Online Program

How adapt health organization when the patient come from around the world?

Monday, November 4, 2013 : 11:30 a.m. - 11:50 a.m.

Lara Maillet, School of Public Health, Health Administration Department, Université de Montréal ESPUM, Montreal, QC, Canada
How do organizations adapt when they face changes that surpass their current capacities? From this question, a study has emerged that attempts to understand how and why public health organizations decide to adapt (or not to adapt) their services to the needs and characteristics of migrant populations in their jurisdictions. Although the dynamics of the migratory process are increasingly well documented, organizational capacities for adaptation are much less established. A conceptual model of how complex adaptive governance is able to reconcile two paradoxical mechanisms of adaptation is proposed: (1) on one hand, multiple autonomous stakeholders are capable of self-organization and act in a heterogeneous manner; (2) on another hand, governance allows these heterogeneous actions, through levers of action, to converge toward a collective process that is more homogeneous and shares a common vision (schemata). To develop this framework, we rely on the literature addressing theories of complexity and governance, particularly clinical governance. Three angles of analysis were chosen that allow us to develop aspects similar to exploration and exploitation through the clinical and administrative spheres of the organization. These three angles also allow us to theoretically develop an integrated view of governance, allowing for adaptation in the support of vulnerable migrant populations through the facilitation of generative relationships and co-evolution with stakeholders in the Environment.

Learning Areas:

Administration, management, leadership
Diversity and culture
Provision of health care to the public
Public health administration or related administration
Public health or related nursing
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Identify governance's actors in health organization, action levers used by strategic, tactic and operational actors of the organization Describe the context of action Development of a new model of multilevel governance, based on complexity theory

Keyword(s): Access Immigration, Health Service

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified because the results of the studie come from my PhD thesis. Among my scientific interests has been the development of strategies for improved access to care for vulnerable population, like migrant population. Therefore, my scientific interest has been too the developpement of conceptual model about the governance, the complexity and the change in the health organizations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.