CREATING HEALTHY BIOCRATIC ORGANIZATIONS

2017

The purpose of this paper is helping managers and leaders in healthcare develop viable organizations that deliver high-level services. Health organizations such as hospitals are exceedingly complex. Therefore, we use Integrative Systems Methodology, a framework designed especially as an enabler for coping with complexity. Within that framework, we combine quantitative and qualitative methods to describe and explain organizational phenomena evolving over time. Rather than a large survey, we use a real-life case study. A single-case setting has been chosen, to enable long-term and in-depth exploration. The case spans 30 years, covering the evolution of the oncological care system of Carinthia, which is a federal state of Austria. The contribution of the chapter is in providing deep insights. It lays open the structures underlying the viability of health organizations. The chapter also provides well-grounded advice for how to build a robust health organization in a context of complexit...

2009

American Journal of Operations Research, 2013

Health systems are paradigmatic examples of human organizations that blend a multitude of different professional and disciplinary features within a critically performance environment. Communication failure and defective processes in health systems have a tremendous impact in society, both in the financial and human aspects. Traditionally, health systems have been regarded as linear hierarchic structures. However, recent developments in the sciences of complexity point out to health systems as complex entities governed by non-linear interaction laws, self-organization and emergent phenomena. In this work we review some aspects of complexity behind health systems and how they can be applied to improve the performance of healthcare organizations.

2017

The study and analysis of the organization in health care, depends on some aspects that include the observation of social phenomena, law categories, and political strategies as well as the administrative behaviors. All these as-pects have led to the overcoming of the traditional concept of bureaucracy, which finds a solid theoretical foun-dation in the studies undertaken by Weber. In the Weber's vi-sion, bureaucracy is the organization of people and resources for a collective purpose, public, ac-cording to any criteria of rationality, impartiality and impersonality. The assumption is that it is hard to perceive organizations oriented towards an end in a rational way, unless as bureaucracies, even considering that there may be non-bureaucratic organizational forms, not rationally oriented to a purpose (Weber 1922). One of the most original contributions of the late twentieth century comes from Luhmann's theory of social systems that is applied to the concept of organization. ...

Purpose -The healthcare sector is always facing turbulent times . In this social context there is a continuous exchange of formal and informal interactions, where the nursing and medical staff put in order specific attitudes and behaviors, among them and with patients and clients. This analysis is an organizational diagnosis aiming at investigating the work environment and the process of organizational well-being so important for employees and patients/clients. Therefore, the organizational climate represents an opportunity of discussion among all the actors and is a tool to better to share knowledge and information. Moreover, this type of survey is able to gather and examine opinions, beliefs and behavior both of employees and clients/patients and also comparing them. The organizational climate survey is indeed nowadays crucial to understand the quality of work, especially in the healthcare sector where the social aspect and the human side are at the forefront to act directly on labor relations, conflicts and discontent. a: § 1, 3, 3.1, 4, 7 b: § 1, 4, 7 c: § 1, 5, 6, 7 d: § 1, 2, 2.1, 7

Theoretical Medicine and Bioethics

In an era of a dynamic, uncertain, complex, and ambiguous health challenges [sic] at all levels and in every setting, this Primer on systems thinking, as it pertains to health, is urgently needed" (p. vii). Thus begins Johnson and colleagues' Primer and it certainly appears at a propitious time as we continue to investigate the COVID-19 pandemic. Why propitious? Specifically, the pandemic has revealed how dysfunctional the global healthcare system is and how badly it needs repair. One such means is through systems theory and thinking. Rather than the reductive approach which exemplifies traditional biomedical thinking and results in fragmented healthcare, systems thinking provides a holistic approach to meet the dynamics and complexities requisite to deliver quality and safe healthcare. After a brief preface, which frames the authors' motivation for the Primer, they discuss systems thinking and its application to the healthcare system throughout five chapters. The first chapter is an introduction to systems theory and thinking. The authors initially discuss systems theory and its foundations, most notably Ludwig von Bertalanffy's general systems theory. Rather than uniting the sciences via their reduction to physics, Bertalanffy strove to unify the sciences by integrating them as a dynamic and complex system. The authors then turn to complex adaptive systems (CASs) as the paradigm for understanding the functioning of healthcare systems. They discuss the various components and attributes of CASs, including agents, interconnections, self-organization, emergence, and co-evolution, among others. Next, the authors cite the World Health Organization (WHO) regarding the requirements of systems thinking: "a deeper understanding of the linkages, relationships, interactions, and behaviors among the elements to characterize the entire system" (p. 9). The authors then explore systems thinking by reframing a problem from a perspective of the "whole"

Journal of Urban Health-bulletin of The New York Academy of Medicine, 1998

PrimaryCare, 2010

From its roots in physics, mathematics, and biology, the study of complexity science, or complex adaptive systems, has expanded into the domain of organizations and systems of organizations. Complexity science is useful for studying the evolution of complex organizations --entities with multiple, diverse, interconnected elements. Evolution of complex organizations often is accompanied by feedback effects, nonlinearity, and other conditions that add to the complexity of existing organizations and the unpredictability of the emergence of new entities.

Biomedical instrumentation & technology / Association for the Advancement of Medical Instrumentation, 2014