Toward a Values-Informed Approach to Complexity in Health Care: Hermeneutic Review

More than 20 years ago, a series of articles in the British Medical Journal introduced a novel approach to innovation and change, referred to as “complexity thinking” or “complexity theory,” which emphasized the dynamic and unpredictable nature of health care systems.^1-4 That series, along with other conceptual papers published at the time,^5-7 have been widely cited and informed policies, programs, and research studies around the world. However, these early articles, which depicted complexity in broadly mathematical terms, missed—or, at best, failed sufficiently to emphasize—a key aspect of complexity in health care systems: human values.

In this review paper, we explore the crucial contribution of human values to complex interaction and change. In the form of “simple rules,” we offer some preliminary recommendations for a more contemporary and values-informed approach to complexity in health care. We invite a new generation of research to extend the existing evidence base.

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References

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4. Fraser SW, Greenhalgh T. Coping with complexity: educating for capability. BMJ. 2001;323(7316):799-803.
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