Complexity dynamics: managerialism and undesirable emergence in healthcare organisations

Carlisle, Ysanne (2011). Complexity dynamics: managerialism and undesirable emergence in healthcare organisations. Journal of Medical Marketing, 11(4) pp. 284–293.

DOI: https://doi.org/10.1177/1745790411424972

Abstract

Managerialist approaches to change have been applied to many public sector organizations including health care, but little attention has been given to how complexity dynamics can lead to undesirable emergences in such contexts to the detriment of motivation, commitment, performance and long term organizational adaptiveness. This article describes complexity dynamics and explains why and how they can lead to undesirable and unethical emergences in top-down driven change programmes. In particular it considers the problem of toxic workplace cultures, a phenomenon which has flourished in some health care environments. Complexity dynamics can explain why such cultures emerge. Complexity theory suggests alternative management approaches which can deliver adaptive change without the human and organizational costs of such undesirable side-effects.

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