A preliminary investigation of complex adaptive systems as a model for explaining organisational change caused by the introduction of health information systems

This paper documents the preliminary development of a framework for evaluating organisational change processes during the implementation of an electronic nursing documentation system in residential aged care facilities. It starts with a brief outline of organisational change processes. This is followed by a more detailed exposition of the principles underlying complex adaptive systems (CAS) theory, where we explain how mathematical concepts can be used to illuminate qualitative research approaches. Finally we present some preliminary findings on the facilitators and barriers for the introduction of the electronic documentation system, explained with reference to the CAS theory, based on analysis of interviews with care staff members in a residential aged care facility. While there are clear benefits from electronic nursing documentation, we also identified significant risks, and possible unintended consequences, both positive and negative.