Table 1 Complexity Analysis Framework for QI in Health Care
Situation | Problem definition | Response | Primary locus of responsibility for the work | Kind of work | Decision-making process |
|---|---|---|---|---|---|
Simple | Clear Ordered universe with clear causality | Clear Answers are self-evident, undisputed, and can be determined based on facts and evidence | Manager | Technical Often a question of solution implementation | Sense Categorize Respond Responses are developed through the categorization of existing facts |
Complicated | Clear Ordered universe with clear causality, though not perceived by everyone | Requires learning May contain multiple correct answers; involves analysis, expert consultations, and the creation of working groups. Requires coordination and collaboration, time consuming, often with a tradeoff between the “best” answer and making a decision, but complete data becomes available … eventually | Manager and staff | Technical and adaptive Often a question of solution implementation and evolution of new responses through experimentation and discovery | Sense Analyze Respond Responses are developed based on analyzing several options |
Complex | Requires learning Unordered universe without clear causality | Requires learning No right answers exist – decisions often based on incomplete data | Staff > manager | Adaptive Often a question of evolution of new responses through experimentation and discovery | Probe Sense Respond Responses are developed by letting them emerge by testing different ideas |
Chaotic | Requires action to create stability in an unordered universe | Requires action to stabilize in order to gain perspective and enable diagnosis – no point to search for right answers | Manager | Technical | Act Sense Respond By first acting, order can be established so that a response can be developed |