Promoting Coevolution Between Healthcare Organizations and Communities as Part of Social and Health Pathways Management in Quebec: Contributions of the Complex Adaptive Systems Approach
The implementation of sociosanitary pathways in the Quebec healthcare system aims to better meet the needs of communities and strengthen their participation at all levels of governance. This initiative will form the basis of our article, which will look at the challenges of adaptation both inside an...
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SAGE Publishing
2025-04-01
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| Series: | Health Services Insights |
| Online Access: | https://doi.org/10.1177/11786329251332797 |
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| author | Lara Maillet Georges-Charles Thiebaut Anna Goudet Jean-Sébastien Marchand |
| author_facet | Lara Maillet Georges-Charles Thiebaut Anna Goudet Jean-Sébastien Marchand |
| author_sort | Lara Maillet |
| collection | DOAJ |
| description | The implementation of sociosanitary pathways in the Quebec healthcare system aims to better meet the needs of communities and strengthen their participation at all levels of governance. This initiative will form the basis of our article, which will look at the challenges of adaptation both inside and outside organizations. Drawing on the complex adaptive systems approach, we have developed an analytical framework to highlight the processes that can lead to the adaptation of governance to facilitate community participation in the management of this pathways. The aim of this article is to propose a better understanding of coevolution in the process(es) of adaption of the governance of a complex healthcare organization to its environment, by mobilizing the complex adaptive systems approach. We conducted a qualitative case study, based on 4 sources: documents (n = 70) produced or used during implementation, participatory observations on various tactical and operational committees of the management structure, collaborative workshops with members of the management committee, and semi-structured interviews (n = 18) with managers, department heads, partners, and users of health and social services. To understand the co-evolutionary processes involved in the implementation of management by social and health pathways, we present our results in response to 3 research proposals on the theme of internal and external coherence in a healthcare organization, in terms of vision (cultural), structures (organizational and clinical), and relationships with external partners (environment). Our findings show that to implement and manage an innovation in a healthcare organization, it is fundamental to foster coevolution at operational, tactical and strategic levels, as well as with the external environment. To achieve this, it is necessary to maintain a balance and internal coherence between the structure being implemented and the existing structure, to establish formal and informal communication channels to ensure seamless interactions, while recognizing and reinforcing mutual interdependence in a systemic perspective. |
| format | Article |
| id | doaj-art-8321c9c9eebf4e6980ece9463e57f4cb |
| institution | DOAJ |
| issn | 1178-6329 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Health Services Insights |
| spelling | doaj-art-8321c9c9eebf4e6980ece9463e57f4cb2025-08-20T03:14:09ZengSAGE PublishingHealth Services Insights1178-63292025-04-011810.1177/11786329251332797Promoting Coevolution Between Healthcare Organizations and Communities as Part of Social and Health Pathways Management in Quebec: Contributions of the Complex Adaptive Systems ApproachLara Maillet0Georges-Charles Thiebaut1Anna Goudet2Jean-Sébastien Marchand3Canada Research Chair in Adaptive Systems for Health and Social Services Tier 2, CRC Sa3S, Laboratory for Systemic Health Research and Interventions (LabRIS), ENAP, Montreal, QC, CanadaCommissaire à la santé et au bien-être/Commissionner of Health and Wellness (CSBE), Montreal, QC, CanadaCanada Research Chair in Adaptive Systems for Health and Social Services Tier 2, CRC Sa3S, Laboratory for Systemic Health Research and Interventions (LabRIS), ENAP, Montreal, QC, CanadaCentre de recherche Charles-Le Moyne (CRCLM), Longueuil, QC, CANADAThe implementation of sociosanitary pathways in the Quebec healthcare system aims to better meet the needs of communities and strengthen their participation at all levels of governance. This initiative will form the basis of our article, which will look at the challenges of adaptation both inside and outside organizations. Drawing on the complex adaptive systems approach, we have developed an analytical framework to highlight the processes that can lead to the adaptation of governance to facilitate community participation in the management of this pathways. The aim of this article is to propose a better understanding of coevolution in the process(es) of adaption of the governance of a complex healthcare organization to its environment, by mobilizing the complex adaptive systems approach. We conducted a qualitative case study, based on 4 sources: documents (n = 70) produced or used during implementation, participatory observations on various tactical and operational committees of the management structure, collaborative workshops with members of the management committee, and semi-structured interviews (n = 18) with managers, department heads, partners, and users of health and social services. To understand the co-evolutionary processes involved in the implementation of management by social and health pathways, we present our results in response to 3 research proposals on the theme of internal and external coherence in a healthcare organization, in terms of vision (cultural), structures (organizational and clinical), and relationships with external partners (environment). Our findings show that to implement and manage an innovation in a healthcare organization, it is fundamental to foster coevolution at operational, tactical and strategic levels, as well as with the external environment. To achieve this, it is necessary to maintain a balance and internal coherence between the structure being implemented and the existing structure, to establish formal and informal communication channels to ensure seamless interactions, while recognizing and reinforcing mutual interdependence in a systemic perspective.https://doi.org/10.1177/11786329251332797 |
| spellingShingle | Lara Maillet Georges-Charles Thiebaut Anna Goudet Jean-Sébastien Marchand Promoting Coevolution Between Healthcare Organizations and Communities as Part of Social and Health Pathways Management in Quebec: Contributions of the Complex Adaptive Systems Approach Health Services Insights |
| title | Promoting Coevolution Between Healthcare Organizations and Communities as Part of Social and Health Pathways Management in Quebec: Contributions of the Complex Adaptive Systems Approach |
| title_full | Promoting Coevolution Between Healthcare Organizations and Communities as Part of Social and Health Pathways Management in Quebec: Contributions of the Complex Adaptive Systems Approach |
| title_fullStr | Promoting Coevolution Between Healthcare Organizations and Communities as Part of Social and Health Pathways Management in Quebec: Contributions of the Complex Adaptive Systems Approach |
| title_full_unstemmed | Promoting Coevolution Between Healthcare Organizations and Communities as Part of Social and Health Pathways Management in Quebec: Contributions of the Complex Adaptive Systems Approach |
| title_short | Promoting Coevolution Between Healthcare Organizations and Communities as Part of Social and Health Pathways Management in Quebec: Contributions of the Complex Adaptive Systems Approach |
| title_sort | promoting coevolution between healthcare organizations and communities as part of social and health pathways management in quebec contributions of the complex adaptive systems approach |
| url | https://doi.org/10.1177/11786329251332797 |
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