Change and Integration in Senior Health Care Systems: The Case of Sault Ste. Marie

Abstract

This thesis organizes information that will assist a community in the selection or construction of a context sensitive integrated senior healthcare system model. The senior healthcare system within Sault Ste. Marie, Ontario is used as a case study. Institutional Ethnography is used to collect data guided by a change management model adapted from the literature. Data sources were non-participant observations, key informant interviews, focus groups, and texts. Institutional ethnographic local and high level analyses methods were used to analyze this data. Results identified many more restraining than driving forces for integration within Sault Ste. Marie’s senior healthcare system. Study findings indicate that macro level activities are perpetuating micro level obstacles to integration. These results can be used to identify where improvements need to be made at the macro level in order for successful change to occur at the micro level.