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EMERGENCE |
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Bottom Line |
Much coming from little |
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Significance
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In a rarified world of scientific research, a revolution has been brewing. Its activists are not anarchists, but rather Nobel Laureates in physics and economics and pony-tailed graduates, mathematicians and computer scientists from all over the world. They have formed an iconoclastic think-tank and their radical idea is to create a new science: complexity. They want to know how a primordial soup of simple molecules managed to turn itself into the first living cell - and what the origin of life some four billion years ago can tell us about the process of technological innovation today. This book is their story - the story of how they have tried to forge what they like to call "the science of the 21st century".
After the Second World War, the Sante Fé Institute (a charitable foundation) brought together biologists, psychologists and people who were writing code for the huge mainframe computers of the time.
They came up with two important concepts – the definition of complexity and the definition of emergence.
“Two concepts important to understanding the nature of complexity are inequality and heterogeneity. Inequality may be thought of as vertical differentiation, ranking, or unequal access to material and social resources. Heterogeneity is a subtler concept. It refers to the number of distinctive parts or components to a society, and at the same time to the ways in which a population is distributed among these parts.”
Source: Tainter, J.A. (1988) The Collapse of Complex Societies. Cambridge University Press. (p.23)
The definition of “emergence”, from the book of that title, emphasises the importance of involving everyone, including patients and carers, in service design and redesign.
“Much coming from little.”
Source: Holland, J.H. (1998) Emergence. From chaos to order. Oxford University Press. (p.1)
Healthcare clearly provides an excellent example of complexity and the two books by Kieran Sweeney, the first Complexity in Primary Care, the second Complexity and Healthcare, describe how this approach, rather than a linear approach, can be very helpful.
Complexity is, of course, also present in clinical practice. For example, the 85-year-old woman with four diagnoses and seven prescriptions being looked after by a 55-year-old daughter who lives eight miles away and whose own daughter has just become pregnant without knowing the father is an example of the type of complex problem that general practitioners deal with on a daily basis. |
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Examples of how the term is used; Extract from the Better Value Healthcare 21st Century Glossary |
1. “Much coming from little.” Source: Holland, J.H. (1998) Emergence. From chaos to order. Oxford University Press. (p.1)
2. “As I understand it, emergence refers to a pattern arising across a population that is not the realization of a prior design or plan for that population-wide pattern but flows from many, many local interactions. Source: Stacey, R.D. (2010) Complexity and Organizational Reality. Routledge (p. 81)
3. “Emergent properties are system-level properties that arise over time from the local interactions among agents.” Source: Lanham, H.J., McDaniel Jr., R.R., Crabtree, B.F., Miller, W.L., Stange, K.C., Tallia, A.E., Nutting, P.A. (2009) Organizational Change and Learning. How improving practice relationships among clinicians and nonclinicians can improve quality in primary care. The Joint Commission Journal on Quality and Patient Safety; (35)9:458 |
