Embedding research in health systems: lessons from complexity theory

• DOI: 10.1186/s12961-016-0128-x
• Publication Date: 2016-07-22T12:57:19Z
• Authors: Louise Caffrey; Charles Wolfe; Christopher McKevitt
• Keywords: Health administration; Complex adaptive system; Health Services Research

Internationally, there has been increasing focus on creating health research systems. This article aims to investigate the challenges of implementing apparently simple strategies support development a system. We case study an English National Health Service Hospital Trust that sought implement national recommendation organisations should introduce statement about all patient admission letters. apply core concepts from complexity theory and undertake documentary analysis email dialogue between staff involved in this initiative. The process letters one clinical service took 1 year 21 days. length time needed was influenced firstly by adaptive self-organisation, underpinned competing interests. Secondly, it relationship systems, rather than simply being product issues within those system weaker might have expected. Responsibilities were unclear, leading confusion delayed action. Conventional ways thinking suggest change happens when leaders managers strategic vision, structure or procedures organisation then persuade others rationally strategy. However, systems are complex characterised high levels unpredictability due self-organisation systemic interactions, which give rise 'emergent' properties. argue for need how micro-processes organisational dynamics may macro patterns behaviour direction use approaches emergent properties