The system model reflects management thinking and strategy. The plan must match the reality of the system’s environment to be effective. The work of Ralph D Stacey and Dave Snowden (Cynefin framework) helps to set the general expectation of what is necessary. A rough description includes three categories to consider. For this narrow scope, we can collapse their categorization of environments to three.
|Ordered||May be simple or complicated. Is highly constrained and predictable. Low levels of uncertainty and close to agreement for management. Cause and effect understandable.||Manage performance with best practices|
|Complex||Is inherently unpredictable. Little certainty and no straightforward solutions. Elements in system interactive and constrained by other elements leading to emergence of new circumstances and events. Only retrospective assessment of proximate causality possible. Root cause not knowable due to unknowable number and type of influence.||Enable performance through connectivity, supporting initiative, motivation toward goal, challenge assumptions|
|Chaos||Elements are fully decoupled and unconstrained by each other. Events are random. Understanding and prediction impossible||Respond as able|
Healthcare delivery exists in an environment of biological and social complexity. The social complexity is important because of important human characteristics.
- Humans are intelligent agents that make decisions based on patterns
- Humans create and support multiple identities
- Humans ascribe intentionality and cause where none necessarily exist
- Humans have learned how to structure their social interactions to create order
Complex environments like healthcare cannot be managed efficiently and effectively with strategies needing a predictable and ordered environment.
What do you want to know more about?
- The Curandi Model™— A Framework for Success
- Ashby’s Law of Requisite Variety
- Managing Healthcare from the Community Perspective
- What healthcare can learn from the Internet
† Snoden, David J “Multi-ontology sense making, Management Today Yearbook 2005