A Conceptual Framework for Applying the Anticipatory Theory of Complex Systems to Improve Safety and Quality in Healthcare

  • Thomas O. StaigerEmail author
  • Patricia A. Kritek
  • Erin L. Blakeney
  • Brenda K. Zierler
  • Kurt O’Brien
  • Ross H. Ehrmantraut


Effective anticipation is a fundamental characteristic of highly reliable organizations. In Rosen’s anticipatory theory of complex systems, all living systems and virtually all other complex systems require anticipatory models to maintain an organized state. This paper provides an overview of Rosen’s anticipatory theory of complex systems and presents a conceptual framework for applying this framework to improve safety and quality in healthcare. Organizational interventions based on this theory could include education of clinicians, patients, and families on how anticipatory complex systems function and improve safety in clinical environments, and systems interventions to promote optimal concordance between a team’s model of a clinical situation and the actual clinical situation. Enhanced general understandings of anticipatory complex systems and of their failure modes could help reduce communications failures that are a common cause of serious adverse events.


Anticipation Complexity Safety Quality Medicine Situational awareness Communication 


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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • Thomas O. Staiger
    • 1
    Email author
  • Patricia A. Kritek
    • 1
  • Erin L. Blakeney
    • 2
  • Brenda K. Zierler
    • 2
  • Kurt O’Brien
    • 3
  • Ross H. Ehrmantraut
    • 3
  1. 1.Department of MedicineUniversity of WashingtonSeattleUSA
  2. 2.School of Nursing University of WashingtonSeattleUSA
  3. 3.UW Medicine Organizational Development and TrainingUniversity of WashingtonSeattleUSA

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