Putting Complexity to Work: Supporting Practitioners in Health Systems

This chapter sheds a light on the practical use of insights stemming from Complexity Science for successful transformations in day-to-day practice in the wide field of health systems. A lot of research work has been conducted in the past years regarding how Complexity Science explains complex phenomena that have been observed in the health sector and described in numerous studies, articles and discussion papers. However, little has been offered to people working in the sector regarding the practical implications of the opportunities offered by the successful exploitation of Complexity Science insights. Practitioners—those who deal with complex realities in their day-to-day work, for example those involved in policy-making, community matters, humanitarian aid and emergency response or financial and spatial planning or organisation management—often lack a systematic appreciation of and approach for how to deal with complexity. These practitioners work in routine situations, but also with the unpredictable and novel events in dynamic environments that we call Complex realities—defined as: ‘Real-world situations which co-evolve with humans in an environment and in a dynamic manner which cannot be stopped and which can only be changed through engagement and influence’. In health systems, a wide variety of specific issues in such complex realities are described, which a few examples regarding the aspects of patient care shall illustrate: Matlow et al. [1] point out that the coordination of multi-disciplinary care is a key ingredient of quality patient care; Leykum et al. [2] pick up on the fact that the identification of effective ways to improve care of patients with chronic disease has been difficult because the non-linear nature of practice has not been recognised and systematically addressed; Browne and Varcoe [3] argue that in relation to Aboriginal health, nurses have to develop greater critical awareness of politics, culture and history, and how these have shaped people's health; Singhal [4] reviews the complex factors which affect the provision of high quality care of nursing homes and points out the importance of the quality of the relationships between nursing home staff members. These papers indicate that Complexity Science can provide useful explanations of individual complex phenomena observed. To work and engage with these dynamic phenomena, however, require appropriate integrative ways-of-working in the diverse areas in or related to the health sector—ways that are immediately usable to practitioners in their particular context.