A Complex Adaptive System (Plesk, 1997)

Is a non-linear network of semiautonomous, competing and collaborating individuals who interact and co-evolve with their surrounding environment. Uses input from previous experiences to constantly modify the relationship among its members resulting in emergent self-organized behaviors.

Reflective Adaptive Process (Stroebel et al., 2005)

Change is guided by vision, mission, and shared values. Creating time and space is necessary for learning and reflection. Tension and discomfort are essential and normal during change. System agents, including patients, with varying views of the system and its environment should be included in improvement teams. Supportive leaders who are actively involved in the change process are required for system change.