HealthcarePapers 3(3) January 2003 : 29-35.doi:10.12927/hcpap..17127

Evidence-Based Decision-Making in Healthcare: Exploring the Issues through the Lens of Complex, Adaptive Systems Theory

Ronald R. Lindstrom


Browman, Snider and Ellis have articulated several reasons as to why and how manager s should address the implementation of evidence - based decision-making (EBDM) in healthcare.While their observations are acknowledged to be from the unique perspective of an oncology setting, this is a timely and welcome lead article with significance in other settings . The authors invite opinions on transferability, thus forming the basis of this commentary. In response, this commentary offers a number of supportive and differing views. Complex , adaptive systems (CAS) theory is first addressed as an appropriate lens to reframe our conceptualization of the health system. Then , in contrast to negotiation, dialogue through participatory planning and decision-making is introduced. Evidence - based decision-making (EBDM) and knowledge translation (KT) are expanded upon in the context of CAS and participatory environments. Finally, concrete suggestions are offered on how to structure multiple-stakeholder involvement in the decision-making process, including the growing role of consumers in the new complex, adaptive systems reality of healthcare.



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