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Benham-Hutchins, M. & Clancy ,T. R. (2010). Managing organizational complexity. social networks as embedded complex adaptive systems. The Journal of Nursing Administration, 40(9), 352. The authors of this article, both of whom are faculty at Texas Women's University School of Nursing, identify social network analysis (SNA) as a tool that is complementary to the theatrical underpinnings of complexity science. They assert that interprofessional communication is influenced not only by two individuals in communication with one another, but also by the social networks of which each is a part. The authors focus on the non-linear processes involved in communication between professionals and units when transferring a patient. Incorporating the theories of complexity sciences into research on communication networks could increase the applicability to healthcare organizations. Recognizing the complex nature and influence of social networks within an organization will assist the nurse leaders in our case study formulate solutions for the non-linear challenges they face.

I thought the dynamic figures in this article were telling. However in the patient centered environment, it was odd to me that very little attention was paid to the patient in the midst of this complex transfer especially in Figure 3. I think we all must be aware that the true definition of a CAS is the ability to learn and adapt based on environmental cues, feedback or events. We often have complex systems but not complex adaptive systems.

This article, written by Dr. Thomas Clancy, a Clinical Professor at the University of Minnesota's School of Nursing discusses complexities within healthcare systems (specifically hospitals) as it relates to directing. Using a complex systems perspective, the author suggests innovative methods in directing high functioning teams. In congruence with characteristics and models of complex adaptive systems as presented by the Institute of Healthcare Improvement Modules and Dr. Bonnie Jennings (2013), the author gives a clear depiction of how nurses function within these systems. Rapid cognition and structured spontaneity are two skills the author suggests are crucial for nurse administrators to develop among teams within complex environments (high potentials). This article suggests the development of these skills will enable "nurses to make independent decisions within limits defined by policy" (p. 62). In other words, decision making would be less autocratic and more participatory which would enable the director to higher levels of directing. Data from this series of articles are relevant to today's practice and may be particularly resources for healthcare leaders as they redesign and implement innovatieve techniques within macro, mess, or microsystems. Clancy ,T. R. (2008). Managing organizational complexity. Directing: A complex systems perspective. The Journal of Nursing Administration, 38(2), 61-63.

A great article and what an interesting contribution to nursing education with use of simulation to develop the rapid cognition and structured spontaneity.

This article is a useful example of a complex adaptive system. From a personal business perspective, the author discusses several reasons as to why the implementation of The Affordable Care Act has been challenging. This example of a macro system exhibits the need for multiple aspects within the system to work in collaboration with key stakeholders including government parties, insurance companies, business and individuals. Seib, G. (2013). Why new health law is so complicated. The Wall Street Journal. Retrieved from http://online.wsj.com/articles/SB10001424052702303755504579205800232065892

This article also provides insight into how the macro, micro and meso systems become so intertwined in such a large undertaking and how its implementation philosophically is even more complex as it advances both parties polar opposite desires of privatization and unification of health care delivery. Great short read!