The Library
Application of simplified Complexity Theory concepts for healthcare social systems to explain the implementation of evidence into practice
Tools
Chandler-Oatts, Jacqueline, Rycroft-Malone, Jo, Hawkes, C. M. and Noyes, Jane (2016) Application of simplified Complexity Theory concepts for healthcare social systems to explain the implementation of evidence into practice. Journal of Advanced Nursing, 72 (2). pp. 461-480. doi:10.1111/jan.12815 ISSN 0309-2402.
Research output not available from this repository.
Request-a-Copy directly from author or use local Library Get it For Me service.
Official URL: http://dx.doi.org/10.1111/jan.12815
Abstract
Aim
To examine the application of core concepts from Complexity Theory to explain the findings from a process evaluation undertaken in a trial evaluating implementation strategies for recommendations about reducing surgical fasting times.
Background
The proliferation of evidence-based guidance requires a greater focus on its implementation. Theory is required to explain the complex processes across the multiple healthcare organizational levels. This social healthcare context involves the interaction between professionals, patients and the organizational systems in care delivery. Complexity Theory may provide an explanatory framework to explain the complexities inherent in implementation in social healthcare contexts.
Design
A secondary thematic analysis of qualitative process evaluation data informed by Complexity Theory.
Method
Seminal texts applying Complexity Theory to the social context were annotated, key concepts extracted and core Complexity Theory concepts identified. These core concepts were applied as a theoretical lens to provide an explanation of themes from a process evaluation of a trial evaluating the implementation of strategies to reduce surgical fasting times. Sampled substantive texts provided a representative spread of theoretical development and application of Complexity Theory from late 1990's–2013 in social science, healthcare, management and philosophy.
Findings
Five Complexity Theory core concepts extracted were ‘self-organization’, ‘interaction’, ‘emergence’, ‘system history’ and ‘temporality’. Application of these concepts suggests routine surgical fasting practice is habituated in the social healthcare system and therefore it cannot easily be reversed. A reduction to fasting times requires an incentivised new approach to emerge in the surgical system's priority of completing the operating list.
Conclusion
The application of Complexity Theory provides a useful explanation for resistance to change fasting practice. Its utility in implementation research warrants further attention and evaluation.
Item Type: | Journal Article | ||||||||
---|---|---|---|---|---|---|---|---|---|
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
||||||||
Journal or Publication Title: | Journal of Advanced Nursing | ||||||||
Publisher: | Wiley-Blackwell Publishing Ltd. | ||||||||
ISSN: | 0309-2402 | ||||||||
Official Date: | 12 January 2016 | ||||||||
Dates: |
|
||||||||
Volume: | 72 | ||||||||
Number: | 2 | ||||||||
Page Range: | pp. 461-480 | ||||||||
DOI: | 10.1111/jan.12815 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Restricted or Subscription Access |
Request changes or add full text files to a record
Repository staff actions (login required)
View Item |