Home Organizational Psychology System Dynamics / Complexity Delivering Health Care in Complex Adaptive Systems III: The Diverse Challenges

Delivering Health Care in Complex Adaptive Systems III: The Diverse Challenges

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Encountering the Virus

At the start, as the ball is rolling down the warped plane it encounters the first warp (a ridge with two adjacent valleys). At this point, it tends to oscillate. As just noted, oscillations tend to precede bifurcation. At the point when the ball ceases to oscillate and begins to move down one of the adjacent valleys, an irreversible decision has occurred.

This is the dynamic operating when a virus leaps from one region of the world (one valley on the plane) to another region. Typically, there is just a small number of infected people who usually have traveled from the original region of infection. The infection can be immediately detected, and the infected person quarantined. Nothing occurs. The virus is “stopped in its track.” It is a matter of perfect timing and fast response. The oscillation in this instance is the moment of decision being made by those in medical authority. Unfortunately, the response is often not timely or fast. Many delaying or deferring questions are asked:

“Are we sure this is the dreaded virus?”

“I thought it was present only in XYZ (name of country or region).”

“This could just be a nasty flu. We certainly don’t want to alarm people in this community—they are already stressed out.”

“If we announce that one person has been infected and quarantined then our economy will immediately go down in flames! All because one old person got sick (or) All because that damned tourist went to the wrong country and hung out with the wrong people!”

As we noted in the first essay in this series (Fish and Bergquist, 2023) the identification of delays in any system is critical to understanding it’s dynamic operations. System theorists (e.g. Meadows, 2008) tell us that one of the most important (and often overlooked) features of any system is the delay function. How long does it take to detect a change that is acting on the system from outside (or inside)? How long does it take to share information with other sectors of the system about this change? How long does it take to act upon the information that has been received and shared? In the case of COVID-19 (and other viruses) a delay of even one day can be devastating. The ball no longer oscillates. It moves into the new valley (infecting residents of this second valley at a high rate).

There is more to say here about the movement of the ball (and the virus) down the new valley. When the ball begins to move down one of the valleys, it usually doesn’t roll directly down the center of the valley. Rather, because it entered the valley from an angle (having oscillated among several options before entering the valley), it rolls up the side of one of the valley’s ridges. The ball then corrects itself by rolling back across the floor of the valley and up the other ridge of the valley—while continuing to move down the valley. Leaders in the system operates in this valley are vacillating. They are moving back and forth regarding what to do next. Ideally, the leaders (and those people who are residing in this second valley) soon end their vacillation. They make thoughtful decisions in a slow, measured manner (Kahneman, 2011).  Those operating in this second valley make quick, yet orderly adjustments and minor changes at this point. Collectively, they are agile, moving in a self-correcting fashion. This is all well and good—provided that the system is operating in an optimal manner, with abundant agility.

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