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Jayesh Mahesh Bellara Discussion Week 1COLLAPSEIn the simplest form, Complex Adaptive Systems (CAS) can be defined as a way of thinking and analyzing things based on their complexity, patterns, and inter-relationships rather than focusing on the cause and effect. Since this is an early definition, there have been many changes since this term was coined. The most recent and accepted definition of CAS is “complex and patterned output arising from simple, fundamental principles, but requires many actors and multiple interactions over time to produce the emergent complexity. Yet, this characterization represents only a sample of the myriad of different facets of complexity” (Dodder R, 2000). A CAS may be sensitive to specific small changes in initial conditions. An apparently trivial difference in the beginning state of the system may result in enormously different outcomes. This phenomenon is sometimes called the “butterfly effect.” However, this sensitivity has to do with the complex system’s exact path into the future rather than its general pattern. CAS, including the weather, tends to maintain generally bounded behavior, sometimes called an “attractor,” regardless of small changes in initial conditions. As a result, CAS is robust or fit. They exhibit the ability to alter themselves in response to feedback. Complex systems possess a range of coupling patterns, from tight to loose (Marion, R., 2000). These different patterns help organizations survive a variety of environmental conditions. CAS has been used to inform thinking about leadership and organizational development in various sectors outside of healthcare services. These sectors are economics, engineering, urban planning, engineering, management, etc. (Burns, L., 2011).
Healthcare remains the major field where CAS is applied extensively for its day-to-day management. Significant areas of focus in healthcare management are organizational development, workforce development, service delivery, behavior change, clinical analysis, and leadership management. A US hospital used complex adaptive systems thinking to grow organizational capacity and cope with unexpected surges in demand for services. Seventeen improvement projects were implemented over two years. Using a complex adaptive systems approach, improvement ideas ’emerged’ from the microsystem at the point of care. Rigorous reporting and testing of process adaptations and staff motivation and interactions drove innovation. Hundreds of clinical and administrative staff at all levels were encouraged to redesign processes and roles to increase organizational capacity. Capacity increased, and this approach was cost-effective. The authors concluded that complex adaptive systems thinking could encourage multiple, coordinated, and concurrent projects that will create a more significant impact than possible with a single improvement project (MacKenzie R, 2008). Researchers in England used complex adaptive systems thinking to explore why the effect of a single intervention incorporated into a complex clinical environment may be different from what is expected. Demographic and health information was collected from all patients admitted to a UK hospital between January 2003 and June 2004. Using charts, continuous process monitoring was undertaken to detect planned or unplanned organizational process changes affecting mortality outcomes (Cockings JG, 2006). These examples show that complex adaptive systems thinking has been used increasingly frequently to analyze development and delivery, organizational planning, and research development tools in healthcare, with favorable results.
Since around 2000, complex leadership (CL) has been applied in health care management and organization. Leadership is regarded as behavior or set of behaviors that emerge from the interaction among individuals and groups in organizations occurring throughout the organization, not a role or function formally assigned to an individual. However, CL and organizational performance in healthcare are not as developed as some of the other fields. Many researchers emphasized the need to pay closer attention to the quality and nature of leadership in the field of healthcare in order to have lasting effectiveness (Belrhiti, Z.,2018). A survey conducted by Burns JP in 2001 found that healthcare leaders intuitively support the principles of complexity science. The authors argue that building on complex adaptive systems thinking principles can help leaders focus less on prediction and control and more on fostering relationships and creating conditions so systems can evolve and produce creative outcomes (Burns JP, 2001).

Burns, L., Bradley, E.,

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