Aug 30, 2007

Organizational interventions employing principles of complexity science have improved outcomes for patients with Type II diabetes

Implementation Science : IS
Luci K LeykumReuben R McDaniel

Abstract

Despite the development of several models of care delivery for patients with chronic illness, consistent improvements in outcomes have not been achieved. These inconsistent results may be less related to the content of the models themselves, but to their underlying conceptualization of clinical settings as linear, predictable systems. The science of complex adaptive systems (CAS), suggests that clinical settings are non-linear, and increasingly has been used as a framework for describing and understanding clinical systems. The purpose of this study is to broaden the conceptualization by examining the relationship between interventions that leverage CAS characteristics in intervention design and implementation, and effectiveness of reported outcomes for patients with Type II diabetes. We conducted a systematic review of the literature on organizational interventions to improve care of Type II diabetes. For each study we recorded measured process and clinical outcomes of diabetic patients. Two independent reviewers gave each study a score that reflected whether organizational interventions reflected one or more characteristics of a complex adaptive system. The effectiveness of the intervention was assessed by standardizing the sc...Continue Reading

Mentioned in this Paper

Glycated Hemoglobin TEST
Diabetes Mellitus, Non-Insulin-Dependent
Chronic Disease
Glucohemoglobin Measurement
Clinical Trial [Publication Type]
Therapeutic Aspects
Glycosylated hemoglobin A
Fisher's Exact Test
Adherence (Attribute)

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