Complex systems and unintended consequences

Unintended consequences are the outcomes of a purposeful action that are not foreseen. Nothing exists in isolation, and there are ripple effects in everything we do. These ripple effects are more likely to lead to unintended consequences as system complexity increases, where outcomes may be less predictable, and appear unrelated to our initial action.

Because health systems are dynamic, consequences may be delayed, as further flow on effects comes into play. Impacts on safety culture in healthcare organizations, for example, can sometimes take many years to be felt. Unintended consequences may also be noticed now or not noticed until later. Implementing resilient systems, such as a capability for anticipating and monitoring, may improve our ability to notice unintended consequences early and put in place countermeasures to mitigate these effects. A system approach to the problem provides the best chance of identifying and preventing unintended consequences.