Complexity in practice: understanding primary care as a complex adaptive system

<strong>Background</strong> This series summarises new empirical research on quality improvement through case studies of the implementation of clinical governance arrangements in two primary care organisations (PCOs). <strong>Objective</strong> To describe a new socio-technic...

Full description

Bibliographic Details
Main Author: Beverley Ellis
Format: Article
Language:English
Published: BCS, The Chartered Institute for IT 2010-06-01
Series:Journal of Innovation in Health Informatics
Subjects:
Online Access:http://hijournal.bcs.org/index.php/jhi/article/view/763
_version_ 1818025922160230400
author Beverley Ellis
author_facet Beverley Ellis
author_sort Beverley Ellis
collection DOAJ
description <strong>Background</strong> This series summarises new empirical research on quality improvement through case studies of the implementation of clinical governance arrangements in two primary care organisations (PCOs). <strong>Objective</strong> To describe a new socio-technical model for effective quality improvement and clinical governance. <strong>Method</strong> The research strategy included a literature review, survey, in-depth interviews, participant observation and purposively sampled case studies, conducted within a social constructionist ontological perspective. This approach contextualises the origins of clinical governance and the trend towards collaborative partnerships and federated models of practice, enabled by developments in primary care informatics. <strong>Results</strong> People operating within multidisciplinary networks communicate with each other to determine actions that govern their most relevant concerns. Quality improvement in two PCOs is enabled through social interactions between individuals and groups with complex relationships; and information technology (IT) systems which make some aspects of the quality of care explicit. <strong>Conclusions</strong> The results are real-world exemplars of the emergent properties of complex adaptive systems. Improving clinical governance in primary care requires both complex social interactions and underpinning informatics. The socio-technical lessons learned from this research should inform future management approaches.
first_indexed 2024-12-10T04:23:48Z
format Article
id doaj.art-42c161daeda54398b2c127b33d10ab5a
institution Directory Open Access Journal
issn 2058-4555
2058-4563
language English
last_indexed 2024-12-10T04:23:48Z
publishDate 2010-06-01
publisher BCS, The Chartered Institute for IT
record_format Article
series Journal of Innovation in Health Informatics
spelling doaj.art-42c161daeda54398b2c127b33d10ab5a2022-12-22T02:02:20ZengBCS, The Chartered Institute for ITJournal of Innovation in Health Informatics2058-45552058-45632010-06-0118213514010.14236/jhi.v18i2.763705Complexity in practice: understanding primary care as a complex adaptive systemBeverley Ellis<strong>Background</strong> This series summarises new empirical research on quality improvement through case studies of the implementation of clinical governance arrangements in two primary care organisations (PCOs). <strong>Objective</strong> To describe a new socio-technical model for effective quality improvement and clinical governance. <strong>Method</strong> The research strategy included a literature review, survey, in-depth interviews, participant observation and purposively sampled case studies, conducted within a social constructionist ontological perspective. This approach contextualises the origins of clinical governance and the trend towards collaborative partnerships and federated models of practice, enabled by developments in primary care informatics. <strong>Results</strong> People operating within multidisciplinary networks communicate with each other to determine actions that govern their most relevant concerns. Quality improvement in two PCOs is enabled through social interactions between individuals and groups with complex relationships; and information technology (IT) systems which make some aspects of the quality of care explicit. <strong>Conclusions</strong> The results are real-world exemplars of the emergent properties of complex adaptive systems. Improving clinical governance in primary care requires both complex social interactions and underpinning informatics. The socio-technical lessons learned from this research should inform future management approaches.http://hijournal.bcs.org/index.php/jhi/article/view/763clinical governancecomplex adaptive systemsinformaticsprimary carequality assurancesocio-technical
spellingShingle Beverley Ellis
Complexity in practice: understanding primary care as a complex adaptive system
Journal of Innovation in Health Informatics
clinical governance
complex adaptive systems
informatics
primary care
quality assurance
socio-technical
title Complexity in practice: understanding primary care as a complex adaptive system
title_full Complexity in practice: understanding primary care as a complex adaptive system
title_fullStr Complexity in practice: understanding primary care as a complex adaptive system
title_full_unstemmed Complexity in practice: understanding primary care as a complex adaptive system
title_short Complexity in practice: understanding primary care as a complex adaptive system
title_sort complexity in practice understanding primary care as a complex adaptive system
topic clinical governance
complex adaptive systems
informatics
primary care
quality assurance
socio-technical
url http://hijournal.bcs.org/index.php/jhi/article/view/763
work_keys_str_mv AT beverleyellis complexityinpracticeunderstandingprimarycareasacomplexadaptivesystem