Complexity science: Complexity, leadership, and management in healthcare organisations

Plsek, Paul E.; Wilson, Tim

doi:10.1136/bmj.323.7315.746

Cited by 622 publications

(536 citation statements)

References 11 publications

Supporting

Mentioning

493

Contrasting

Unclassified

Order By: Relevance

“…Technically, The Global Fund application criteria limit the contribution that countries can make to their own applications to those that conform to accepted practice, as illustrated by China. However, not only is the idea of best practice contested, it is also recognized that best practice must evolve over time to reflect successful innovations (16,17). Recipient country experiences are crucial to this evolution; therefore, the increased demand for existing knowledge was accompanied by an increased demand for learning from experience as projects were implemented.…”

Section: Resultsmentioning

confidence: 99%

The role of innovative global institutions in linking knowledge and action

Kerkhoff

Szlezák

2010

Proc. Natl. Acad. Sci. U.S.A.

View full text Add to dashboard Cite

It is becoming increasingly recognized that our collective ability to tackle complex problems will require the development of new, adaptive, and innovative institutional arrangements that can deal with rapidly changing knowledge and have effective learning capabilities. In this paper, we applied a knowledge-systems perspective to examine how institutional innovations can affect the generation, sharing, and application of scientific and technical knowledge. We report on a case study that examined the effects that one large innovative organization, The Global Fund to Fight AIDS, Tuberculosis, and Malaria, is having on the knowledge dimensions of decision-making in global health. The case study shows that the organization created demand for new knowledge from a range of actors, but it did not incorporate strategies for meeting this demand into their own rules, incentives, or procedures. This made it difficult for some applicants to meet the organization's dual aims of scientific soundness and national ownership of projects. It also highlighted that scientific knowledge needed to be integrated with managerial and situational knowledge for success. More generally, the study illustrates that institutional change targeting implementation can also significantly affect the dynamics of knowledge creation (learning), access, distribution, and use. Recognizing how action-oriented institutions can affect these dynamics across their knowledge system can help institutional designers build more efficient and effective institutions for sustainable development.aid financing | governance | HIV/AIDS | knowledge transfer | science-policy interface T he importance of flexible, adaptive institutions in tackling complex problems is becoming increasingly recognized, and there is a call for institutional change that highlights the key role of knowledge and learning in the context of action and implementation (1, 2). As a result, institutions for sustainable development are undergoing rapid change. Existing centralized international and state-based systems are increasingly being complemented and challenged by new forms of collaboration, including public-private partnerships, multisector collaborations, and demand-led funding mechanisms (3). These changes are largely driven by dissatisfaction with the perceived inability of traditional institutions to move toward more sustainable development trajectories (4, 5) and pose new opportunities to link knowledge with action.In this study, we examined how one innovative, action-focused organization has affected the dynamics of knowledge sharing, generation, and application across their network of stakeholders using a theoretical framing based on the concept of knowledge systems. Building on work by Cash et al. (6) and van Kerkhoff and Lebel (7) for this project, we defined a knowledge system as a network of actors connected by social relationships, formal or informal, that dynamically combined knowing, doing, and learning to bring about specific actions for sustainable development (8). We were in...

show abstract

Section: Resultsmentioning

confidence: 99%

The role of innovative global institutions in linking knowledge and action

Kerkhoff

Szlezák

2010

Proc. Natl. Acad. Sci. U.S.A.

View full text Add to dashboard Cite

show abstract

“…This is evidenced through, for instance, the manner in which multi-organisational quality improvement collaborative networks are being proffered as a solution for improving quality within the healthcare sector (Dainty et al, 2013). Observers (Plsek and Wilson, 2001) historically point to the fallibility of disparate budgets and performance targets across primary, secondary and tertiary care, due to a propensity for inward operational focus on system elements, rather than on the systems' higher level functioning. However, there is a notable shift towards more collective and networked models of institutional innovation (Hargrave and Van de Ven, 2006;Bandeira et al, 2014;Long et al, 2014).…”

Section: Characteristics Of High-performing Health Systemsmentioning

confidence: 99%

Innovation and sustainability in a large-scale healthcare improvement collaborative - seven propositions for achieving system-wide innovation and sustainability

Amoo

Malby

Mervyn

2016

IJSSM

View full text Add to dashboard Cite

Change and reform in the healthcare system, and policy determination to reduce costs has now necessitated a rethink and more innovation for this sector. Leadership needs to strengthen professionals who have the dual responsibility for ensuring the quality and effectiveness of healthcare and this requires new organisational forms beyond the traditional hierarchical structures. Drawing upon strategic management and leadership discourse to underpin the study into sustainable and high performing healthcare systems, we present seven key lessons (propositions) from a mixed-methods study of a city-wide collaboratives in Leeds, UK. Our study suggested that the sustainability of such collaboratives, requires a more effective structure that could be local city-wide collaborative in contrast to national/regional collaboratives. However, there are also several unknowns in such novel organisational structures. The study also finds that both an energetic strategic leader and promotion of professional learning cultures are vital for the sustainability of such collaboratives.

show abstract

“…Unlike the management thinking of machine metaphor, complexity thinking suggests that relationships between parts are more important than the parts themselves, that minimum specifications generate more creativity than detailed plans. Treating health care organizations as complex adaptive systems allows a new and more productive management style to emerge [10] .…”

Section: Uncertainty In Health Care Deliverymentioning

confidence: 99%

Challenges of implementing sustainable health care delivery in Nigeria under environmental uncertainty

Emmanuel

2014

JHA

View full text Add to dashboard Cite

Introduction: The increasing cost of health care in developed and developing economies has called for a change in the way health activities are implemented. Nigeria is faced with fundamental health care related challenges coupled with recent security issues. Uncertainty prevails as health system dynamics unfolds.Objectives: To explore the relationship between environmental uncertainty and health care delivery system in Nigeria. The study aims at reviewing the dynamics of health care delivery in some developed economies and Nigeria with regard to methods of adaptation of health care under uncertainty, and developing a framework for sustainable health care delivery. Methods:Databases were searched for relevant literatures using the following keywords: environmental and health uncertainty, Nigerian health care system, Nigerian primary health care, health care financing and sustainability. Other keywords used include: US, Europe and China health care dynamics, among others. Scientific databases obtained from the Internet were used including online journals, which were sourced mainly from the Google. Relationships if any were established and a framework for sustainability developed. Results:Environmental uncertainty has a multiplicity of interactions with different aspects of health care system, resulting in poor infrastructural development, inadequate government funding, absence of integrated system for disease prevention and surveillance, policy reversals, security challenges, and unimpressive health indicators in Nigeria. A framework for implementing sustainable health care delivery under uncertainty is proposed. Discussion and conclusion: Uncertainty abounds in the Nigerian health care delivery system; causing further distortion in development of the health sector. Effective mobilization of health care professionals, use of sustainable care plans by government, use of integrated medical intelligence and surveillance systems, accountability, commitment, and above all quality leadership -will minimize uncertainty factors and enhance health care performance and sustainability in Nigeria.

show abstract

Complexity science: Complexity, leadership, and management in healthcare organisations

Cited by 622 publications

References 11 publications

The role of innovative global institutions in linking knowledge and action

The role of innovative global institutions in linking knowledge and action

Innovation and sustainability in a large-scale healthcare improvement collaborative - seven propositions for achieving system-wide innovation and sustainability

Challenges of implementing sustainable health care delivery in Nigeria under environmental uncertainty

Contact Info

Product

Resources

About