CASs exist in co-evolution with the environment.
Order a CASs exist in co-evolution with the environment. paper today!
The concept of co-evolution refers to the process whereby a CAS is continuously adapting as it responds to its environment and, simultaneously, the environment is constantly adapting as it responds to the changing CAS. They are evolving together in a co-evolutionary interactive process. The adaptive response of a complex system to environmental change and the resulting environmental change from that adaptation includes an element of unpredictability. The overall pattern of adaptation that emerges from the adaptive changes within each unit is unique to each organization and impossible to predict completely. For example, computerized provider order entry (CPOE) changed the workflow for unit secretaries, nurses, physicians, and hospital departments. Each of these units within the system is creating adaptations at the same time as it is adjusting to changes occurring in the other units. A significant number of these changes (whether they were seen as positive or negative by individuals in the institution) are experienced as unintended consequences.
A CAS includes both order and disorder. A certain level of order is necessary for a CAS to be effective and efficient. However, the more firmly order is imposed, the less flexibility the CAS has to adjust to change. Systems that are too tightly controlled can become fragile. A CAS needs to maintain some slack and redundancy to buffer against environmental changes that are not anticipated. This balance between creating a unified whole and an institution with enough flexibility to adapt to the changing internal and external environment can be a challenge when integrated healthcare institutions attempt to merge hospitals, long-term care facilities, clinics, and other settings into one healthcare system. The larger and more diffuse the organization, the more likely it is to include a degree of order and disorder and, therefore, more potential to survive in some form. For example, individual hospitals, clinics, and third-party payers may go out of business, but the healthcare system as a societal institution will continue to exist in ever-evolving ways. The characteristics of a CAS interact together in a synergistic manner, ensuring that a certain