous by common geography, research focus, inspiration or institutional affiliation. As a loosely related set of sciences, many public health researchers have developed different aspects of ST based on their underlying perspective. Early studies were inspired by Managementrelated literature, while later groups adopted a broadly inclusive understanding which incorporated related Systems sciences and approaches. Conclusion ST is an increasingly popular subject of discussion within public health although its understanding and approaches remain unclear. Briefly tracing the introduction and development of these ideas and author groups in public health literature may provide clarity and opportunities for further learning, research and development.

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Interventions to improve the oral health of people with dementia or cognitive impairment: A review of the literature

Siegel

Cations

Wright

et al. 2016

J Nutr Health Aging

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There is a lack of high quality evidence to support the effectiveness of oral health interventions and implementation strategies for older people with dementia or cognitive impairment. More rigorous, large scale research is needed in this area. Recommendations are provided to improve the overall quality of evaluation in this area. Emphasis must be placed on developing evidence-based, achievable and sustainable oral health strategies if the needs of people with dementia and cognitive impairment are to be met into the future.

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Leadership and transitions: maintaining the science in complexity and complex systems

Cited by 6 publications

References 65 publications

Complex Leadership in Healthcare: A Scoping Review

Complex Leadership in Healthcare: A Scoping Review

Systems thinking in public health: a bibliographic contribution to a meta-narrative review

Interventions to improve the oral health of people with dementia or cognitive impairment: A review of the literature

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