ARTICLE
TITLE

Complex adaptive systems (CAS): an overview of key elements, characteristics and application to management theory

SUMMARY

Objective To identify key elements and characteristics of complex adaptive systems (CAS) relevant to implementing clinical governance, drawing on lessons from quality improvement programmes and the use of informatics in primary care.Method The research strategy includes a literature review to develop theoretical models of clinical governance of quality improvement in primary care organisations (PCOs) and a survey of PCOs.Results Complex adaptive system theories are a valuable tool to help make sense of natural phenomena, which include human responses to problem solving within the sampled PCOs. The research commenced with a survey; 76% (n16) of respondents preferred to support the implementation of clinical governance initiatives guided by outputs from general practice electronic health records. There was considerable variation in the way in which consultation data was captured, recorded and organised. Incentivised information sharing led to consensus on coding policies and models of data recording ahead of national contractual requirements. Informatics was acknowledged as a mechanism to link electronic health record outputs, quality improvement and resources. Investment in informatics was identified as a development priority in order to embed clinical governance principles in practice.Conclusions Complex adaptive system theory usefully describes evolutionary change processes, providing insight into how the origins of quality assurance were predicated on rational reductionism and linearity. New forms of governance do not neutralise previous models, but add further dimensions to them. Clinical governance models have moved from deterministic and 'objective' factors to incorporate cultural aspects with feedback about quality enabled by informatics. The socio-technical lessons highlighted should inform healthcare management.

 Articles related

Per Engelseth,Anniken Karlsen,Tim Verwaart    

 The purpose of this study is to model and thereby enable simulation of the complete business entity of fresh food supply. A case narrative of fresh strawberry supply provides basis for this modelling. Lamming et al. (2000) point to the importance o... see more


Amalina Abdullah, Channarong Banmongkol, Naebboon Hoonchareong, Hidaka Kunihiko    

Issues on detecting the occurrence of a fault, justifying the type, and estimating the exact location of the fault should be resolved to eliminate faults promptly and restore power supply with minimum interruption. Conventional approaches have contribute... see more


shanliang yang, Kedi Huang    

The weapon system portfolio problem is considered as a typical constrained combinatorial optimization problem with the purpose of maximizing the expected&... see more


S. Abbaspour,A. Fallah    

Background: The electrocardiogram artifact is a major contamination in the electromyogram signals when electromyogram signal is recorded from upper trunk muscles and because of that the contaminated electromyogram is not useful.Objective: Removing electr... see more


Nazmat Surajudeen-Bakinde, Nasir Faruk, Abdulkarim Oloyede, Abubakar Abdulkarim, Lukman Olawoyin, Segun Popoola, Emmanuel Adetiba    

Today, the world is technology-driven and so of these technologies are driven using wireless systems. Signal coverage and quality of service are pertinent for network providers and path loss prediction is very important in the design and planning of thes... see more