Medical Device Integration Blog

Healthcare as a Complex Adaptive System

Posted by Michelle Grate, RN MSN CPHIMS on May 01, 2014 @ 09:00 AM

For decades, complex systems have been a topic of study in natural sciences like physics, chemistry, mathematics, and engineering. The concept of complex systems has been used to explain phenomena such as immune system functions and weather patterns.  Complex adaptive systems evolve in response to the changing environment; the need to adapt in order to survive. Tremendous progress has been made in applying Complex Adaptive Systems (CAS) modeling to other disciplines with a more social nature.

Healthcare is a CAS on many levels, from the daily interactions between patients and staff to the overarching interaction of healthcare systems. These systems have a natural tendency to adapt to change; to dynamic events that unfold in unpredictable and unique ways. Each individual component affects the other creating a chain of events.

I’d like to explore how these complex adaptive systems are important to clinical informatics.

Simply put, as new processes are introduced we, healthcare informaticists,need to review and study the potential outcome. We must always be aware that systems will adapt naturally to meet their needs.

It is well known that nurses are masters at procuring and creating workarounds in an effort to survive a change in workflow. Therefore, as we introduce new products, we must consider the concept of healthcare as a CAS and evaluate the potential adaptive behavior. For example, launching a new process or product in a pilot location my help to identify a potential negative work-around. The new process should then be evaluated and possibly adjusted to be sure that it is meeting the needs of the clinicians.   As a vendor, having clinicians on staff with an awareness of CAS will promote the delivery of proven CAS methodology products.

What does your organization do to assure negative workarounds are not implemented with new products or processes?
What are your biggest challenges with implementing new products?

Tags: Informatics, Complex Adaptive Systems (CAS), Workaround