The demise of linearity in managing health services: a call for post normal health care

The emerging science of complex adaptive systems offers a complementary perspective on organisational analysis and is already finding an application within health care. The emphasis moves away from the features of normal science (analysis, prediction and control) to focus instead on the configuration of relationships among the system's components and an understanding of what creates patterns of order and behaviour among them. The important features are connectivity, recursive feedback, diversity and the existence of self-ordering rules that give systems the capacity to emerge to new patterns of order. This paper describes some of these complexity insights and their application to health care delivery and development.