Properties of Complex Adaptive Systems & Relevance to People Skills- Part I-Adaptability

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Cflock of geeseomplexity Science also known as the study of Complex Adaptive Systems (CASs) is gaining traction as helpful insights for patient safety, education of nurses, and leadership processes.  The patterns of behaviors that are illuminated by studying CASs are powerful incentives for getting better at teaching basics in communication, emotional intelligence, and collaboration.  The combination of which makes up “People Skills”.

Appendix B by Paul Plsek in the landmark IOM book, Crossing the Quality Chasm is an excellent introduction to CASs with a focus on healthcare systems.  And it is only 10 pages!

How are Adaptable elements related to Communication, Emotional Intelligence, & Collaboration? Click To Tweet

One of the properties common to CASs is that they are made up of Adaptable elements. The elements of the system can change themselves. Examples include antibiotic-resistant organisms and anyone who learns.  In machines, change must be imposed, whereas under the right conditions in a CAS, change can happen from within.

How are Adaptable elements related to Communication, Emotional Intelligence, & Collaboration?

All of these are inherent in the words,  “anyone who learns”!  Think of the ability to share information or take it in, also known as assertiveness or listening.  Emotional intelligence comes into play because so many capacities like self-awareness, social skills, and ability to manage emotions will impact how information is expressed and received.  Adaptability can also be associated with one’s ability to be flexible.  This varies to some extent with emotional maturity and openness to change.  Sometimes, I think nurses have a reputation for being ‘resistant” to change, but I can help but wonder if this is a symptom of not being heard or respected.  As organizational theorist Peter Senge has said, “People don’t resist change, they resist being changed”.

What does this mean in terms of leadership and followership?

Inviting input and listening to it is key for engaging staff.  Leaders sometimes avoid this because they assume that staff will expect them to follow all recommendations and this will lead to conflict.  Instead of validating, explaining or setting limits, which is an extremely powerful way of demonstrating respect and engaging staff, they simply avoid asking. Human beings in a Complex Adaptive System may use resistance as a passive-aggressive way of being heard.  Most people will accept reasonable limits especially if they have been heard!

Also, listening is a very powerful way to teach assertiveness.  When leaders ask, what do you need to comply with hand-washing protocols and listen, they are also telling staff that they have important thoughts and ideas.  This indirectly builds self-esteem, self-efficacy, and a willingness to collaborate in problem solving.  If an RN says s/he wants six additional hand wash stations on the unit, this may be totally unrealistic, but perhaps negotiating for one along with ensuring supplies are stocked might lead to increased compliance and the most cost-effective way of reducing HAIs.

Beth Boynton, RN, MS

Complexity Science is becoming more and more a resource for developing healthy teams and organizations and the practice of respectful communication must be part of the foundation! It makes sense, doesn’t it?  Since complex adaptive systems involving human beings are a web of relationships and relationships rely on communication, the healthier the communication, the healthier the relationships and the healthier the system!

What is available to help healthcare professionals develop these skills?

In addition to the obvious communication training in giving and receiving constructive feedback, there are two new ideas that will contribute to positive workplaces and interprofessional relationships.

Medical Improv offers huge promise for building individual people skills and interdisciplinary relationships!  Learn more about this innovative and fun process! Medical Improv Youtube  or contact beth@bethboynton.com  Also, check out the newly launched Medical Improv Website by Professor Katie Watson and Dr. Belinda Fu!  We can create the right conditions for healthy change in our many CASs.

Appendix B by Paul Plsek in the landmark IOM book, Crossing the Quality Chasm is an excellent introduction to CASs with a focus on healthcare systems.  And it is only 10 pages!

 

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