Complex systems, complex practice, complex outcomes: A call for the development of complexity-informed implementation models (CIIM) for traditional, complementary, and integrative medicine.

Abstract

Introduction: Implementation science is the vehicle for ensuring that research evidence informs and shapes clinical practice. However, implementation models structured along linear and mechanistic lines are not necessarily aligned with the complexity of clinical practice. In this article we explore the development and value of a complexity informed implementation model primarily for use in traditional, complementary, and integrative medicine. Discussion: Conventional linear mechanistic models of knowledge translation may be insufficient to address the needs of real-life clinical practice. Existing implementation models may pose particular challenges for use in traditional, integrative, and complementary systems of medicine due to their holistic orientation and perspective of human organisms as whole complex systems nested within other complex systems. This paper discusses how a complexity informed implementation model, non-linear in nature and founded on iterative processes, may better reflect the complex nature of the traditional, integrative, and complementary medicine clinical encounter and patient as a complex adaptive system. Conclusion: The emergence of complexity science provides an opportunity to re-imagine implementation models and processes to support the translation of evidence into traditional, complementary, and integrative systems of medicine. We propose a complexity-informed implementation model to better meet the complex needs of real-life clinical practice.