Increased focus on complexity for quality improvement in care

​Increasing personalization of care, more patients with multiple diseases, different care professions that need to cooperate. These are some of the challenges that make care increasingly complex. This complexity must be described and understood. In her doctoral thesis, Sara Dahlin has explored the usefulness of methods that describe the complexity of care, in order to support the quality improvement efforts in health and social care.
​“The main challenge for quality improvement I focus on is the high and increasing complexity in care today, arising from different sources such as an increasing personalization of care and an older population suffering from multiple diseases. Practitioners, such as medical doctors, need to understand the complexity of the provided care to take appropriate actions and thereby improve care. Failure to understand and correctly handle the complexity may lead to wrong decisions resulting in inefficiencies and even harm.”
The understanding is supported by the use of different methods both during planning and evaluation of care. However, many methods for quality development today describe a much smaller part of the complexity, so new methods describing more of the complexity is needed. There is also a possibility to expand the use of existing methods for quality improvement describing complexity.
“I address this challenge by exploring both new methods and new use of a current method describing care complexity in my research, identifying their usefulness for supporting quality improvement. More specifically, I have together with practitioners explored two methods visualizing patient process complexity, and another method where a model is used for planning care in such a way that the care complexity on the organisational level is described to support quality improvement.”

What were the main findings of your research?

“My main finding is that the explored methods have additional and complementary usefulness compared to current quality improvement methods for both planning and evaluation of care, and for example to drive motivation and patient focus in the organisation. As different method properties lead to different benefits, one main conclusion is that there is a need to carefully choose methods for each specific context. This is not always the case today, but rather, a few methods are often emphasized in quality improvement.”
“Additionally, the description of care complexity was generally shown useful for the practitioners in at least two ways. First, by objectively presenting the complexity, the stakeholders were supported in their discussions, and second, the stakeholders not only learned about their specific data but also seemed to develop a deeper understanding of quality improvement through these descriptions. These may lead to positive outcomes such as increased motivation or patient focus for both for stakeholders and the care organisation.”

What do you hope your research will lead to?

“I hope that the focus on using relevant methods for each context in quality improvement will increase; to use existing methods when appropriate and to explore and use new methods, when they are better suited. I also hope that my research makes impact and the methods I have explored gain increased use. Ultimately, I hope my research will lead to improved care.” 
Text compilation: Daniel Karlsson
More about Sara Dahlin

Published: Tue 10 Dec 2019.