Simple, complicated and complex
Up until fairly recently I thought complicated and complex were interchangeable, maybe thanks to my love and use of a thesaurus over the years, which as this article points out out has a lot to answer for. There are distinct differences and it's important you are clear on the differences. The problems arise when you are trying to fix a complex problem or issue with a solution designed for a simple or complicated problem. You just aren't going to get the result or outcomes you really want or need.
This is one of the clearest articles I found to help you pull the simple, complicated and complex apart. Trust me, there is a lot out there on this and it began to pull me in all sorts of directions. Put clearly - hammers are simple, buildings are complicated and cities are complex. Of course there is more to dig into and in healthcare thinking safe care and good outcomes being delivered you need to know what you are looking at and talking about.
The reason this is important to grasp in healthcare is that delivering care safely is something we are frequently trying to improve or solve. That falls prevention work, the wrong drug to the wrong patient or learning from a patient who deteriorated without anyone noticing or acting. These are all things I've been involved with trying to improve over the years. Why doesn't telling people what to do and updating the policy work? Knowing the type of problem guides us more clearly to the solution type that will best help.
Suzette Woodward writes a great blog on patient safety and now has a book - Implementing Patient Safety. In the book there is a great section that tackles the definitions and why even with that clear in your mind, it still isn't that simple. From the book which references Glouberman and Zimmerman (2002) and I'm also using an article by Pupulidity and Vesel (2017).
Following a cake recipe is simple
There are clear instructions, it's pretty standardised, there are some variable like equipment or the oven, overall though if you follow the instructions, you'll get a cake.
In simple systems there is a cause and an effect, the parts are interconnected and interactive.A question would have one discrete answer.
Sending a rocket to the moon is complicated
While it may sound complex, it can be broken down into a series of problems and tasks. It takes expertise and lots of regulations. It can though be repeated with a level of certainty - a bit like the cake.
The parts of a complicated system are interconnected, interactive and diverse. There would be a limited number of discrete answers to a question
Raising a child is complex
Each child is unique, the same actions with a different child will give different results. Experience can help but doesn't guarantee success. Huge uncertainty exists and there a huge number of variables. It is though possible to raise a child.
Complex systems have parts that are interconnected, interactive, diverse and adaptive. There are unlimited answers to a number of questions (how many times have you answered 'it depends'). There needs to be a sensemaking pathway and adapting in real time.
For the video watchers out there, this 6 minute intro does a pretty neat job of summing up the difference between the concepts, using the same examples.
Healthcare is classified as a complex adaptive system. People in the mix makes it complex, we are unpredictable and huge numbers of variables affect our decision making and thinking. Managing a team is a complex thing. Within our complex system though there is a mix of simple, complicated and complex processes. Exploring the connections, interconnections, uncertainties and variables will help you grasp the type of problem you are looking at. It will help guide how you can learn and improve and explore why simple solutions to complex problems might not be working.
