Studying complexity in health services research
Desperately seeking an overdue paradigm shift
Bibliographic Data
| ID | 23366379 |
|---|---|
| Authors | Trisha Greenhalgh (0000-0003-2369-8088, John Radcliffe Hospital, corresponding author), Chrysanthi Papoutsi (0000-0003-1189-7100, John Radcliffe Hospital) |
| Year | 2018 |
| Volume | 16 |
| Issue | 1 |
| Pages | 95-95 |
| Publication date | 2018-12-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | BMC Medicine (JOURNAL) |
| Journal identifiers | ISSN: 1741-7015 • E-ISSN: 1741-7015 |
| Publisher | Springer Science and Business Media LLC (PUBLISHER) |
| DOI | 10.1186/s12916-018-1089-4 |
| PMID | 29921272 |
| OpenAlex | W2808353110 |
| Language | EN |
| Citations received | 147 |
| References cited | 28 |
Complexity is much talked about but sub-optimally studied in health services research. Although the significance of the complex system as an analytic lens is increasingly recognised, many researchers are still using methods that assume a closed system in which predictive studies in general, and controlled experiments in particular, are possible and preferred. We argue that in open systems characterised by dynamically changing inter-relationships and tensions, conventional research designs predicated on linearity and predictability must be augmented by the study of how we can best deal with uncertainty, unpredictability and emergent causality. Accordingly, the study of complexity in health services and systems requires new standards of research quality, namely (for example) rich theorising, generative learning, and pragmatic adaptation to changing contexts. This framing of complexity-informed health services research provides a backdrop for a new collection of empirical studies. Each of the initial five papers in this collection illustrates, in different ways, the value of theoretically grounded, methodologically pluralistic, flexible and adaptive study designs. We propose an agenda for future research and invite researchers to contribute to this on-going series.
Complex adaptive system · Data science · Empirical research · Epistemology · Framing (construction) · Generative grammar · Management science · Predictability · Artificial Intelligence · Computer Science · Health Policy Implementation Science · Health Systems, Economic Evaluations, Quality of Life · Medicine · Primary Care and Health Outcomes
A critical realist critique on evidence conceptions in occupational mental health research
Critical Analysis of Healthcare Systems, Leadership Challenges, and Public Health Solutions
Following the science? Views from scientists on government advisory boards during the Covid-19 pandemic
Engaging with uncertainty
Community-led Recovery from the Opioid Crisis through Culturally-based Programs and Community-based Data Governance
Considerations in the use of local and national data for evaluating innovation in children’s social care
Connecting knowledge and action in complex health systems
Exploring the value and role of creative practices in research co-production
Using Forum Theatre to mobilise knowledge and improve NHS care
Co-producing evidence-informed criminal legal re-entry policy with the community
“FREED instils a bit of hope in the eating disorder community… that things can change.”
Implementing Integrated Care in Practice – Learning from MDTs Driving the Integrated Care Programme for Older Persons in Ireland
The mismeasurement of complexity
Building engagement to support adoption of community-based substance use prevention initiatives
How Clinicians Decide? Exploring Complexity of Antibiotic Prescribing in Emergency Departments Using Video-Reflexive Ethnography
Examining the optimal factors that promote implementation and sustainability of a network intervention to alleviate loneliness in community contexts
What can sociology offer urban public health
The quest for diffusible community health worker projects and the pitfalls of scaling culture
You'll come in and dose even in a global pandemic”
The development of EU health policy and the Covid-19 pandemic
Using fairness to reconcile tensions between coaching and assessment
Mental health monitoring apps for depression and anxiety in children and young people
Exploring frailty perspectives of older people and professionals
Configuring possibilities
Police-led multidisciplinary teams in crisis response
Improving employer and employee well-being in small and medium-sized enterprises in Flanders
Self-fulfilling Prophecies in Service Design
A new framework for developing and evaluating complex interventions
What Matters in Sustaining Peer Support for Adults in Mental Health Services? Exploring the Perceptions of Diverse Actors
Multiscalar (Dis)connections in Medical Education and Healthcare Work in Romania and Beyond
Using systems archetypes to understand system behaviour and identify leverage points for change in local obesity prevention in The Netherlands
Effectiveness of Social Prescribing for Mental Health Across Care Intensity Needs
Towards a Program Theory for Family-Focused Practice in Adult Mental Health Care Settings
What Makes a Successful Partnership? Lessons from a Multi-Agency Equity-Focused Maternal and Early Childhood Health Partnership in Victoria, Australia
Early Implementation of a Patient-Centered Medical Home in Singapore
From design to action
A Sustainability Model for Family-Focused Practice in Adult Mental Health Services
Effects of applying a standardized assessment and evaluation protocol in housing adaptation implementation – results from a quasi-experimental study
Strengthening implementation of integrated care for small and nutritionally at‐risk infants under six months and their mothers
Public health emergency preparedness
Older Adults’ Experiences of a Physical Activity and Sedentary Behaviour Intervention
Examining the implementation of the Icelandic model for primary prevention of substance use in a rural Canadian community
The Daily Mile as a public health intervention
Digital Health Innovation by Design
Barriers and Facilitating Factors of Adherence to Antidepressant Treatments
Trauma and Violence Informed Care Through Decolonising Interagency Partnerships
Using Relational Community Engagement within the Digital Health Intervention (DHI) to Improve Access and Retention among People Living with HIV (PLWH)
Current Guidelines for Protecting Health Workers from Occupational Tuberculosis Are Necessary, but Not Sufficient
Public health and integrated governance across the sustainable development goals beyond 2030
Navigating shared decision making in community mental health services
Holostasis
Technology integration in nursing and healthcare administration
Wicked problems in a post-truth political economy
Reconciling fragmented sectors of health research regulation
Improving partnerships to improve outcomes for children and young people with special educational needs and disabilities
A case for a quantum informed approach to health communication research
Innovations in Addressing Mental Health Needs in Humanitarian Settings
The reflexive relationship between available university services and mental health ideations
What a Pandemic Has Taught Us About the Potential for Innovation in Rural Health
Artificial intelligence in public health
Three days inside
Knowing equity, doing equity
Creating healthy workplaces in healthcare
Systems thinking in practice when implementing a national policy program for the improvement of women's healthcare
Traditional, complementary and integrative health within universal systems
Challenges and Opportunities in Collaborative Cross‐Sectoral (Healthy) Urban Food Environment Planning
Improving facility-based care
Gender, mental health and resilience in armed conflict
What’s in a name? Unpacking ‘Community Blank ’ terminology in reproductive, maternal, newborn and child health
Understanding maternity waiting home uptake and scale-up within low-income and middle-income countries
Data for whom? Experiences and perceptions of a perinatal eRegistry in two hospitals in Mtwara region, Tanzania
Deliberation-based learning
Power and politics
The compatibility of reductionistic and complexity approaches in a sociomedical innovation perspective
Ageing and complexity
Duas críticas às normativas dos Núcleos de Apoio à Saúde da Família
From Patterns to Attractor‐Like Modes
Factors Associated with Tobacco Cessation Services Request Among Users of an Online Self-Screening Questionnaire
Creating a Resilient Ecosystem for the Employment of Autistic Individuals
Interdisciplinarity and epistemic reflexivity. A methodological approach to the study of later-life transitions
Doctors' attitudes to maintenance of professional competence
Trust, trustworthiness and sharing patient data for research
Rutas saludables, más allá del ejercicio físico
Developing a conceptual evaluation framework for gender equality interventions in research and innovation
The pursuit of fairness in assessment
Ready, set, go! Evaluating readiness to implement competency-based medical education
Interprofessional education for healthcare professionals. A Beme realist review of what works, why, for whom and in what circumstances in undergraduate health sciences education
Diffusion of Innovations Theory and Its Applicability in Research Studies on Nursing and Health
‘You can sleep hungry just to buy the medicine’
Inducing labour in the United Kingdom
The ties that bind
Integrated care systems in England
Beyond Policy
Evaluating Large-Scale Integrated Care Projects
The Integrated Care World is a Stage
Scaling-Out Digitally Enabled Integrated Care in Europe Through Good Practices Transfer
Complexities in interdisciplinary community engagement projects
Talking it better
Navigating health and social care systems
Development of a ‘real-world’ logic model through testing the feasibility of a complex healthcare intervention
Beyond Adoption
Complexities
Complex interventions or complex systems? Implications for health economic evaluation
When complexity science meets implementation science
The challenge of complexity in health care
Complexity, leadership, and management in healthcare organisations
Complex interventions
The need for a complex systems model of evidence for public health
Coping with complexity
Framework for design and evaluation of complex interventions to improve health
Process evaluation of complex interventions
Developing and evaluating complex interventions
Theorising Interventions as Events in Systems
How complexity science can inform scale-up and spread in health care
Integrated care in the emergency department
Realist RCTs of complex interventions - An oxymoron
Five Misunderstandings About Case-Study Research
| Unique citing works | 147 |
|---|---|
| Citations per year | 18,38 |
| Citation span | 2018 - 2026 (9) |
| Citation velocity | current |
| Highly cited | Yes |
| Citation types | Neutral: 122 |