• Bruce Ramshaw.
• Haslam College of Business, University of Tennessee, Knoxville, Tennessee, USA.
• J Eval Clin Pract. 2020 Oct 1; 26 (5): 1559-1563.

Aims And ObjectivesTo describe the application of systems and complexity science principles to real patient care.RationaleOur current global health care system is not sustainable. It is structured based on the principles of reductionist science, which was discovered and developed over the past 400 to 600 years. Because of increasing pace of change and increasing complexity in our world, we have increased fragmentation in our health care system leading to more harm and waste. Over 100 years ago, the principles of systems, or complexity, science were discovered, first in the discipline of physics. These principles accommodate the constant change and biologic variability in our world. While reductionist principles would be applicable in a static, mechanical world where parts of the system could be isolated, this does not exist in the real biologic world.MethodsFor the past decade, our abdominal wall hernia team has been applying the principles of systems science to real patient care. Some of the tools we have applied include continuous quality improvement for whole hernia patient processes and non-linear analytical tools to gain insight to improve value-based outcomes. Until we learn to apply and scale these principles across our whole global health care system, we will continue to suffer the consequences of our current unsustainable system.ResultsWe have learned that the application of systems and complexity science to real patient care can lead to lower costs and better outcomes in the context of patients with complex hernia problems. However, these concepts have not yet been adopted in our global health care system.ConclusionApplying the principles of systems and complexity science to our global health care system has the potential to lower costs and improve patient outcomes for any patient care process to which it is applied.© 2020 John Wiley & Sons, Ltd.

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