Attributes of complex adaptive systems
| ATTRIBUTE | DEFINITION | PRIMARY CARE PREVENTIVE SCREENING EXAMPLES |
|---|---|---|
| Agents who learn | People can and will process information, as well as react to changes in information | Team members access knowledge translation tools to understand a conditional recommendation and then apply the knowledge in discussions with patients |
| Interconnectedness | Individuals and groups connect and interact in multiple ways, formally and informally and changing over time | Different practice staff groups (physicians, nurses, nurse practitioners, administrative staff) are involved in developing pathways toward shared decision making that respect patients’ preferences about cancer screening |
| Self-organization | Order is created in a system without explicit hierarchical direction | Nurse practitioners develop their own approach to organizing patient flow for diabetes risk assessment, which is then included in the practice’s overall preventive screening plan |
| Co-evolution | The system and the environment influence each other’s development | Over the course of a year, recognizing that the practice waiting times for doctor appointments are rising, the team pilot-tests additional monthly nurse-led group information sessions about cancer screening tests |
Adapted from Leykum et al.22