Université de Montréal


Paul A. Lamarche is professor at the Department of Health Administration, School of Public Health, University of Montreal. He holds a Ph.D. in Health care Organization and Policies from the University of Michigan. His research area is organization of health services and more specifically its influence on users’ appreciation of their health care experience and the health of the population. His theoretical framework borrows heavily on the configuration approach and the complexity perspective.

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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.