TY - JOUR AB - Purpose Healthcare quality improvement is a key concern for policy makers, regulators, carers and service users. Despite a contemporary consensus among policy makers that integrated care represents a means to substantially improve service outcomes, progress has been slow. Difficulties achieving sustained improvement at scale imply that methods employed are not sufficient and that healthcare improvement attributes may be different when compared to prior reference domains. The purpose of this paper is to examine and synthesise key improvement attributes relevant to a complex healthcare change process, specifically integrated care.Design/methodology/approach This study is based on an integrative literature review on systemic improvement in healthcare.Findings A central theme emerging from the literature review indicates that implementing systemic change needs to address the relationship between vision, methods and participant social dynamics.Practical implications Accommodating personal and professional network dynamics is required for systemic improvement, especially among high autonomy individuals. This reinforces the need to recognise the change process as taking place in a complex adaptive system where personal/professional purpose/meaning is central to the process.Originality/value Shared personal/professional narratives are insufficiently recognised as a powerful change force, under-represented in linear and rational empirical improvement approaches. VL - 31 IS - 3 SN - 0952-6862 DO - 10.1108/IJHCQA-07-2016-0097 UR - https://doi.org/10.1108/IJHCQA-07-2016-0097 AU - Harnett Patrick John PY - 2018 Y1 - 2018/01/01 TI - Improvement attributes in healthcare: implications for integrated care T2 - International Journal of Health Care Quality Assurance PB - Emerald Publishing Limited SP - 214 EP - 227 Y2 - 2024/04/18 ER -