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Healthcare systems are increasingly recognised as complex, in which a range of non-linear and emergent behaviours occur. China’s healthcare system is no exception. The hugeness of China, and the variation in conditions in different jurisdictions present very substantial challenges to reformers, and militate against adopting one-size-fits-all policy solutions. As a consequence, approaches to change management in China have frequently emphasised the importance of sub-national experimentation,...
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While agile approaches can be extremely effective at a project level, they can impose significant complexity and a need for adaptiveness at the project portfolio level. While this has proven to be highly problematic, there is little research on how to manage a set of agile projects at the project portfolio level. What limited research that does exist often assumes that portfolio-level agility can be achieved by simply scaling project level agile approaches such as Scrum. This study uses a...
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There are increasing criticisms of dominant models for scaling up health systems in developing countries and a recognition that approaches are needed that better take into account the complexity of health interventions. Since Reform and Opening in the late 1970s, Chinese government has managed complex, rapid and intersecting reforms across many policy areas. As with reforms in other policy areas, reform of the health system has been through a process of trial and error. There is increasing...
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Rigour can be reductionist or inclusive. To learn about and understand conditions of complexity, emergence, nonlinearity and unpredictability, the inclusive rigour of mixed methods has been a step in the right direction. From analysis of mixed methods and participatory approaches and methods, this article postulates canons for inclusive rigour for research and evaluation for complexity: eclectic methodological pluralism; improvisation and innovation; adaptive iteration; triangulation; plural...
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The challenges currently facing resource managers are large-scale and complex, and demand new approaches to balance development and conservation goals. One approach that shows considerable promise for addressing these challenges is adaptive management, which by now is broadly seen as a natural, intuitive, and potentially effective way to address decision-making in the face of uncertainties. Yet the concept of adaptive management continues to evolve, and its record of success remains limited....
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Today's environments of increasing business change require software development methodologies that are more adaptable. This article examines how complex adaptive systems (CAS) theory can be used to increase our understanding of how agile software development practices can be used to develop this capability. A mapping of agile practices to CAS principles and three dimensions (product, process, and people) results in several recommendations for “best practices” in systems development.
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