In Chapter 1, we discussed complexity science and complex adaptive systems in nursing. It is important to realize that causality in a complex adaptive system is not linear, meaning that it is difficult to predict the end result of a specific employee- or patient-focused intervention. As nurses we know that the success of our patient-centred care interventions is dependent upon many factors. All too often, despite extensive planning and hard work, a patient care intervention fails to lead to the intended results. Factors beyond our control, and often beyond our knowledge, change the intended outcomes. This is typical of events in a complex adaptive system.
So how can we be successful leaders if we cannot predict what will happen when we attempt to guide others? Perhaps a review of the first two principles of the complex adaptive system, discussed in Chapter 1, will provide an answer to this question. The first principle, which is focused on using the lens of complexity, and the second principle, which describes good enough vision, provide us with clues on how to lead others within the complex adaptive health care system. Organizations and nurse leaders acknowledge that they cannot control change, and thus they do not try to control every aspect of organizational change. Successful health care leaders attempt to give a general sense of direction to employees, rather than focus on specific details. Next, leaders also encourage employees to develop innovative responses that best meet their individual strengths and needs and meet the health care system’s ultimate goal of quality patient care. Leaders cannot predict all the factors that will influence the final results of change activities, but by following these principles, they know that the final response will be what is best suited to the environment, or health care system, and the needs of the individual.
Essential Learning Activity 5.1.1
What are we talking about when we speak about systems theory in a health care organization? For a deeper understanding, watch this video titled “System Theory of Management” (7:37) by Nguyen Thanh Thi, then answer the following questions:
- What are the three basic system types? Describe each type.
- What type of system is a hospital?
- What is synergy? What is entropy?
There are three fundamental concepts that, when applied to our individual organizations, can transform the way we provide health care. For additional information, watch this video titled “Systems Thinking and Complexity in Health: A Short Introduction” (5:02), then complete the following exercises:
- List the three fundamental concepts that can transform the way we provide health care.
- Define these three concepts and give an example of how they can make a difference to health care provision.
Finally, watch the video “Interview with Judith Shamian on International Nurses Day 2016” (4:44) as she speaks about inviting citizens to work with nurses in creating a positive health care system. Judith Shamian is President of the International Council of Nurses.