Cynefin Framework in Healthcare
What is the definition of healthcare?
The google definition is, “Health care, health-care, or healthcare is the maintenance or improvement of health via the prevention, diagnosis, treatment, recovery, or cure of disease, illness, injury, and other physical and mental impairments in people.¹ Health care is delivered by health professionals in allied health fields.”¹
Also from google, they have defined the purpose of healthcare which is, “The fundamental purpose of health care is to enhance quality of life by enhancing health. Commercial businesses focus on creating financial profit to support their valuation and remain viable. Health care must focus on creating social profit to fulfill its promise to society.”¹
Decision Making
Because of listed definition and purpose of healthcare, you could easily see why decision making is so crucial. In other words, our promise to society is to continue making the right decision. Lives literally depend on healthcare providers all the way from janitors to physician are held accountable to make the correct decisions. Healthcare is saving or improving quality of life, decisions are the biggest part but how do we work at making sure the best decision is made?
Cynefin Framework
Cynefin framework is consisted of five domains to follow in order to conclude a proper decision that is beneficial.¹ Those five domains are Simple/ Obvious, Complicated, Complex, Chaotic, Disorder/Confusion.¹ But why would this framework be beneficial towards healthcare decisions? Well that is Simple, Obvious because the Cynefin Framework is necessary so that each decision is well thought out and considered deeply before enforcing it.¹ It is one theory towards a successful healthcare system but it is well-rounded because there is not always just one way to do things.¹ If another theory works better for a specific system than it should be utilized. There is never just one way to do things. Which also leads in this system, proper decision making- what system do you use?
Simple, Obvious
This domain is based off protocols.¹ When “A” action happens, expect “B” to be the response.¹ For an example, when a healthcare provider is stuck by a dirty needle, expect testing for diseases. This domain is simple, like its name of course. When certain things happen there is a way the situation needs to be resolved.¹ That is, when it is simple in the first place.¹ Which leads us to the next domain.
Complicated
This domain is when a situation becomes complicated and deliberation is required. There is no textbook answer for this domain. It takes research, expert opinions, and outside/ unbiased looks into the complicated situation. There is no specific answer for anything when it comes to the complicated domain. When outsiders and research comes into part of the decision making, the answer will be different every time. But it will have the necessary backup to save the outcome. With outside sources this may seem like it could be the chaotic domain- but that is not the case.
Chaotic
The Chaotic domain is unclear all around.¹ Chaotic from the beginning to the end- unpredictable and mainly decisions made on the spot and quickly.¹The chaotic domain doesn’t fall far from the original definition of the word.¹ There is no simple approach when it comes to this domain so at all cost, maybe avoid this approach.¹
Disorder, Confusion
This is the domain where it cannot point to one specific domain from the four previously listed.¹ Rather than just one domain being the answer, the situation will benefit mostly from being broken down into parts and choosing a domain for each part.¹ This way, an answer can be correlated and will be well rounded towards making the correct decision.¹ When it comes to the point when the chaotic approach is to be considered, to the best you can to have the disorder/confusion approach to overcome that decision.¹
Decision making while adapting to behavior
In all or most healthcare systems, protocols are created but hard to enforce in certain circumstances because no event is ever the same. This is when we bring behavior in to affect decision making but how do we adapt. Protocol should always be enforced in simple domain situations regardless of the action that may be received. Behavior can impact a lot of decisions but protocols should be built to be simple and to the point. Decision making shouldn’t be changing when it comes to protocol. Yes, majority of situations are never the exact same but as protocols are created, they should be easily followed. Decision making during chaotic situations can lead to drastic responses. They may not always be right so its important that these decision are enforced by the correct people that are in the right state of minds. Behavior of the decision can impact decisions so those in charge need to be able to adapt and act responsibly- remember and enforce the protocol that these domains have developed.
Applying to Healthcare
Using this framework can easily impact the healthcare systems. Every decision is so crucial to the system that they need to be thought out, even in chaotic situations. This framework applies to all involved in the healthcare field whether its the janitor, the assistants, the healthcare provider, or the CEO. Each role played into the system are highly important. One will always find a way to effect the other. The time to apply this correctly is all the time! Every decision made will effect everyone. The time that a decision isn’t correctly made, other domains become involved rather than the simple and obvious one.
Conclusion
Cynefin framework needs to be considered while making Healthcare decisions.¹ Every decision is crucial especially when beginning a healthcare system. The cynefin framework can help create wonderful protocols with the five domains provided and outlook on things.¹
References
- Anonymous. “Cynefin Framework” Wikipedia April 26, 2020, en.wikipedia.org/wiki/Cynefin_framework
- Oxford. “Healthcare Definition” Google Search Engine April 26, 2020, https://www.google.com/search?q=healthcare+definition&oq=Healthcare+def&aqs=chrome.1.69i57j0l3j46j0l3.9149j0j7&sourceid=chrome&ie=UTF-8https://en.wikipedia.org/wiki/Cynefin_framework