Applying a complex adaptive systems approach to the management of integrated care

PURPOSE: Integrated health and social care is necessarily complex since the competence needed for carrying out the task of care does not lie within one individual provider organization, but requires deliberate co-operation between different providers. In this world, the primary managerial task is variously seen as seeking the efficient administration of human and material resources, and achieving prescribed performance targets for activities, or attracting and supporting all available resources to meet patient needs. In this paper, the authors take this latter approach and suggest how managers can apply complex adaptive systems thinking to the tasks of providing integrated care. THEORY: The paper draws on the growing literature on complex adaptive systems (CAS) to identify crucial issues: bringing together different providers; the place of the patient as a co-producer of care; and the managers' responsibility for the proper use of resources. METHOD: This paper is a research review. It is a conceptual analysis of the issues above based on CAS literature. An application of the CAS approach to the field of integrated care is presented. RESULTS AND CONCLUSIONS: The benefits of the CAS approach to the manager of integrated care are distilled. Some guiding principles are offered to managers to facilitate the development of a learning and flexible mode of working.