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Stasis and adaptation.

Enrico Coiera1

  • 1Centre for Health Informatics, Australian Institute of Health innovation, University of New South Wales, Sydney, Australia.

Studies in Health Technology and Informatics
|August 15, 2013
PubMed
Summary
This summary is machine-generated.

Societal systems, including healthcare, suffer from inertia due to complexity. This study explores interventions like questioning standards, programmed removal of structures (apoptosis), and market-based control to foster adaptability and overcome inertia.

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Area of Science:

  • Systems Science
  • Healthcare Management
  • Societal Complexity

Background:

  • Societal systems, particularly healthcare, face challenges in adopting best practices and maintaining financial sustainability.
  • This resistance to change is attributed to system inertia, stemming from increasing human system complexity.
  • Healthcare exhibits unwarranted variation in care delivery and struggles with financially unsustainable models.

Purpose of the Study:

  • To explore system-level interventions that can mitigate system inertia.
  • To identify strategies for designing adaptive systems and improving current ones.
  • To address the challenge of system inertia in complex human systems.

Main Methods:

  • Critically examining the reliance on standards as an intervention that can promote inertia.
  • Investigating the concept of apoptosis as a mechanism for programmatic removal of outdated structures.
  • Exploring market-based control as a flexible, albeit controversial, system management approach.

Main Results:

  • Standards, while intended to ensure consistency, may inadvertently cause system inertia by minimizing adaptation.
  • Programmatic removal of existing structures (apoptosis) can free up resources for necessary adaptation.
  • Market-based control offers a potentially adaptive, though controversial, management strategy.

Conclusions:

  • System inertia is a significant barrier to progress in complex societal systems like healthcare.
  • Interventions such as re-evaluating standards, implementing apoptosis, and considering market-based control may offer pathways to increased adaptability.
  • Further research is needed to determine the efficacy of these interventions in overcoming system inertia.