The Use of the Cynefin Framework in Healthcare

Emmery Ristvedt
4 min readMay 4, 2020


Cynefin (which is pronounced “ku-nev-in,”) is described as elements that influence our views and perceptions for reasons, we do not understand that derive from situations we have been involved with from our history.
This framework is used for problem solving by putting situations or problems in five different domains so an individual can respond accordingly. Dave Snowden created this problem-solving framework in 1999. The Cynefin Framework can improve the organization of healthcare systems. Using this method, it can conceptualize decision making and to understand new viewpoints to help leaders of organizations and departments make decisions. Cynefin Framework can make sense of our healthcare system by dividing it into different models to explore new and innovative solutions to everyday problems that arise. You can do this by putting the situation/s in one of the five described domains to understand the cause-effect relationship.

The Domains

Cynefin Framework gives a visual on systems operation. It does this by placing the situation/s in the five domains. These domains are in the columns of ordered and unordered. The domains consist of obvious, complicated, complex, chaotic, and disorder

Obvious (formerly known as simple)

This means placing a situation in the domain, there is a direct relationship between the cause and effect. This is known as best practices. Though this is known as the best, in some cases those who have dealt with the problem or situation before may not be open to new ideas or answers because it is assumed by those individuals that the previous solutions will work. To avoid this becoming an issue, all leaders should practice staying open minded and be willing to come up with new ideas.


Experimentations needed to establish a cause and effect relationship to view possible solutions in hindsight to find the “correct” solution, this is known as emergent practice. These situations are most often unpredictable. It is best to look for patterns in these situations to best assess a solution. It is important to understand that not all ideas will work and to accept that failure as a part of the learning process to come up with new ideas.


There are multiple right answers to establish a cause and effect relationship, but further investigation is needed by an expert, also known as good practice. In this, there may be multiple solutions to a situation. This problem when looking at this domain, organizational leaders may depend heavily on expert opinions, while doing so, they ignore creative solutions from others around them. To solve this, creating a team made of individuals with different qualifications or backgrounds to have different insights.


In the domain, a rapid response is required. It is meant to correct the symptoms to contain the effects of the problem, also known as novel practice. In this, individuals must act quickly to address the most emergent issues at hand and try to move the situation over to the domain of complexity. It is important when dealing with these types of situations, a risk analysis must be performed and to have a crisis plan. Make sure all situations are communicated throughout the organization or department.


This domain is located in the middle of the framework. This only applies when a situation does not belong in any of the other categories. Since this situation never falls originally under any of the other categories, it is important to gather more information on the situation to place it into a category.


When using this decision-making tool, it can be applied at all levels of an organization that needs problem or situation solving. By using this, it can give us different approaches and solutions of problems we face in healthcare every day. Implementing this problem-solving method will take time for many to understand and use properly, but once done, I believe that many situations we face can and will be solved in our future healthcare issues.

1 “Making Sense of Problems with The Cynefin Framework.” TXM Lean Solutions, September 30, 2019.

2 “Cynefin® Framework Introduction.” Cognitive Edge, 2018.

3 Midgie, JTrouw, Yolande, Mind Tools Content Team, Mind Tools Content Team, and Mind Tools Content Team. “The Cynefin Framework: Using the Most Appropriate Problem-Solving Process.” Problem-Solving Skills From Accessed May 1, 2020.