From Theory to Real-World Integration: Implementation Science and Beyond

Abstract

The increasing complexity and dynamicity of our society (and world of work) have meant that healthcare systems have and continue to change and consequently the state of healthcare systems continues to assume different characteristics. The causes of mortality are an excellent example of this rapid transformation: non-communicable diseases have become the leading cause of death, according to World Health Organization (WHO) data, but at the same time there are new problems emerging such as infectious diseases, like Ebola or some forms of influenza, which occur unexpectedly or without advanced warning. Many of these new diseases diffuse rapidly through the different parts of the globe due to the increasingly interconnected nature of the world. Another example of the healthcare transformation is the innovation associated with the introduction and development of advanced communication and technology systems (such as minimally invasive surgery and robotics, transplantation, automated antiblastic preparation) at all levels of care. Consequently, the social and technical dimensions of healthcare are becoming more and more complex and provide a significant challenge for all the stakeholders in the system to make sense of and ensure high quality healthcare. These stakeholders include but are not limited to patients and their families, caregivers, clinicians, managers, policymakers, regulators, and politicians. It is an inescapable truth that Humans are always going to be part of the healthcare systems, and it is these human, who by their very nature introduce variability and complexity to the system (we do not necessarily view this as a negative and this chapter will illustrate). A microlevel a central relationship in focus is that between the clinician and the patient, two human beings, making the health system a very peculiar organization compared to similarly high-risk organizations such as aviation or nuclear energy. This double human being system [1] requires significant effort (good design) in managing unpredictability through the development of personal and organization skills, such as the ability to react positively and rapidly to unexpected events and to adopt a resilient strategy for survival and advancement. In contrast to other similar industries, in terms of level of risk and system safety, healthcare settings are still plagued by numerous errors and negative events involving humans (and other elements) at various levels within the system. The emotional involvement is very high due to the exposure to social relationships daily and results in significant challenges to address both technical and non-technical issues simultaneously