Primary author:Zhangzhang Li

Complex systems adaptive theory is derived from complex systems theory. It not only consists of variable components, but also is a dynamic network between behavior changes and experience. Although the applications of complex systems adaptive theory are extensive, the utilization in public health is among health organization policy area, the health system and patient’s relationship, the amelioration of ecological environment, and the intervention of disease by social behavior changes (Lanham et al., 2009). Although different definitions have been given to complex systems adaptive theory, the major concepts of CAS are five key components. The key components are the following: (a) diverse agents, (b) nonlinear interdependencies, (c) self-organization, (d) emergence, and (e) coevolution (McDaniel, Lanham, & Anderson, 2009).
McDaniel’s study mentioned that the Health Care Organizations were typical complex adaptive systems. Because Health Care System is complex and dynamic. Despite device manufacturers in health region, there are variable agents, such as pharmaceutical companies, health care providers, health planners, and patients. Although in the universal scope no healthcare system can be labeled effective, the application of complex adaptive systems can enhance the effectiveness of the health care system (The Health Care Blog., 2010). However, the main issue in this area for researchers is to comprehend the nonlinear interdependencies among diverse agents (McDaniel, Lanham, & Anderson, 2009). Although there are five key components in CAS, one of the most essential constructs is diverse agents, when CAS is applied in the Health Care Organizations’ field. Other constructs are oriented by diverse agents for researchers to prompt the whole system (Hong & Page, 2001). Health care providers, such as hospital and health institutions, have significant environment influences on people’s behaviors, because these providers are based on society (Diez-Roux, 2000). In health care organization’s area, diverse agents mainly include health care providers, patients and people who are in the sub-health condition. As a result, using complex adaptive systems can provide a theoretical tool to establish social networks to study the internal and external relationships among diverse agents (Thygeson, Morrissey, & Ulstad, 2010).
When internal relationships among diverse agents are considered in health care Organizations’ area, the relationships among health care instituions or companies are most crucial. Because diverse agents are oriented, interdependencies, self-organization, emergencies and coevlution can all focun on social networks. In order to comprehend the complex adaptive systems in health care organizations, a great number of nursing and healthcare researchers and leaders study the utilization of the complex adaptive systems (Brown, 2006). The reciprocal networks can be established by using the complex adaptive systems. Such networks must combine with health care organizations and deal with the relationship among health care institutions (Burns, 2001). For example, the communication of every health care provider cannot be independent, but should be concentrated on self-organization of patients and divert patients’ health information and care responsibility among health care providers (Haffner & Zepter, 2003). Moreover, to address this issue effectively, interdependence between every health care providers is the most crucial factor by applying the complex adaptive systems (Benham-Hutchins & Clancy, 2010). Another issue in this aspect is using complex adaptive systems to decide health policy. Not all health institutions and related companies have a great interested in enhancing the whole health care systems’ efficiency. For example, some hospitals would like to establish insurance system and employment system, arrange products and facilities, and provide warranties. These methods can definitely improve the efficiency. However, some of the pharmaceutical companies, health planners and manufacturers may contribute less in this aspect (The Health Care Blog., 2010).
The most significant issue of external relationships among diverse agents is the relationship between doctors and patients. Although a great number of financial resources have been spent on health care systems, the enhancement of efficiency is not disproportionate with the cost of money (Grove, 2005). The reason of this problem is that hospitals and health institutions are not able to positively influence the relationships of doctors and patients, and of society, behaviors and environment and patients’ health (Barer, Evans, Holt, & Morrison, 1994). Another problem is some doctors are not satisfied with their work, while some patients cannot afford the cost of treatment (Shanafelt, Sloan, & Habermann, 2003). According to the study of Heifetz, there are two parts which can contribute to solve the problems above. Firstly, it is important to identify what kind of work that doctors can do for patients and what kind of adaptive work only patients can do for themselves. For example, quitting smoking and taking regular effective respiration can enhance the condition of lung cancer patients who are after surgery. Such adaptive work must be acknowledged to patients, but whether patients can regular do it is not directly determined by doctors. Another part is that some adaptive policies should help doctors to improve adaptive health work. For example, some policies mention that how many facilities related to rehabilitation a hospital should have (Heifetz & Laurie, 1997). Another study also illustrated the importance of enhancing health care systems efficiency by complex adaptive systems. In Thygeson’s study, he mentioned that one of the diverse agent—patients faced increasing technical and adaptive health challenges. Although self-organization and self-adaptive work by patients themselves are essential, the approach of doctors applying adaptive leadership and practice medicine is the most significant issue (Thygeson, et al., 2010).
In conclusion, the requirements of the health care organizations to solve these problems need to be based on the complex adaptive systems. The use of the complex adaptive systems cannot be confined just in health care institutions and providers, but also should link to the financial and social resources, and cultural and human personalities to address the problems. Therefore, the policies, methods and social networks based on complex adaptive systems can make the whole health care systems more effective and make the relationship between patients and doctors more sustainable (Thygeson, et al., 2010).

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