The myriad layers of social, political, economic, and climate change are thrusting upon us new ways to learn, to live and to do both with complexity.
These are days where even the most unique phrases developed for them seem insufficient. Entanglements, confusion, and uncertainty are all words that are being used describe what the world is experiencing and witnessing in 2026. At least, those are the ones that aren’t expletives.
I was thinking back to this time six years ago when much of the world was holed up at home, watching the news feeds filled with stories of tense and exhausted healthcare workers, overworked public health officials (many of whom became household names), and confused and fearful politicians.
Times Like These: Lessons from Complexity
Aside from the cleverly recorded and catchy remake of Foo Fighters’ Times Like These, the phrase is worthy of consideration from the perspective of complexity.
Complexity is a set of conditions where there are many relationships, actions, and dynamics at play that make it difficult or impossible to layer prediction and control in a meaningful way. This is how living systems function. You can create the conditions that encourage certain outcomes and steward situations with small adaptive actions, but there’s no guarantee that our efforts will yield a certain outcome. We influence living systems and are influenced by them, we don’t control them.
Complexity is experienced in degrees, not absolutes, when it comes to working within living systems. Our health system(s) is a living system, made of people, organisms (e.g., viruses, bacteria, tumours), and a variety of processes, procedures and other socio-technical interactions between people, technology, and context.
What makes complexity difficult at an organizational level for staff, managers, and leaders is that there isn’t a playbook. You can’t simply grab a set of HBR-like management tools to shape behaviour. At the same time, we still have to work. There are things to do. What can we learn from complexity that we can apply to how we run health systems and care?
Let’s look back at those uncertain early days of the COVID-19 pandemic for some guidance on how complexity thinking can apply to today’s situation.
Change: Pace, Care, and Intelligence
One of the biggest lessons of COVID was how the scale, scope, and direction of the pandemic evolved. From the initial detection of a novel coronovirus in Wuhan Province in China, to the initial overseas spread (and the hyper-localized early outbreaks, like those in Lombardy, Italy), to the rapid closing of airspace, public places, and “lockdowns” in some cities. From there, we went into seclusion, with vast differences in how cities, regions, and countries managed different restrictions.
Then came the backlash. First to restrictions, then to the vaccines and public policies governing their availability, use, and requirements.
How about the waves, such as Omicron?
And so it went. It was exhausting, confusing and a prolonged period of destabilized care for us all. It’s easy to forget the myriad details.
One of my favourite examples to illustrate how to manage it all was to consider the way champion dogsledder Blair Braverman addressed uncertainty with her sled dogs.
Here’s the thing about sled dogs: They never know how far they’re going to run.
This meant managing her team — just like a healthcare leader might — with care, intelligence, and a sense of pace. She had a plan, but knew it has to be adaptive. She had to be attentive. She also had to watch how the dogs’ behaviour reinforced each other. We see this with teams. This means both positively through emotional support, knowledge sharing, motivation, and coordination. It also means understanding that people may reinforce poor habits (no breaks, cutting corners, failing to engage in self-care) or mire each other in a culture of negativity.
Too fast, not enough care and attention, and no reflection period (learning from what you’re doing), means that complexity will create many more difficulties and challenges than can be addressed.
Strategic Design for Complexity
Designing for complexity means being ready, set, and able to go with a plan. I’ll be writing much more about this in the months to come.
Strategic design brings together systems thinking (structures, relationships, and interactions), behavioural science (knowing how people think, act, and work together), with evaluation (feedback, learning, and data) through the act of creating purpose-driven plans and systems that work in the real world (strategy). The mistake in creating supports for health systems is that we view strategy as a plan that is often independent of the systems, behavioural profile, and necessary inputs (data, learning) required to function in complexity.
We treat our strategy as a plan and a GPS map that will tell us where to go, when we’ll get there, and how far our destination is. Except, we’re driving in rush-hour traffic, with accidents, construction, downed trees, and road closures due to festivals or protests, and we have to make two stops along the way.
When we can’t go straight to the destination, we get frustrated. We give up.
Except, in health services, people’s wellbeing, comfort, and lives might depend on us staying the course. Designing with complexity in mind is what’s needed.
This is the first in a series where we’ll look at what it means to be a complexity set organization, how to lead through it, and how to design for complexity in ways that promote health, provide service, and care for our clients, patients, communities and our staff.