The Stacey Matrix

A second model is offered by Ralph Stacey (1996, p. 47)—an equally as insightful observer of the human condition and the operation of complex organizational systems. The Stacey diagram offers guidance for practices related to Complex Adaptive Systems which we will be addressing later in this essay:

In the Stacey model, we find a chart moving from Simple to Complicated and from Complicated to Complex. Movement is along the axis of Certainty and Agreement. High certainty and high agreement, find us in the zone of simplicity—clear rules, clear roles, certain actions and outcomes, proximal feedback. As certainty wains, as feedback becomes more distant (in time and space) and agreement becomes more challenging, we move into the zone of the complicated—requiring the more tightly coupled and serial decisions and actions of that zone. Once uncertainty is dominant, feedback is distant and often contradictory, and disagreement is more likely than agreement—we find ourselves in the zone of complexity.

In a somewhat oversimplified example of healthcare, we may say the actions and decisions within an emergency room are in the simple zone—if we narrow it down to “where does this person need to be? Home, a nursing home, this hospital, another hospital, in critical care here or somewhere else?” When it comes to the patient’s disposition, the Emergency Department can focus on simple rules and come to a high degree of certainty and agreement after an initial assessment and evaluation with laboratory and imaging data. Once the decision is made to put the patient in a specific level of care in the hospital, then things likely become more complicated. Several specialists might be called in to share their views on the diagnosis and provision of care.