{"id":1436,"date":"2017-04-18T08:35:19","date_gmt":"2017-04-18T13:35:19","guid":{"rendered":"http:\/\/crmcspl-blog.recherche.usherbrooke.ca\/?p=1436"},"modified":"2017-04-18T08:35:19","modified_gmt":"2017-04-18T13:35:19","slug":"multimorbidity-as-a-complex-systems-phenomenon-a-series-exploring-this-perspective-from-the-journal-of-evaluation-in-clinical-practice","status":"publish","type":"post","link":"https:\/\/crmcspl-blog.recherche.usherbrooke.ca\/?p=1436","title":{"rendered":"Multimorbidity as a complex systems phenomenon: a series exploring this perspective from the Journal of Evaluation in Clinical Practice"},"content":{"rendered":"<p><a class=\"twitter-share-button\" href=\"https:\/\/twitter.com\/share\">Tweet<\/a> <script type=\"text\/javascript\">\/\/ <![CDATA[\n!function(d,s,id){var js,fjs=d.getElementsByTagName(s)[0],p=\/^http:\/.test(d.location)?'http':'https';if(!d.getElementById(id)){js=d.createElement(s);js.id=id;js.src=p+':\/\/platform.twitter.com\/widgets.js';fjs.parentNode.insertBefore(js,fjs);}}(document, 'script', 'twitter-wjs');\n\/\/ ]]><\/script><\/p>\n<div id=\"_mcePaste\">By Ren\u00e9 Melis<\/div>\n<div><a href=\"https:\/\/crmcspl-blog.recherche.usherbrooke.ca\/wp-content\/uploads\/Ren\u00e9-Melis.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-1438\" title=\"Ren\u00e9 Melis\" src=\"https:\/\/crmcspl-blog.recherche.usherbrooke.ca\/wp-content\/uploads\/Ren\u00e9-Melis.jpg\" alt=\"\" width=\"106\" height=\"143\" \/><\/a><\/div>\n<div id=\"_mcePaste\">Multimorbidity is one of public health and healthcare\u2019s top priorities. Yet despite this, healthcare continues to struggle to provide solutions to deal with multimorbidity in healthcare that work. It is recognized that our healthcare systems \u2013 due to their focus on the acute phase of single diseases \u2013 are not well positioned to deal with multimorbidity. Unfortunately, our dealings with changing the system do not easily translate into successes: there are so many stakeholders involved and multimorbidity is interconnected with a huge number of aspects of life and society. Where to begin? Our multimorbidity challenge has all the characteristics of a \u201cwicked problem\u201d: a societal problem that is so complex that is seems difficult or even impossible to solve. In the most recent Complexity Forum of the Journal of Evaluation in Clinical Practice a series of articles explore multimorbidity and how we should shape our healthcare from the perspective of complex systems thinking (<a href=\"http:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jep.12723\/full\" target=\"_blank\">http:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jep.12723\/full<\/a>). Rather than a stable, albeit complicated, arrangement of individual elements with predictable results following from inputs in a linear way, a complex system is a dynamic, ecological system in which outcomes seem to emerge quite unpredictably out of the interaction of the starting conditioning. For the reasons mentioned above, this \u201ccomplexity\u201d approach might fit very well to the multimorbidity challenge.<\/div>\n<div id=\"_mcePaste\">The series starts with an introductory paper of Dr Joachim Sturmberg and colleagues. Sturmberg, who is a general practitioner as well as a longstanding expert on complexity in health (care systems), together with his colleagues explore how taking multimorbidity as a complexity phenomenon might shape integrated, personalized care differently. Following, this work is commented on by several authors from different perspectives. Being a \u201cwicked problem\u201d neither of these works provide a miracle potion to solve our multimorbidity issue, however, the richness of the perspectives included does shed new light. The famous Cynefin framework (<a href=\"https:\/\/hbr.org\/2007\/11\/a-leaders-framework-for-decision-making\" target=\"_blank\">https:\/\/hbr.org\/2007\/11\/a-leaders-framework-for-decision-making<\/a>) for management problems tells us that managing complex problems \u2013 and multimorbidity sure is! \u2013 has to begin with uncovering the \u201cunknown unknowns\u201d and we need to \u201cprobe first, then sense, and then respond\u201d. The latter is what this series hopefully has to offer to the multimorbidity community.<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Tweet By Ren\u00e9 Melis Multimorbidity is one of public health and healthcare\u2019s top priorities. Yet despite this, healthcare continues to struggle to provide solutions to deal with multimorbidity in healthcare that work. It is recognized that our healthcare systems \u2013 due to their focus on the acute phase of single diseases \u2013 are not well <a href=\"https:\/\/crmcspl-blog.recherche.usherbrooke.ca\/?p=1436\"> read more <span class=\"meta-nav\">&raquo;<\/span><\/a><\/p>\n","protected":false},"author":61,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_s2mail":"yes","footnotes":""},"categories":[6],"tags":[],"class_list":["post-1436","post","type-post","status-publish","format-standard","hentry","category-theory-concept-measure"],"_links":{"self":[{"href":"https:\/\/crmcspl-blog.recherche.usherbrooke.ca\/index.php?rest_route=\/wp\/v2\/posts\/1436","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/crmcspl-blog.recherche.usherbrooke.ca\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/crmcspl-blog.recherche.usherbrooke.ca\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/crmcspl-blog.recherche.usherbrooke.ca\/index.php?rest_route=\/wp\/v2\/users\/61"}],"replies":[{"embeddable":true,"href":"https:\/\/crmcspl-blog.recherche.usherbrooke.ca\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1436"}],"version-history":[{"count":4,"href":"https:\/\/crmcspl-blog.recherche.usherbrooke.ca\/index.php?rest_route=\/wp\/v2\/posts\/1436\/revisions"}],"predecessor-version":[{"id":1441,"href":"https:\/\/crmcspl-blog.recherche.usherbrooke.ca\/index.php?rest_route=\/wp\/v2\/posts\/1436\/revisions\/1441"}],"wp:attachment":[{"href":"https:\/\/crmcspl-blog.recherche.usherbrooke.ca\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1436"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/crmcspl-blog.recherche.usherbrooke.ca\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1436"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/crmcspl-blog.recherche.usherbrooke.ca\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1436"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}