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Making Sense: From Complex Systems Theories, Models, and Analytics to Adapting Actions and Practices in Health and Health Care

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Handbook of Systems and Complexity in Health

Abstract

Common to complex systems are two fundamental themes—the universal interconnectedness and interdependence of all phenomena, and the intrinsically dynamic nature of reality [2]. “At each level of complexity we encounter systems that are integrated, self-organizing wholes consisting of smaller parts and, at the same time, acting as parts of larger wholes” (Capra [3]).

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Notes

  1. 1.

     Writer and management consultant who studies organizational behavior. Her approach includes systems thinking, theories of change, chaos theory, leadership, and the learning organization: particularly its capacity to self-organize.

  2. 2.

     In 2004 a new contract between Primary Care Trusts (PCTs) and General Practitioner (GP) practices was negotiated. The new contract‘s centerpiece, the Quality and Outcomes Framework (QOF), included 146 check list targets in four domains (clinical, organizational, patient experience, and other services), which are revised periodically. The cost of QOF, around £600 million in the first year, and around £1 billion thereafter, formed part of the planned increased investment in primary medical care services. “To date, there is no evidence that the high expenditure on QOF can be linked to improvements in health outcomes. The high expenditure on the program makes it critical to be sure that the performance improvement is not achieved at the expense of other more valuable initiatives, services, or nonmeasurable aspects of patient care.” [14]

  3. 3.

     The term “sensemaking” has primarily marked three distinct but related research areas since the 1970s: Sensemaking was introduced to human–computer interaction by PARC researchers Russell, Stefik, Pirolli, and Card in 1993, to information science by Brenda Dervin, and organizational studies by Karl Weick. In information science the term is most often written as “sense-making.” In both cases, the concept has been used to bring together insights drawn from philosophy, sociology, and cognitive science (especially social psychology) [22].

  4. 4.

     For example, cluster analysis, principle component analysis, decision tree learning, Bayesian network models, artificial neural networks, and genetic programming.

  5. 5.

     For more details, see Norman and Yip., Chap. 34.

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Author information

Authors and Affiliations

  1. Department of Public Health and Primary Care, Trinity College, College Green, Dublin D2, Ireland

    Carmel M. Martin

  2. Department of General Practice, Monash University, Melbourne, VIC, Australia

    Joachim P. Sturmberg

  3. The Newcastle University, Newcastle, 3010, Wamberal, NSW, 2260, Australia

    Joachim P. Sturmberg

Authors
  1. Carmel M. Martin
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  2. Joachim P. Sturmberg
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Corresponding author

Correspondence to Carmel M. Martin .

Editor information

Editors and Affiliations

  1. , Department of General Practice, Monash University, PO Box 3010, Wamberal, 2260, New South Wales, Australia

    Joachim P. Sturmberg

  2. Northern Ontario School of Medicine, Merchandise Mart Plaza, Suite 1212 222, Chicago, 60654, Illinois, USA

    Carmel M. Martin

Appendix

Appendix

The underlying principles, called the Toyota Way, have been outlined by Toyota as follows:

Continuous improvement

  • Challenge (We form a long-term vision, meeting challenges with courage and creativity to realize our dreams.)

  • Kaizen (We improve our business operations continuously, always driving for innovation and evolution.)

  • Genchi Genbutsu (Go to the source to find the facts to make correct decisions.)

Respect for people

  • Respect (We respect others, make every effort to understand each other, take responsibility and do our best to build mutual trust.)

  • Teamwork (We stimulate personal and professional growth, share the opportunities of development and maximize individual and team performance.)

External observers have summarized the principles of the Toyota Way as:

Long-term philosophy

  • Base your management decisions on a long-term philosophy, even at the expense of short-term financial goals.

The right process will produce the right results

  • Create continuous process flow to bring problems to the surface.

  • Use the “pull” system to avoid overproduction.

  • Level out the workload (heijunka). (Work like the tortoise, not the hare.)

  • Build a culture of stopping to fix problems, to get quality right from the first.

  • Standardized tasks are the foundation for ­continuous improvement and employee empowerment.

  • Use visual control so no problems are hidden.

  • Use only reliable, thoroughly tested technology that serves your people and processes.

Add value to the organization by developing your people and partners

  • Grow leaders who thoroughly understand the work, live the philosophy, and teach it to others.

  • Develop exceptional people and teams who follow your company’s philosophy.

  • Respect your extended network of partners and suppliers by challenging them and helping them improve.

Continuously solving root problems drives organizational learning

  • Go and see for yourself to thoroughly understand the situation (Genchi Genbutsu).

  • Make decisions slowly by consensus, thoroughly considering all options (Nemawashi); implement decisions rapidly.

  • Become a learning organization through relentless reflection (Hansei) and continuous improvement (Kaizen).

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Martin, C.M., Sturmberg, J.P. (2013). Making Sense: From Complex Systems Theories, Models, and Analytics to Adapting Actions and Practices in Health and Health Care. In: Sturmberg, J., Martin, C. (eds) Handbook of Systems and Complexity in Health. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4998-0_45

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