Nonlinear systems theory in medical care management.
Health care is provided to biological, not mechanical systems. The focus of attention is a human being, not an automobile or clock. Biological systems are highly complex and their behavior can be nonlinear. By understanding this difference, we can begin to answer the question of how can we deliver efficient and effective clinical care, while controlling spiraling costs. This article describes the behavior of complex systems and explores what has been learned about managing such systems in non health care fields. The author translates that learning into the health care setting and proposes a new model for the health care environment, based on the principles of complex adaptive systems. The approach advocated is to design models that can learn and adapt, and then to implement them with skill. Such models should include the elements of roadmaps, decision aids, and continuous improvement.