SU_NSG6601_W4_A2_Sornoza_S

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1 Week 4 Project Sharon Sornoza South University NSG6601 Managing Complex Healthcare Systems CP01 Dr. Cheryl DeHart November 20, 2023

2 Week 4 Project Leading and managing in an ever-changing environment such as healthcare requires flexibility and resiliency. Complexity science allows leaders to be fluid throughout change while maintaining the ability to lead. Complexity theory, inspired by the works of Prigogine’s dissipative structures in non-equilibrium thermodynamics, Lorenz’s butterfly effect theory, and the Chaos theory by Lamarck, came to fruition in the mid-late 20 th century (Park, 2017). Complexity science does not have one specific definition. Instead, it describes how organizations, with their many pieces, can work together effectively. It is called “complex” because of the diverse, interdependent, and autonomous parts involved (Goulielmos, 2005). As stated by Goulielmos (2005), “Complexity is also the quantity of information needed to describe a system and that theory that processes with a large number of seemingly independent agents that can spontaneously organize themselves into coherent system”. This theory is very useful in the workforce due to its fluidity principles and the adaptation one must take to meet the goals of the organization. “Leaders can use error, as a constituent of change, to evaluate a change process and determine the best activities for advancing the system and preventing the same mistakes or flaws from recurring” (Albert et al., 2020, p. 74). Examples of utilization of complexity theory are seen with our problem with the Hill-Rom call system and how to improve our response times. While you might think it depends on answering the call light at the nurse station, it relies on so much more. When a patient pushes on the call light, it activates the call system at the nurse station to alert

3 the staff that a patient is in need. The call is answered and then routed to the correct staff member: a nurse/certified nurse assistant (CNA). Once the staff member is alerted, they go to the patient's room to see what the patient needs and assist them. If they only do that it does not count as being responsive. The staff member must turn off the call light in the room to show that the call is being addressed, otherwise, it appears the patient’s call has not been answered. In this example, we have technology and human behavior that affect the outcome of our measurement. When looking at how to improve, we realized that the time stamp depended on answering the call light at the nurse station and room and the alert you received on your phone. Once we realized all three factors had to be addressed our call times drastically improved. I chose this theory for my issue because I felt it applied since the system, we were looking at involved different factors. The ability to learn how the system worked and demonstrate responsiveness ultimately showed that our team responded promptly to patient needs. How do we get data to support how long the nurses responded to the call lights? Our database has a tool called Hill-Rom 1- HCA Orange Park. When you access this tool, many reports can be run, each measuring different parameters of the call system, Bed status report, Nurse call summary report, etc. By running a report on the nurse call summary, I can determine how long my team takes to respond to patient call lights. I can specify what types of calls are being measured. For example, I can measure response times for bathroom requests, pain medication requests, ice requests, bed exit alarms, chair alarms, etc. I will review the data gathered with my team, the expectation is that this will increase their knowledge of what is being measured, what the data is showing, and how long it is taking to respond to patient calls and therefore will “accelerate response times,

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4 address patient satisfaction issues, and understand the technology” ( Reporting & Analytics , n.d., Overview section) being used. I will get a daily report showing me the previous day's data. I will then be able to see by the specific nurse, how long it takes them to respond and can address that specific team member, explore the barriers they may face, and come up with a solution to how they can improve. In conclusion, complexity theory emerged in the mid-late 20 th century, and it is helpful as its applicability is to the organization, no matter what area or department is involved. The value of this theory is that just as organizations can be affected by different changes, being able to adapt to the changes to continue to meet the organization's goals is still achieved. Applying this theory to the Hill-Rom call system allowed my team to go from an average response time of over 30 minutes to just under 4 minutes. I can run reports daily to show my team's progress and identify barriers that could affect how long it takes to respond to patient needs.

5 References Albert, N. M., Pappas, S., Porter-O'Grady, T., & Malloch, K. (2020). Quantum Leadership (6th ed.). https://digitalbookshelf.southuniversity.edu/books/9781284229066 Goulielmos, A. M. (2005). Complexity theory: A science where historical accidents matter. Disaster Prevention and Management: An International Journal , 14 (4), 533–547. https://doi.org/10.1108/09653560510618366 Park, J. (2017, October 8). An introduction to complexity theory . Medium. https://medium.com/@junp01/an-introduction-to-complexity-theory- 3c20695725f8#:~:text=Complexity%20Theory%20and%20its%20related,i.e.%20the %20butterfly%20effect)%2C%20Chaos Reporting & analytics . (n.d.). Hill-Rom. https://www.hillrom.com/en/products/care-comms- reporting/ Situational leadership: A guide to coaching employee performance . (n.d.). https://mep.purdue.edu/news-folder/situational-leadership-a-guide-to-coaching- employee-performance/

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