A healthcare delivery organization is a complex adaptive system, meaning that interactions and relationships of different components affect and shape the system. With that being said, the care that is delivered varies between situations. The Agile Implementation book mentions variability in care delivery specifically referencing clinical care. There are three main sources of variation: clinical decision, production line, and patient response.

Clinical decisions often require the input of several providers with varied experiences, knowledge and practices. An initial provider may make a recommendation based on guidelines they practice and experiences with similar clients, but these recommendations may differ from a provider down the road who may have different experiences. After clinical decisions are made, they are translated into patient care. How fast this care is delivered is based on the provider, the resources and/or processes that will be utilized to ensure quality of care. In addition, the variability in staff aids in the delivery of care.

The last source of variation is the patient response to the care that was delivered. Patient response will vary from person to person due to different demographics, attitudes, and characteristics. Although it is near impossible to control a patient’s response, it is possible to influence or nudge individuals to exhibit an expected behavior. Due to the vast variability in care delivery, a Five Factor Framework has been established. This framework has been utilized to implement successful and sustainable healthcare solutions.

To learn more about the Five Factor Framework and how it relates to variability in care delivery, please reference the Agile Implementation book by Malaz Boustani, Jose Azar and Craig A. Solid. You can reserve a copy at http://www.hii.iu.edu/.