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Embracing uncertainty, managing complexity: applying complexity thinking principles to transformation efforts in healthcare systems

Overview of attention for article published in BMC Health Services Research, March 2018
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (92nd percentile)

Mentioned by

news
1 news outlet
twitter
31 tweeters
facebook
1 Facebook page

Citations

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19 Dimensions

Readers on

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137 Mendeley
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Title
Embracing uncertainty, managing complexity: applying complexity thinking principles to transformation efforts in healthcare systems
Published in
BMC Health Services Research, March 2018
DOI 10.1186/s12913-018-2994-0
Pubmed ID
Authors

Sobia Khan, Ashley Vandermorris, John Shepherd, James W. Begun, Holly Jordan Lanham, Mary Uhl-Bien, Whitney Berta

Abstract

Complexity thinking is increasingly being embraced in healthcare, which is often described as a complex adaptive system (CAS). Applying CAS to healthcare as an explanatory model for understanding the nature of the system, and to stimulate changes and transformations within the system, is valuable. A seminar series on systems and complexity thinking hosted at the University of Toronto in 2016 offered a number of insights on applications of CAS perspectives to healthcare that we explore here. We synthesized topics from this series into a set of six insights on how complexity thinking fosters a deeper understanding of accepted ideas in healthcare, applications of CAS to actors within the system, and paradoxes in applications of complexity thinking that may require further debate: 1) a complexity lens helps us better understand the nebulous term "context"; 2) concepts of CAS may be applied differently when actors are cognizant of the system in which they operate; 3) actor responses to uncertainty within a CAS is a mechanism for emergent and intentional adaptation; 4) acknowledging complexity supports patient-centred intersectional approaches to patient care; 5) complexity perspectives can support ways that leaders manage change (and transformation) in healthcare; and 6) complexity demands different ways of implementing ideas and assessing the system. To enhance our exploration of key insights, we augmented the knowledge gleaned from the series with key articles on complexity in the literature. Ultimately, complexity thinking acknowledges the "messiness" that we seek to control in healthcare and encourages us to embrace it. This means seeing challenges as opportunities for adaptation, stimulating innovative solutions to ensure positive adaptation, leveraging the social system to enable ideas to emerge and spread across the system, and even more important, acknowledging that these adaptive actions are part of system behaviour just as much as periods of stability are. By embracing uncertainty and adapting innovatively, complexity thinking enables system actors to engage meaningfully and comfortably in healthcare system transformation.

Twitter Demographics

The data shown below were collected from the profiles of 31 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 137 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 137 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 27 20%
Student > Ph. D. Student 22 16%
Student > Doctoral Student 17 12%
Other 12 9%
Researcher 9 7%
Other 28 20%
Unknown 22 16%
Readers by discipline Count As %
Medicine and Dentistry 25 18%
Nursing and Health Professions 23 17%
Business, Management and Accounting 20 15%
Social Sciences 10 7%
Arts and Humanities 4 3%
Other 27 20%
Unknown 28 20%

Attention Score in Context

This research output has an Altmetric Attention Score of 33. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 27 August 2019.
All research outputs
#682,656
of 16,176,596 outputs
Outputs from BMC Health Services Research
#187
of 5,605 outputs
Outputs of similar age
#21,930
of 282,620 outputs
Outputs of similar age from BMC Health Services Research
#1
of 2 outputs
Altmetric has tracked 16,176,596 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 5,605 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.9. This one has done particularly well, scoring higher than 96% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 282,620 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 92% of its contemporaries.
We're also able to compare this research output to 2 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them