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Complexity and Change in Nurse Workflows

Vardaman, James M. PhD; Cornell, Paul T. PhD; Clancy, Thomas R. PhD, MBA, RN

Journal of Nursing Administration: February 2012 - Volume 42 - Issue 2 - p 78–82
doi: 10.1097/NNA.0b013e3182433677
Departments: Managing Organizational Complexity

As systems evolve over time, their natural tendency is to become increasingly more complex. Studies in the field of complex systems have generated new perspectives on management in social organizations such as hospitals. Much of this research appears as a natural extension of the cross-disciplinary field of systems theory. This is the 20th in a series of articles applying complex systems science to the traditional management concepts of planning, organizing, directing, coordinating, and controlling. In this article, the authors discuss how nurse workflow is characteristic of complex adaptive systems and the need for caution when selecting a performance improvement method.

Author Affiliations: Assistant Professor (Dr Vardaman), Department of Management, Mississippi State University; President (Cornell), Healthcare Practice Transformation, LLC, Dallas, Texas; Clinical Professor and Assistant Dean (Dr Clancy), School of Nursing, University of Minnesota, Minneapolis.

The authors declare no conflict of interest.

Correspondence: Dr Clancy, School of Nursing, University of Minnesota, 5-140 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455 (

© 2012 Lippincott Williams & Wilkins, Inc.