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Healthcare complexity requires a new approach focusing on value complexity. Understanding how values and practices co-develop offers a better way to manage healthcare challenges and conflicts.

Keywords:
complexity theoryethnographynew pragmatismsecondary analysisvalue complexityvalues

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Area of Science:

  • Healthcare Management
  • Sociology of Health
  • Philosophy of Science

Background:

  • Complexity theory, rooted in positivism, has limitations in addressing healthcare's inherent complexities.
  • Existing frameworks struggle to capture the dynamic interplay of values and practices in healthcare settings.

Purpose of the Study:

  • To propose a rethinking of healthcare complexity through the lens of 'value complexity'.
  • To introduce a pragmatist approach emphasizing situated and embedded values.
  • To analyze how values and practices co-develop in complex healthcare systems.

Main Methods:

  • Secondary analysis of ethnographic and action research (2010-2022) in Dutch healthcare.
  • Focus on older person care and services for chronic diseases, disabilities, and mental illness.
  • Application of a pragmatist framework to understand value-practice co-development.

Main Results:

  • A layered conceptualization of value complexity was developed.
  • Three strategies for managing value complexity were identified: 'working around,' 'working against,' and 'working with'.
  • The (dis)advantages of each management strategy were examined.

Conclusions:

  • 'Working with' value complexity, though challenging, holds significant potential for responsible conflict management.
  • Rethinking healthcare complexity through value complexity offers a more nuanced understanding of wicked problems.
  • The study provides practical insights for practitioners and scholars navigating value-based healthcare challenges.