Anticipating the unexpected: Simulating a health care system showing counterintuitive behavior

Abstract

Complex systems often exhibit counterintuitive behavior. They confront us with the unexpected, and the idea of anticipating the unexpected is a challenge to commonsense. The purpose of this contribution is to demonstrate the power of modeling and simulation in discovering the structures that generate counterintuitive behavior in and of organizations. The research question here is if and how these generative “mechanisms” that produce unexpected behavior can be ascertained. If this can be achieved, then unexpected patterns of behavior become amenable to being anticipated as contingencies. If not, system behavior cannot be anticipated, and it remains in the dark. To answer our research question, we revert to a case study of a health-care system that showed unexpected behavior.