A complexity perspective on health care improvement and reform in general practice and primary health care

Barbara J. Booth, Nicholas Zwar, Mark Harris

Research output: Contribution to journalArticleResearchpeer-review

5 Citations (Scopus)

Abstract

Health care improvement is always on the planning agenda but can prove frustrating when 'the system' seems to have a life of its own and responds in unpredictable ways to reform initiatives. Looking back over 20 years of general practice and primary health care in Australia, there has been plenty of planning and plenty of change, but not always a direct cause and effect relationship between the two. This article explores in detail an alternative view to the current orthodoxy of design, control and predictability in organisational change. The language of complexity is increasingly fashionable in talking about the dynamics of organisational behaviour and health care improvement, but its popular use often ignores challenging implications. However, when interpreted through human sociology and psychology, a complexity perspective offers a better match with everyday human experience of change. As such, it offers some suggestions for leaders, policy makers and managers in health care: that uncertainty and paradox are inherent in organisational change; that health care reform must pay attention to the constraints and politics of the everyday; and that change in health systems results from the complex processes of relating among those involved and that neither 'the system' nor a few individuals can be accountable for overall performance and outcomes.

Original languageEnglish
Pages (from-to)29-35
Number of pages7
JournalAustralian Journal of Primary Health
Volume16
Issue number1
DOIs
Publication statusPublished - 25 Mar 2010
Externally publishedYes

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Health Care Reform
General Practice
Organizational Innovation
Primary Health Care
Delivery of Health Care
Sociology
Politics
Administrative Personnel
Uncertainty
Language
Psychology
Health

Cite this

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A complexity perspective on health care improvement and reform in general practice and primary health care. / Booth, Barbara J.; Zwar, Nicholas; Harris, Mark.

In: Australian Journal of Primary Health, Vol. 16, No. 1, 25.03.2010, p. 29-35.

Research output: Contribution to journalArticleResearchpeer-review

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