Evaluating Effectiveness of Complex System Interventions

Abstract

Persisting high number of serious adverse events during the last 15 years calls for drastic complex health system interventions to improve patient safety and quality of care. However, complex health system interventions are often costly, difficult to implement and even harder to evaluate which, in turn, lead to a dearth of evidence or even controversies in supporting its adoption. In the following chapter, we discussed characteristics of complex system inventions and the importance of adopting sound theoretical frameworks suitable for the purpose of the evaluating a particular complex system intervention. We also emphasised the importance of choosing the appropriate research methodology. In particular, the pitfalls of both designing an evaluation plan (such as a cluster randomised controlled trial) and interpreting the complex system intervention evaluation study results were elaborated. The promises of evaluating complex system intervention in a big data ear to sustain a self-learning health-care system were discussed.