Table 1.

A macro-level analysis of the family caregiving experience using complex adaptive systems

Tenets of complex adaptive systems	Application to the caregiving experience
Non-linear processes	Changes to one area impact other areas in direct and indirect patterns. For example, early discharge from the stroke rehabilitation facility impacts the outpatient physiotherapy wait-list, and access to those services.
Self-organization	The actor’s ability and tendency to adapt to the complex nature of the system. For example, professionals bending protocols or bringing in non-traditional resources.
Emergent behaviour	Behaviours that emerge as a result of the dynamic and complex nature of the system. For example the way an actor adapts to a specific event such missing information.
Feedback loops	Transfer of knowledge or information in response to an experience. For example information and knowledge was fed back into the system from the caregivers, contributing to management of care.
Co-evolution	The role of each actor changes according to the unique needs and attributes of the case. For example, the development of increased awareness of procedures and protocols at the facility and during transitions.
Requisite variety	The unique characteristics of the case, or actors involved, influence the changing context in continuity of care. For example, unique attributes such as past experiences, beliefs, medical knowledge, and social networks, influenced case management.
Connectivity	The relationships between actors in the system. For example, the relationships between actors involved in the case impact communication and information exchange.
Simple rules Non-discrete boundaries	The discovery of rules and boundaries within the system. Examples of rules and boundaries include, facility policies, procedures, and protocols, such as discharge procedures.