Integrated management for long-term performance improvement in complex systems

This is the authors' abstract. We don't add key points for this paper.

Considerable research has emphasized the difficulty of achieving large-scale change and performance improvement in complex systems. Neither of two standard theoretical approaches—modularity theory and complex products and systems theory—have explained how management can drive sustained progress. We address this gap by examining how Varian Medical internalized a previously decentralized cancer radiation therapy ecosystem and over multiple decades upgraded patient outcomes and financial performance dramatically. From Varian’s experience, we derive a new innovation-driven hierarchical approach and contrast it with other approaches to complex systems integration.