RE:

Traditionally those of us who work in health care organizations have viewed surprises as unwelcome and disruptive occurrences. Such has been the case with the COVID-19 pandemic. The reason surprises are so unwelcome in healthcare is that we see them as a threat to our focus on high reliability and error-free performance. They also disrupt our traditional capacity to make sense of a situation and respond appropriately. Sometimes surprises require new mental models if we are to preserve our sense-making ability and learn how to adapt and respond. Such is the case with this insightful reflection by Kumara Raja Sundar in this issue of the Annals. The author presents a new mental model of a new sense-making approach to choosing and sequencing new models of virtual care that draws on understandings from a field of science that we are often not aware of in health care. He is to be commended for doing so. It is now up to all of us to take on this new mental model and tweak it, adapt it, and make it work in a manner that improves on the older models of care for each of our patients.