Indeed, the mismatch between this hypercomplexity and the dominant mechanistic conception of healthcare has been used as a key explanation for the lack of implementation of evidence-based medicine and healthcare innovation. Its emergence provides credence to the growing arguments from health services researchers, namely that the healthcare system contains a level of complexity qualitatively different to other systems due to the social nature of health, and therefore requires a different set of research methods. However, this approach requires a redefinition of implementation success, away from pre-determined outcomes and process fidelity, to one that embraces the continual learning, evolution, and emergence that characterized our project.Ĭomplexity theory has become increasingly popular in healthcare research over the last two decades. We found that, in practice, a pragmatic complexity theory approach provided more flexibility to respond to the rapidly changing context of health services implementation and evaluation. These included a sensitivity to research context, a focus on applied research, and the valuing of different forms of knowledge. We found the commonalities between pragmatism and complexity theory to be striking. We discuss the similarities between complexity theory and pragmatism, and close by revisiting our experiences putting pragmatic complexity theory into practice. ![]() We then argue for the potential of pragmatism as an epistemic foundation for the methodological pluralism currently found in complexity research. We explore the strengths and limitations of complexity theory in evaluating health service interventions, using our experiences as examples. Herein, we describe our experiences implementing and evaluating a health services innovation in the form of simulation modeling. ![]() To help make sense of this complexity, researchers are turning towards new methods and frameworks, including simulation modeling and complexity theory. This is often attributed to the complexity of the healthcare sector, characterized by intersecting biological, social and political systems spread across geographically disparate areas. ![]() The healthcare system has proved a challenging environment for innovation, especially in the area of health services management and research.
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