The Management Complexity of Hospital Psychiatric Ward: A “Small World” Approach

  • Pier Luca BandinelliEmail author
  • Alvaro Busetti
Part of the Contemporary Systems Thinking book series (CST)


Unlike other hospital departments whose internal processes can be considered either a linear or “waterfall” system, the psychiatric one should be considered a highly complex nonlinear system, since each patient must be managed across many different dimensions on top of the clinical one, to manage which different organizational/procedural problems have to be considered which are hardly manageable in a synchronized and coordinated way. Moreover, the turnover of most of the personnel frequently disrupts even the continuity of the single process. Therefore, the complexity and the variability both of the system and the interactions between people involved with different roles on the different aspects of the management of the same patient defines the psychiatric department as an intrinsically complex (as opposed to complicated) system hard to linearize and to manage following a traditional, i.e. mechanistic, approach. It is therefore proposed to analyze the operations of the department as a closed social network of the “small world” type.


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Dipartimento di Salute Mentale ASL Roma 1, Servizio Psichiatrico Diagnosi e Cura (SPDC)Presidio Ospedaliero San Filippo NeriRomaItaly
  2. 2.Freelance Consultant in “Social Enterprise” SectorRomeItaly

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