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Complexity and change in nurse workflows
James M Vardaman1, Paul T Cornell, Thomas R Clancy
1Author Affiliations: Assistant Professor (Dr Vardaman), Department of Management, Mississippi State University; President (Cornell), Healthcare Practice Transformation, LLC, Dallas, Texas; Clinical Professor and Assistant Dean (Dr Clancy), School of Nursing, University of Minnesota, Minneapolis.
Nurse workflow exhibits characteristics of complex adaptive systems. Careful selection of performance improvement methods is crucial for managing this complexity in healthcare organizations.
Area of Science:
- Complex Systems Science
- Systems Theory
- Healthcare Management
Background:
- Organizations naturally increase in complexity over time.
- Complex systems science offers new management perspectives for social organizations like hospitals.
- This article is part of a series applying complex systems science to traditional management concepts.
Purpose of the Study:
- To apply complex systems science to hospital management.
- To analyze nurse workflow as a complex adaptive system.
- To highlight the need for caution in selecting performance improvement methods for nurse workflows.
Main Methods:
- Literature review and conceptual analysis.
- Application of complex adaptive systems principles to healthcare settings.
- Examination of traditional management functions (planning, organizing, directing, coordinating, controlling) through the lens of complex systems.
Main Results:
- Nurse workflow demonstrates characteristics of complex adaptive systems.
- Traditional management approaches may require adaptation when dealing with complex systems.
- Performance improvement initiatives need careful consideration within complex adaptive systems.
Conclusions:
- Nurse workflow is best understood as a complex adaptive system.
- Selecting performance improvement methods requires a nuanced approach sensitive to system complexity.
- Effective management in healthcare necessitates an understanding of complex systems dynamics.
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