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Applying Systems and Complexity Science to Real Patient Care
  • Bruce Ramshaw
Bruce Ramshaw
University of Tennessee
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Abstract Rationale: Our current global healthcare system is not sustainable. It is structured based on the principles of reductionist science which was discovered and developed over the past 400 – 600 years. Because of increasing pace of change and increasing complexity in our world we have increased fragmentation in our healthcare system leading to more harm and waste. Over 100 years ago, the principles of systems, or complexity, science were discovered, first in the discipline of physics. These principles accommodate the constant change and biologic variability in our world. While reductionist principles would be applicable in a static, mechanical world where parts of the system could be isolated, this does not exist in the real biologic world. Method: For the past decade, our abdominal wall hernia team has been applying the principles of systems science to real patient care. Some of the tools we have applied include continuous quality improvement for whole hernia patient processes and non-linear analytical tools to gain insight to improve value-based outcomes. Until we learn to apply and scale these principles across our whole global healthcare system, we will continue to suffer the consequences of our current unsustainable system. Results: We have learned that the application of systems and complexity science to real patient care can lead to lower costs and better outcomes in the context of patients with complex hernia problems. However, these concepts have not yet been adopted in our global healthcare system. Conclusion: Applying the principles of systems and complexity science to our global healthcare system has the potential to lower costs and improve patient outcomes for any patient care process to which it is applied.

Peer review status:ACCEPTED

25 May 2020Submitted to Journal of Evaluation in Clinical Practice
26 May 2020Assigned to Editor
26 May 2020Submission Checks Completed
30 May 2020Reviewer(s) Assigned
24 Jun 2020Review(s) Completed, Editorial Evaluation Pending
25 Jun 2020Editorial Decision: Accept