Missed nursing care and complexity theory: a conceptual paper

2021 ◽  
pp. 174498712110130
Author(s):  
Rania Ali Albsoul ◽  
Gerard FitzGerald ◽  
James A Hughes ◽  
Muhammad Ahmed Alshyyab
Keyword(s):  
Complexity Theory ◽  
Nursing Care ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Nurse Managers ◽  
Systems Approach ◽  
Complex Adaptive ◽  
Missed Care ◽  
Missed Nursing Care ◽  
The Impact

Background Missed nursing care is a complex healthcare problem. Extant literature in this area identifies several interventions that can be used in acute hospital settings to minimise the impact of missed nursing care. However, controversy still exists as to the effectiveness of these interventions on reducing the occurrence of missed nursing care. Aim This theoretical paper aimed to provide a conceptual understanding of missed nursing care using complexity theory. Methods The method utilised for this paper is based on a literature review on missed care and complexity theory in healthcare. Results We found that the key virtues of complexity theory relevant to the missed nursing care phenomenon were adaptation and self-organisation, non-linear interactions and history. It is suggested that the complex adaptive systems approach may be more useful for nurse managers to inform and prepare nurses to meet uncertain encounters in their everyday clinical practice and therefore reduce instances of missed care. Conclusions This paper envisions that it is time that methods used to explore missed care changed. Strategies proposed in this paper may have an important impact on the ability of nursing staff to provide quality and innovative healthcare in the modern healthcare system.

scholarly journals A Transdisciplinary Complex Adaptive Systems (T-CAS) Approach to Developing a National School-Based Culture of Prevention for Health Improvement: the School Health Research Network (SHRN) in Wales

2018 ◽  
Vol 22 (1) ◽  
pp. 50-61 ◽  
Author(s):  
Simon Murphy ◽  
Hannah Littlecott ◽  
Gillian Hewitt ◽  
Sarah MacDonald ◽  
Joan Roberts ◽  
...  
Keyword(s):  
Complex Adaptive Systems ◽  
Health Research ◽  
Adaptive Systems ◽  
School Health ◽  
Systems Approach ◽  
Research Network ◽  
Health Improvement ◽  
Policy And Practice ◽  
Complex Adaptive ◽  
Culture Of Prevention

AbstractThe paper reflects on a transdisciplinary complex adaptive systems (T-CAS) approach to the development of a school health research network (SHRN) in Wales for a national culture of prevention for health improvement in schools. A T-CAS approach focuses on key stages and activities within a continuous network cycle to facilitate systems level change. The theory highlights the importance of establishing transdisciplinary strategic partnerships to identify and develop opportunities for system reorientation. Investment in and the linking of resources develops the capacity for key social agents to take advantage of disruption points in the re-orientated system, and engagement activities develop the network to facilitate new social interactions and opportunities for transdisciplinary activities. A focus on transdisciplinary action research to co-produce interventions, generate research evidence and inform policy and practice is shown to play an important part in developing new normative processes that act to self-regulate the emerging system. Finally, the provision of reciprocal network benefits provides critical feedback loops that stabilise the emerging adaptive system and promote the network cycle. SHRN is shown to have embedded itself in the system by securing sustainability funding from health and education, a key role in national and regional planning and recruiting every eligible school to the network. It has begun to reorient the system to one of evidence generation (56 research studies co-produced) and opportunities for data-led practice at multiple levels. Further capacity development will be required to capitalise on these. The advantages of a complex systems approach to address barriers to change and the transferability of a T-CAS network approach across settings and cultures are highlighted.

scholarly journals Reframing hydrology education to solve coupled human and environmental problems

2012 ◽  
Vol 9 (6) ◽  
pp. 7739-7759 ◽  
Author(s):  
E. G. King ◽  
F. C. O'Donnell ◽  
K. K. Caylor
Keyword(s):  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Earth System ◽  
Educational Approach ◽  
Dynamic Interactions ◽  
Undergraduate Level ◽  
Complex Adaptive ◽  
Sustainability Challenges ◽  
Problem Solvers ◽  
The Impact

Abstract. The impact of human activity on the biophysical world raises myriad challenges for sustaining earth system processes, ecosystem services, and human societies. To engage in meaningful problem-solving in the hydrosphere, this necessitates an approach that recognizes the coupled nature of human and biophysical systems. We argue that in order to produce the next generation of problem-solvers, hydrology education should ensure that students develop an appreciation and working familiarity in the context of coupled human-environmental systems. We illustrate how undergraduate-level hydrology assignments can extend beyond rote computations or basic throughput scenarios to include consideration of the dynamic interactions with social and other biophysical dimensions of complex adaptive systems. Such an educational approach not only builds appropriate breadth of dynamic understanding, but can also empower students toward assuming influential and effective roles in solving sustainability challenges.

Knowledge Management

2011 ◽  
pp. 1-26 ◽  
Author(s):  
Shamin Bodhanya
Keyword(s):  
Knowledge Management ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Social Process ◽  
Situated Action ◽  
Complex Adaptive ◽  
Process Perspective ◽  
The Impact ◽  
Epistemology Of Action ◽  
Organisational Intervention

This chapter demonstrates that despite a plurality of discourses related to knowledge, they are reduced to a single dominant discourse on knowledge management. It draws on systems thinking and complexity theory to reconceptualise organisations as complex adaptive systems within which knowledge ecologies may flourish. The focus thus shifts to knowing in situated action and on knowledge as a dynamic phenomenon. The chapter makes a contribution to strengthening the impact of the epistemology of action and that of a social-process perspective of knowledge. The approach presented has radical implications for knowledge management such that it becomes an enduring organisational intervention as opposed to a management fad. The implications for organisational practice and changes in managerial orientations are shown to be novel offering significant potential towards a second order knowledge management.

Price discovery by the market's mind: an investor's perspective on numerical archetypes

2013 ◽  
Vol 5 (2) ◽  
pp. 140-153
Author(s):  
Patrick Schotanus
Keyword(s):  
Complexity Theory ◽  
Complex Adaptive Systems ◽  
Intelligent Agents ◽  
Adaptive Systems ◽  
Price Discovery ◽  
Adaptive System ◽  
Complex Adaptive System ◽  
Modern Society ◽  
Necessary Condition ◽  
Complex Adaptive

The aim of this paper is to contribute to Jung's later work, with a particular focus on the numerical archetypes viewed from an investor's perspective. It attempts to achieve this via a three-pronged approach. First, placing complex psychology in the framework of complexity theory allows a robust acknowledgement and treatment of ‘elusive’ macroscopic properties, i.e. archetypal dynamics, involved in the ordering of a mind as a complex adaptive system. Second, modern insights in number sense (the direct intuition of what numbers mean) provide neuroscientific support for numerical archetypes and clarify their primacy. Third, this paper points to the empirical relevance of numerical archetypes in price discovery, the self-organizing principle of the capital markets (which allocate resources in modern society). The resulting proposition is that the (collective) mind's unconscious and conscious forces can be considered as ‘intelligent’ agents. The competition between these two domains provides the necessary condition to endogenously generate innovative outcomes, the essential capability of complex adaptive systems. According to this view producing such adaptive novelty is achieved in the form of intuitive insights and imagination, which result in a vast array of symbols, e.g. prices in the case of the market's mind.

scholarly journals Price Tactics For A Turbulent Environment: A Complexity Theory View

2014 ◽  
Vol 14 (1) ◽  
pp. 123
Author(s):  
Roger B. Mason
Keyword(s):  
Complexity Theory ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Business Performance ◽  
External Environment ◽  
Case Method ◽  
Turbulent Environments ◽  
Complex Adaptive ◽  
Price Tactics ◽  
Depth Interviews

This paper proposes that pricing tactics are influenced by the nature of the external environment. It illustrates the pricing tactics suggested for a turbulent, versus a stable, environment, when viewed through a complexity theory lens. A qualitative, case method, using depth interviews, investigated the pricing tactics in four firms to identify the tactics adopted in more successful, versus less successful, firms in turbulent versus stable environments. The results partially confirmed that the use of destabilizing pricing tactics can be helpful in a turbulent market, while stabilizing tactics can be helpful in a stable market. However, the effect of such tactics on business performance was not clear. These findings will benefit marketers by emphasizing a new way to consider future pricing activities. How this approach can assist marketers, and suggestions for further research, are provided. Since businesses and markets are complex adaptive systems, using complexity theory to understand how to cope in turbulent environments is necessary but has not been widely researched. Therefore, this paper can be seen as a foundation for research using complexity theory to better understand pricing tactics in turbulent environments.

scholarly journals Preconditions for Emergence of Lithuanian Clusters: from Informal Cooperation to Its Legitimation

2017 ◽  
Vol 77 (1) ◽  
pp. 37-56 ◽  
Author(s):  
Kristina Grumadaitė ◽  
Giedrius Jucevičius
Keyword(s):  
Complexity Theory ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Change Agents ◽  
New Order ◽  
Industrial Systems ◽  
Complex Adaptive ◽  
The Creation ◽  
Self Organisation ◽  
Informal Cooperation

Abstract This paper reveals preconditions for the emergence of clusters as self-organisation based industrial systems in a context, in which cooperation traditions are insufficiently developed. These preconditions reflect the principles of the emergence of self-organising complex adaptive systems that are analysed in the complexity theory. Those principles are based on the initiation of non-equilibrium and its purposeful direction into the creation of a new order. This paper highlights the main external and internal tensions that influence informal or formal clustering of enterprises, while various change agents perform different roles making self-organising processes to occur.

scholarly journals Understanding health professional role integration in complex adaptive systems A multiple-case study of Physician Assistants in Ontario, Canada

2019 ◽  
Author(s):  
Kristen Burrows ◽  
Julia Abelson ◽  
Patricia Miller ◽  
Mitch Levine ◽  
Meredith Vanstone
Keyword(s):  
Complexity Theory ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Healthcare Providers ◽  
Physician Assistants ◽  
Role Integration ◽  
Complex Adaptive ◽  
Multiple Case

Abstract Background To meet the complex needs of healthcare delivery, the Ministry of Health and Long Term Care (MOHLTC) introduced Physician Assistants (PAs) into the Ontario health care system in 2006 to help increase access to care, decrease wait times, and improve continuity of care. Integration of new health professional roles is often stymied by role resistance and funding barriers. The characterization of healthcare organizations as complex adaptive systems (CAS) may offer insight into the relationships and interactions that optimize and restrict successful PA integration. The aim of this study is to explore the integration of PAs across multiple case settings and to understand the role of PAs within complex adaptive systems.Methods An exploratory, multiple-case study was used to examine PA role integration in four settings: family medicine, emergency, general surgery, and inpatient medicine. Interviews were conducted with 46 healthcare providers and administrators across 13 hospitals and 6 family medicine clinics in Ontario, Canada. Analysis was conducted in three phases: inductive thematic analysis within each of the four cases; a cross-case thematic analysis; and a broader exploration of cross-case patterns pertaining to specific complexity theory principles of interest.Results Support for PA contributions across various health care settings, the importance of role awareness, supervisory relationship attributes, and role vulnerability (in relation to sustainability and funding) are interconnected and dynamic in hospital and community settings. Findings represent the experiences of PAs and other healthcare providers, and demonstrate how the PA’s willingness to work and ability to build relationships within existing health systems allows for the establishment of interprofessional, collaborative, and person-centered care. As a self-organizing agent in complex adaptive systems (i.e. health organizations), PA role exploration revealed patterns of team behavior, non-linear interconnections, open relationships, dynamic systems, and the legacy of role implementation as defined by complexity theory.Conclusions By exploring the role of PAs across multiple sites, the complexity theory lens concurrently fosters an awareness of emerging patterns, relationships and non-linear interactions within the defined context of the Ontario healthcare system. By establishing collaborative, interprofessional care models in community and hospital settings, PAs are making a significant contribution to Ontario healthcare settings.

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