Innovation in the Elderly Care Sector - At the Edge of Chaos

Ageing populations are increasingly confronting the elderly care provision systems in Western countries with a number of challenges, including increasing and changing needs, personnel shortages and financial challenges. This calls for new policy strategies and rethought and restructured organisations and institutions.

So, the elderly care sector needs innovation, but research in this domain is rather limited. Therefore, Katrien Verleye and Prof. Dr. Paul Gemmel conducted a study that aimed to: (1) define what innovation in the elderly care sector means, and (2) identify which factors determine the innovativeness of elderly care organisations.

The challenges in the elderly care sector are diverse. For example, the sector must not only be prepared for increasing care demand, but also for changing care demand. This is due to the fact that:

  • The number of people with Alzheimer’s disease or dementia is growing.
  • Family structures are changing (e.g. smaller household size), complicating informal care, so that more people are ending up in formal care circuits.
  • The expectations for elderly care rose during the twentieth century, because of a rising proportion of elderly people in the population, improved living conditions, and advances in medical technologies.

Consequently, elderly people today not only expect healthcare, but also services in the areas of transport, living conveniences, and welfare to have more autonomy and social contact. Moreover, the sector is characterised by high work pressure and a shortage of care personnel. Finally, growing expenditures in healthcare are provoking financial challenges.

Organisations ‘at the edge of chaos’ are expected to have a higher capacity for innovation.

Complex Adaptive Systems

Via case studies of 5 innovative initiatives within the Flemish elderly care sector, the authors examined the conditions under which these initiatives emerged.

The results of their study show that innovative elderly care organisations partially act as Complex Adaptive Systems (CASs): that is, systems that have a large number of components, often called agents, that interact and adapt or learn. Acting entirely as a CAS, however, is restrained by top-down forces, procedures, and regulations.

On the Verge of Innovation

The 5 elderly care organisations were characterised by continuous change, a high degree of variety and reactivity, and a medium degree of self-organising emergence. In particular, there was a considerable potential for new idea generation within all organisations, as these consisted of a collection of individual agents, who were interconnected and changed each other’s context (cf. variety). Communication and feedback loops demonstrated that the organisations were aware of this potential (cf. reactivity).

However, the agents were not always able to totally adjust their behaviour to cope with internal and external demands (cf. self-organised emergence), because of top-down forces, procedures, and regulations. The organisations were thus situated between disintegration (total chaos) and ossification (total stability), which is also referred to as ‘the edge of chaos’.

Previous studies have shown that organisations at the edge of chaos are expected to have a higher capacity for innovation. Thus, the challenge to managers is to facilitate self-organisation within the organisation by listening to people, improving relationships, enabling participation of different agents in the decision-making process, disseminating information about good practices, and creating small non-threatening changes. The challenge is to move away from too much stability without ending up in total chaos – and thus to find the edge of chaos where innovation can take place.

Related Article

Verleye K. Gemmel P. 2011. Innovation in the elderly care sector: at the edge of chaos. Journal of Management & Marketing in Healthcare.

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