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Hi Ceri, You hit the nail on its head! Acting CAN only be local! We interact on a local level. We respond to each other on a local levels. There might be 'global rules' but they get effectuated (or not!) on a local level. Now, how do you manage that? To me what happens on a global level (really happens, not what we tell SHOULD happen) emerges out of those local interactions. Those are the patterns of relating, if you like. We must see whether we can make those patterns visible. THAT is real leadership task, at a guess. Regards, Frank Smits Symphoenix Ltd Tel: +44 (0)1732 450 495 Mobile: +44 (0)7715 423 150 E-mail: <mailto:[log in to unmask]> [log in to unmask] Website: <http://www.symphoenix.net> www.symphoenix.net -----Original Message----- From: Complexity and chaos theories applied to primary medical and social care [mailto:[log in to unmask]] On Behalf Of Ceri Brown Sent: 16 September 2002 11:09 To: [log in to unmask] Subject: Re: queue theory In a message dated 15/09/2002 18:18:28 GMT Daylight Time, [log in to unmask] writes: Therefore any attempt to manage them as if they were in equilibrium is doomed to fail. Is thinking of dynamic equilibrium the key? We aren't used to thinking in this way, only in terms of static equilibrium. Scientific method is a good example - keep everything else constant and only change one parameter. That's why most Intensive Care research can barely be "termed scientific." What one can do in dynamic systems (e.g. Sepsis) is make perturbations in one, or a few areas, and observe the response against a desired "target." The fashion for "one size fits all" organisational solutions is a result of scientific method and political acceptability. We are talking of the manger/poloitician/doctor in "heroic," mode. The one who knows the true way and encourages/cajoles/forces others to follow the method, without thought for consequences elsewhere. (This is the Holywood philosophy of managerialism which appears to be being played out elsewhere, in real time, at the moment) So how to manage in a Complex environment? Act local, think global. Any help? Ceri Brown Critical Care Programme Project Development and Research 0161 720 2342 (Secretary) 07659 120 038 (pager) 07876 230 561 (mobile) Thanks to my variable clinical commitments, calls to my mobile won't be answered promptly. Please leave a message, or page me. I'm based at North Manchester General Hospital but my postal address is: c/o Critical Care Programme, 4th Floor, St John's House, Leicester. LE1 6NB