From Resistance to Flow – A Systemic Reflection on the Early Development of the Swedish Rheumatology Quality Register (SRQ)

This reflection describes the early systemic transformation of the Swedish Rheumatology Quality Register (SRQ) from a fragmented and manual data collection tool into a self-sustaining, learning system. Built from the ground up through clinical insight, logistics, and mutual trust, SRQ evolved into a structure that continued to function even when staff changed — a flow resilient to organizational boundaries. The process demonstrates how practical system-building, grounded in everyday reality, can generate long-term stability and quality in clinical registries. The experience of observing thousands of patient trajectories later inspired the conceptual development of the RA/Chaos-Theory framework, viewing rheumatoid arthritis as a heterogeneous and self-organising condition.