Patient Journey Record Systems (PaJR)

2011 ◽  
pp. 75-92 ◽  
Author(s):  
Carmel M. Martin ◽  
Rakesh Biswas ◽  
Ankur Joshi ◽  
Joachim P. Sturmberg
Keyword(s):  
Health Care ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Explicit Knowledge ◽  
Care Delivery ◽  
Allied Health Professionals ◽  
Patient Journey ◽  
Complex Adaptive ◽  
Care Systems ◽  
The Individual

This chapter argues the need for a paradigm shift to focus health care from a top down fragmented process driven activity to a user-driven journey of the individual whose health is at stake. Currently many person/patients express needs that are often overlooked or not understood in the health system, and the frontline care workers express frustration in relation to care systems that prevent them from optimizing their care delivery. We argue that complex adaptive systems and social constructionist theories provide a link for knowledge translation that ultimately will lead to improved health care and better personal health outcomes/experiences. We propose the Patient Journey Record System (PaJR) as a conceptual framework to transform health care so that it supports and improves the experience of patients and improves the quality of care through adaptable and interconnected provider information and care systems. Information technology, social networking and digital democracy is proposed as a major solution to the need to put the patient and their journey at the centre of health and health care with real time shaping of care to this end. Placing PaJR at the centre of care would enable patients, caregivers, physicians, nurses, allied health professionals and students to contribute to improving care. PaJR should become a ‘discovery tool’ of new knowledge arising from different types of experiences ranging from the implicit knowledge in narratives through to the explicit knowledge that is formalized in the published peer reviewed literature and translated into clinical knowledge.

Information as Change Agent or Barrier in Health Care Reform?

2013 ◽  
pp. 1-17
Author(s):  
Alan C. Gillies ◽  
John Howard
Keyword(s):  
Health Care ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Process Models ◽  
Value Systems ◽  
Care Services ◽  
Primary Care Services ◽  
Complex Adaptive ◽  
Care Systems

Health care systems across the world are in a state of flux. If the experience of the early 1990s can be used as a model, the recent global economic downturn will lead to very significant pressures to reduce spending and achieve better value. Systems have provided a range of approaches to modeling and evaluating these more complex organizations, from simple process models to complex adaptive systems. This paper considers the pros and cons of such approaches and proposes a new modeling approach that combines the best elements of other techniques. This paper also describes a case study, where the approach has been deployed by the authors. The case study comes from health care services in Ontario, Canada, who are shifting from the traditionally hospital-based system to one that recognizes a greater role for community and primary care services.

scholarly journals Creating Effectiveness Principles for Principles-Focused Developmental Evaluations in Health-Care Initiatives: Lessons Learned from Three Cases in British Colombia

2021 ◽  
Vol 36 (1) ◽  
Author(s):  
Ihoghosa Iyamu ◽  
Mai Berger ◽  
Erika Ono ◽  
Amy Salmon
Keyword(s):  
Health Care ◽  
British Columbia ◽  
Health Care Delivery ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Care Delivery ◽  
Lessons Learned ◽  
Complex Adaptive ◽  
British Colombia ◽  
Method Of Evaluation

Principles-focused developmental evaluation is an emergent method of evaluation that is increasingly achieving relevance in initiatives seeking to transform health-care delivery within complex-adaptive systems. Creating meaningful eff ectiveness principles is considered a crucial first step in setting up such evaluations. In this article, we describe four practical steps that we applied in defi ning eff ectiveness principles to align with Patton’s GUIDE criteria. To illustrate our approach, this article features three principles-focused developmental evaluations implemented in British Columbia, highlighting lessons learned through the process of creating eff ectiveness principles.

scholarly journals Organizing Theories for Disasters into a Complex Adaptive System Framework

Urban Science ◽  
2021 ◽  
Vol 5 (3) ◽  
pp. 61
Author(s):  
Annetta Burger ◽  
William G. Kennedy ◽  
Andrew Crooks
Keyword(s):  
Human Behavior ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Complex Adaptive System ◽  
Disaster Studies ◽  
The Social ◽  
Complex Adaptive ◽  
Interacting Systems ◽  
Individual Actor ◽  
The Individual

Increasingly urbanized populations and climate change have shifted the focus of decision makers from economic growth to the sustainability and resilience of urban infrastructure and communities, especially when communities face multiple hazards and need to recover from recurring disasters. Understanding human behavior and its interactions with built environments in disasters requires disciplinary crossover to explain its complexity, therefore we apply the lens of complex adaptive systems (CAS) to review disaster studies across disciplines. Disasters can be understood to consist of three interacting systems: (1) the physical system, consisting of geological, ecological, and human-built systems; (2) the social system, consisting of informal and formal human collective behavior; and (3) the individual actor system. Exploration of human behavior in these systems shows that CAS properties of heterogeneity, interacting subsystems, emergence, adaptation, and learning are integral, not just to cities, but to disaster studies and connecting them in the CAS framework provides us with a new lens to study disasters across disciplines. This paper explores the theories and models used in disaster studies, provides a framework to study and explain disasters, and discusses how complex adaptive systems can support theory building in disaster science for promoting more sustainable and resilient cities.

scholarly journals The World is More Than Complicated

2011 ◽  
Vol 133 (11) ◽  
pp. 30-35
Author(s):  
Ahmed K. Noor
Keyword(s):  
Complex Systems ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Emergent Behavior ◽  
Global Response ◽  
Emergent Complexity ◽  
Engineering Designs ◽  
Complex Adaptive ◽  
Engineered Systems ◽  
The Individual

This article discusses the need of complex systems to be adaptive, and various innovative technologies that are required to engineer these systems. Complex adaptive systems consist of several simultaneously interacting parts or components, which are expected to function in an uncertain, complex environment, and to adapt to unforeseeable contingencies. The defining characteristics of complex adaptive systems are that the components are continually changing, the systems involve many interactions among components, and configurations cannot be fully determined in advance. Studies have shown that complex systems of the future will require a multidisciplinary framework—an approach that has been called emergent (complexity) engineering. Emergent engineering designs a system from the bottom-up by designing the individual components and their interactions that can lead to a desired global response. Although significant effort has been devoted to understanding complexity in natural and engineered systems, the research into complex adaptive systems is fragmented and is largely focused on specific examples. In order to accelerate the development of future diverse complex systems, there is a profound need for developing the new multidisciplinary framework of emergent engineering, along with associated systematic approaches, and generally valid methods and tools for high-fidelity simulations of the collective emergent behavior of these systems.

scholarly journals Which cultural interventions most effectively reduce retaliatory behavior within organizations

10.28945/4585 ◽  
2020 ◽  
Vol 4 ◽  
pp. 107-118
Author(s):  
Denise A Breckon ◽  
Juan C Cruz ◽  
Katherine Kemmerer ◽  
Bryce Adams
Keyword(s):  
Systematic Review ◽  
Cultural Values ◽  
Social Relations ◽  
Collective Identity ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Shared Responsibility ◽  
Complex Adaptive ◽  
The Individual ◽  
Cultural Interventions

The purpose of this systematic review is to explore retaliation within organizations and their culture. Specifically, this research examines extant scholarly literature regarding retaliation and how senior leaders, managers, and workers can help reduce it. Further, this study provides organizations intervention recommendations to help mitigate retaliation in small and medium organizations. In this study, complex adaptive systems (CASs) theory was found to be an appropriate mechanism for exploring and understanding how to mitigate retaliation effectively in the workplace. CASs is a people-based, people-driven, and behaviorally focused framework that requires collaboration and shared responsibility among the individual agents and agent-groups sharing a particular system, rather than just the system’s leaders or workers. This qualitative systematic review presents consistent evidence that in organizations retaliation can be reduced by: (1) promoting a culture of collective identity and justice; (2) using structures that maintain and restore justice; and (3) using training and pro-social relations to reinforce the organization’s cultural values. Based on the themes found in the research, three recommendations emerge as cultural interventions that will effectively reduce retaliatory behavior within organizations: (1) institutionalize an organizational culture of collective identity and justice; (2) create a structure that maintains and restores justice; and (3) reinforce values and policies through training and positive social relations.

scholarly journals Using Complexity Assessment to Inform the Development and Deployment of a Digital Dashboard for Schizophrenia Care: Case Study (Preprint)

2019 ◽  
Author(s):  
Andreas Gremyr ◽  
Boel Andersson Gäre ◽  
Trisha Greenhalgh ◽  
Ulf Malm ◽  
Johan Thor ◽  
...  
Keyword(s):  
Health Care ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Point Of Care ◽  
Scale Up ◽  
Mental Illnesses ◽  
Complex Adaptive ◽  
Complexity Assessment ◽  
Practical Implications

BACKGROUND Health care is becoming more complex. For an increasing number of individuals, interacting with health care means addressing more than just one illness or disorder, engaging in more than one treatment, and interacting with more than one care provider. Individuals with severe mental illnesses such as schizophrenia are disproportionately affected by this complexity. Characteristic symptoms can make it harder to establish and maintain relationships. Treatment failure is common even where there is access to effective treatments, increasing suicide risk. Knowledge of complex adaptive systems has been increasingly recognized as useful in understanding and developing health care. A complex adaptive system is a collection of interconnected agents with the freedom to act based on their own internalized rules, affecting each other. In a complex health care system, relevant feedback is crucial in enabling continuous learning and improvement on all levels. New technology has potential, but the failure rate of technology projects in health care is high, arguably due to complexity. The Nonadoption, Abandonment, and challenges to Scale-up, Spread, and Sustainability (NASSS) framework and complexity assessment tool (NASSS-CAT) have been developed specifically to help identify and manage complexity in technology-related development projects in health care. OBJECTIVE This study aimed to use a pilot version of the NASSS-CAT instrument to inform the development and deployment of a point-of-care dashboard supporting schizophrenia care in west Sweden. Specifically, we report on the complexity profile of the project, stakeholders’ experiences with using NASSS-CAT, and practical implications. METHODS We used complexity assessment to structure data collection and feedback sessions with stakeholders, thereby informing an emergent approach to the development and deployment of the point-of-care dashboard. We also performed a thematic analysis, drawing on observations and documents related to stakeholders' use of the NASSS-CAT to describe their views on its usefulness. RESULTS Application of the NASSS framework revealed different types of complexity across multiple domains, including the condition, technology, value proposition, organizational tasks and pathways, and wider system. Stakeholders perceived the NASSS-CAT tool as useful in gaining perspective and new insights, covering areas that might otherwise have been neglected. Practical implications derived from feedback sessions with managers and developers are described. CONCLUSIONS This case study shows how stakeholders can identify and plan to address complexities during the introduction of a technological solution. Our findings suggest that NASSS-CAT can bring participants a greater understanding of complexities in digitalization projects in general.

Thinking in groups

2006 ◽  
Vol 14 (2) ◽  
pp. 293-311 ◽  
Author(s):  
Todd M. Gureckis ◽  
Robert L. Goldstone
Keyword(s):  
Cognitive Processes ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Distributed Information ◽  
Behavioral Studies ◽  
Complex Adaptive ◽  
Exclusive Property ◽  
The Individual ◽  
Group Structures ◽  
Level Of Analysis

Is cognition an exclusive property of the individual or can groups have a mind of their own? We explore this question from the perspective of complex adaptive systems. One of the principal insights from this line of work is that rules that govern behavior at one level of analysis (the individual) can cause qualitatively different behavior at higher levels (the group). We review a number of behavioral studies from our lab that demonstrate how groups of people interacting in real-time can self-organize into adaptive, problem-solving group structures. A number of principles are derived concerning the critical features of such “distributed” information processing systems. We suggest that while cognitive science has traditionally focused on the individual, cognitive processes may manifest at many levels including the emergent group-level behavior that results from the interaction of multiple agents and their environment.

Digital Swarms

2017 ◽  
pp. 44-59
Author(s):  
Carlos M. Fernandes ◽  
Ivo Dias de Sousa
Keyword(s):  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Large Scale ◽  
Urban Life ◽  
Personal Communications ◽  
Network Nodes ◽  
Eusocial Insects ◽  
Complex Adaptive ◽  
The Individual ◽  
New Generation

By converting a fixed network into a mobile system, personal communications technology radically transformed the way we interact with each other and with the environment. Recently, new generation mobile phones (known as smartphones) increased the capacity of the network nodes and added new properties to mobility, converting a once ordered system into a complex and perhaps adaptive network. In this paper, we argue that contemporary mobile phone networks are large-scale complex adaptive systems—with niches, hierarchy, recirculation of information, coevolutionary interactions, and sophisticated collective behavior—that display remarkable similarities with eusocial insects (ants, bees, wasps and termites). Under this framework, we will discuss the impact of personal communications networks in the urban life, without losing sight of the effects—either positive or negative—of the system's emergent patterns on the network itself and on the individual nodes (personal devices and users).

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