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Reading: Implementing Integrated Care: Moving away from Project Management to Adaptive Learning


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Implementing Integrated Care: Moving away from Project Management to Adaptive Learning


Samantha Laxton ,

Health Standards Organization, CA
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Kasia Bruski,

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Jennifer Wilkie,

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Emily Alexander

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Transformation in health systems is often approached with the assumption that the solution is known, and the complex issue can be solved with an available process or expertise. However, we have seen technical solutions to complex adaptive problems never work. Integrated care initiatives have highlighted the need for an adaptive approach, however this practice rarely extends to on the ground. Health Standards Organization (HSO) identified the need not only to teach adaptive change, but live it through the implementation of their integrated care initiative bringing a culture of learning and the ability to adapt the project based on real-time feedback.

Aims Objectives Theory or Methods

HSO’s Improving Integrated for Youth Initiative (IICY) aims to drive sustainable improvements and better outcomes in the integration of community-based services for youth through the co-design, testing and adoption of evidence-based HSO standards and implementation tools that promote integrated care best practices. Participating in this work are six integrated youth service networks across Canada. The networks began to share feedback that the approach needed to be adapted to better enable their work on the ground. The project shifted priorities and embraced an adaptive approach, learning from the feedback in real-time and adjusting the initiative to better meet the networks needs.

Highlights or Results or Key Findings

Leading by example, knowing the risk to deliverables and timelines, HSO took an intentional pause early into the implementation to ensure feedback could be actioned meaningfully. From there, HSO developed an adaptive approach to incorporate real-time feedback from the networks into the implementation and the products. This included:

•           Creating more opportunities for collaboration and knowledge exchange through online platforms and shared meetings

•           Development of a framework to evaluate and adjust implementation approaches and materials moving forward

•           Building “What We’ve Heard” into group meetings and information sessions

The outcome of the pause and feedback approach included:

•           Increased engagement and participation by networks

•           Increased trust and meaningful participation from all stakeholders including youth, community providers, etc

•           Higher quality feedback on HSO standards and tools


It is not enough to teach adaptability and learning to those leading on the ground. For initiatives to be successful, an adaptive approach must be taken at every level. This top-down, bottom-up approach has supported HSO in developing higher quality standards and tools for sustainable transformation towards more integrated care.

Implications for applicability/transferability sustainability and limitations

The outcome of the IICY initiative will be a series of tools and learnings informed by evidence and lived experience that will be shared through HSO with the rest of Canada and Internationally.

How to Cite: Laxton S, Bruski K, Wilkie J, Alexander E. Implementing Integrated Care: Moving away from Project Management to Adaptive Learning. International Journal of Integrated Care. 2022;22(S2):192. DOI:
Published on 16 May 2022.


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