Organizational pathways through uncertainty: innovative healthcare organizations building autonomy through interdependencies

This paper will examine the case of ‘nurse-led clinics’ (NLCs) deployed in the province of
Quebec, in Canada since December 2022. If the deployment of this type of organization is not new at a global scale, it represents a regional rupture. The paper will seek to understand the trajectory of NLCs, as a case of organizational innovation. Doing so, the analysis will bring some elements to answer these questions: how an organizational innovation derives from its initial model? What explain the direction it takes? As part of a larger system, we hypothesize that the innovation trajectory depends on interactions with other organizations in the healthcare system. The analysis of a large body of empirical material will be based on several notions from Luhmann's theory of social systems (Luhmann, 2010). In line with the questions raised in the call for papers, the analysis will demonstrate the contribution of concepts derived from systems theory to shed light on a process of organisational innovation in local and regional areas characterised by a high degree of complexity.