National School of Public Administration


Lara Maillet is postdoctoral fellow at the National School of Public Administration in Montreal. She holds a Ph.D in Public Health (Health Administration) from the University of Montreal. Her research area is the development of strategies for improved access to care for vulnerable population like migrant populations. Therefore, her scientific interests revolve around also development of conceptual model about the governance, the complexity and the change in the healthcare organizations. Her doctoral thesis allowed to develop and applied the framework of multilevel adaptive governance presented in this paper.

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At the heart of adapting healthcare organizations:
Volume: 17, Issue 3
Originating from a concern on the linkage between health policies and immigration policies within healthcare organizations, our goal is to understand how and why healthcare organizations adapt their services to the needs and characteristics of migrant populations. In doing so, we used three angles of analysis: (1) interactions between the stakeholders within an organization viewed as a Complex Adaptive System (CAS), especially between an organization’s various levels of governance; (2) the levers of action implemented by the multiple stakeholders; and (3) the factors that influence the stakeholders. We propose a conceptual model of multilevel adaptive governance able to reconcile two paradoxical adaptation mechanisms: (1) multiple autonomous stakeholders are able to self-organize while acting in a heterogeneous manner; (2) governance allows these heterogeneous actions, through levers of action, to converge toward a more homogeneous collective process.