Thinking systems need systems thinking

After describing machine and complex adaptive systems (CASs), we define thinking system as a CAS with two additional, unique characteristics: (1) having goal(s) separate from survival, and (2) having the capability to structure its own learning and to innovate purposefully. Thinking systems always learn. Healthcare can be considered a paradigm of the thinking system and is repeatedly plagued with unintended, adverse outcomes, particularly fixes that fail. Systems thinking can dissolve such dysfunction in healthcare and by extension in any thinking system. Specific recommendations follow from this rationale. Copyright © 2007 John Wiley & Sons, Ltd.

[1]  J. B. Ritchie,et al.  We (Still) Need a World of Scholar-Leaders , 2005 .

[2]  Franklin P. Schargel,et al.  Twins in trouble: The need for system-wide reform of both healthcare and education , 2003 .

[3]  Steven A. Yourstone,et al.  Learning Curves in Health Care , 2003, Health care management review.

[4]  J.D. Sterman,et al.  System Dynamics Modeling: Tools for Learning in a Complex World , 2001, IEEE Engineering Management Review.

[5]  Learning from the Bristol Inquiry , 2001, Cardiology in the Young.

[6]  R. McDaniel,et al.  Complexity science and health care management , 2001 .

[7]  Dennis Duchon,et al.  Organizational responses to complexity: the effect on organizational performance , 2000 .

[8]  J. Peirce,et al.  The paradox of physicians and administrators in health care organizations. , 2000, Health care management review.

[9]  S. Shortell,et al.  Assessing the impact of continuous quality improvement on clinical practice: what it will take to accelerate progress. , 1998, The Milbank quarterly.

[10]  R. Axelsson,et al.  Towards an evidence based health care management. , 1998, The International journal of health planning and management.

[11]  K C Stange,et al.  Understanding change in primary care practice using complexity theory. , 1998, The Journal of family practice.

[12]  R R McDaniel,et al.  Participation as a Complicating Mechanism: The Effect of Clinical Professional and Middle Manager Participation on Hospital Performance , 1998, Health care management review.

[13]  Tim Rowley Moving Beyond Dyadic Ties: A Network Theory of Stakeholder Influences , 1997 .

[14]  R R McDaniel,et al.  Strategic Leadership: A View from Quantum and Chaos Theories , 1997, Health care management review.

[15]  Eric D. Beinhocker Strategy at the edge of chaos , 1997 .

[16]  D. Lewin,et al.  Managing workforce diversity: macro and micro level HR implications of network analysis , 1996 .

[17]  A. Edmondson Learning from Mistakes is Easier Said Than Done: Group and Organizational Influences on the Detection and Correction of Human Error , 1996 .

[18]  K. Weick The Collapse of Sensemaking in Organizations: The Mann Gulch Disaster , 1993 .

[19]  H. Ibarra NETWORK CENTRALITY, POWER, AND INNOVATION INVOLVEMENT: DETERMINANTS OF TECHNICAL AND ADMINISTRATIVE ROLES , 1993 .

[20]  Daniel J. Brass,et al.  POTENTIAL POWER AND POWER USE: AN INVESTIGATION OF STRUCTURE AND BEHAVIOR , 1993 .

[21]  S M Shortell,et al.  Creating organized delivery systems: the barriers and facilitators. , 1993, Hospital & health services administration.

[22]  T. Brennan,et al.  The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practice Study II. , 1991, The New England journal of medicine.

[23]  D M Berwick,et al.  Continuous improvement as an ideal in health care. , 1989, The New England journal of medicine.

[24]  M. Fennell,et al.  Patterns of decision making in multihospital systems. , 1986, Journal of health and social behavior.

[25]  K. Cameron Cultural Congruence, Strength, and Type: Relationships to Effectiveness , 1985 .

[26]  J. Kotter,et al.  Choosing strategies for change. , 1979, Harvard business review.

[27]  P. Feldstein,et al.  Payment for Hospital Services: Objectives and Alternatives , 1977, Health care management review.

[28]  S. Kerr On the folly of rewarding A, while hoping for B. , 1975 .

[29]  J. Coleman,et al.  The Diffusion of an Innovation Among Physicians , 1957 .