A Complex Adaptive Health System Redesign from an Organisational Perspective

  • Joachim P. Sturmberg


The organisational literature considers an organisation’s function and structure at four different scales. The organisation of a health system involves at:
  • The macro level policy and governance issues

  • The meso level the organisation and coordination of regional health, community, social and infrastructure services

  • The micro level the provision of local/individual care delivery in the local community

  • The nano level issues of personal health, functional independence, and the self-management of one’s well-being and diseases

As outlined in the previous chapter a seamlessly integrated complex adaptive organisation needs to maintain its overarching focus on its purpose, goals, values, and “simple (operating) rules”.

From a complex adaptive systems perspective, a seamlessly integrated complex adaptive, equitable, and sustainable health system needs to:
  • Develop its own value based systems, and translate them in its “organisational structures and interactions” (in the form of “simple rules”)

  • Recognise that within a health system there are simple, complicated, and complex domains each necessitating different organisational and management approaches

  • Have leaders that “direct without directives” and foster co-operation between all staff

  • Have leaders that embrace the emergent nature of health systems and healthcare systems in their unique local contexts

  • Accept that health system outcomes will inevitably vary depending on the conditions of the local environment

These principles do not prevent subsystems to adopt their own set of purpose, goals, values, and “simple (operating) rules”, however, these need to be consistent with those of the “health system as a whole”.


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Joachim P. Sturmberg
    • 1
  1. 1.University of NewcastleWamberalAustralia

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