title: Quality of Care as an Emergent Phenomenon out of a Small-World Network of Relational Actors.
abstract: In Healthcare Decision Support System, the development and evaluation of effective "Quality of Care" (QOC) indicators, in simulation-based training, are key feature to develop resilient and antifragile organization scenarios. Is it possible to conceive of QOC not only as a result of a voluntary and rational decision, imposed or even not, but also as an overall system "emergent phenomenon" out of a small-world network of relational synthetic actors, endowed with their own personality profiles to simulate human behaviour (for short, called "subjects")? In order to answer this question and to observe the phenomena of real emergence we should use computational models of high complexity, with heavy computational load and extensive computational time. Nevertheless, De Giacomo's Elementary Pragmatic Model (EPM) intrinsic self-reflexive functional logical closure enables to run simulation examples to classify the outcomes grown out of a small-world network of relational subjects fast and effectively. Therefore, it is possible to take note and to learn of how much strategic systemic interventions can induce context conditions of QOC facilitation, which can improve the effectiveness of specific actions, which otherwise might be paradoxically counterproductive also. Early results are so encouraging to use EPM as basic block to start designing more powerful Evolutive Elementary Pragmatic Model (E2PM) for real emergence computational model, to cope with ontological uncertainty at system level.
authors.affiliation: DEIB, Politecnico di Milano, Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Fiorini
authors.affiliation: Dept. Of Neurological and Psychiatric Sciences, Univ. of Bari, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: De Giacomo
authors.affiliation: ARTEMIS Neurosciences, Italy.
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Marconi
authors.affiliation: Georgia State University, Atlanta, GA, USA.
authors.forename: Luciano
authors.initials: L
authors.lastname: L'Abate
mesh_terms: D003198:Computer Simulation; D020000:Decision Support Systems, Clinical / Q000458:organization & administration*; D006801:Humans; D017146:Models, Organizational; D017063:Outcome Assessment, Health Care / Q000458:organization & administration*; D010347:Patient Care Planning / Q000458:organization & administration*; D011787:Quality of Health Care / Q000458:organization & administration*; D012919:Social Behavior