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Models of integrated care are prime examples of complex interventions, incorporating multiple interacting components that work through varying mechanisms to impact numerous outcomes. The purpose of this paper is to explore summative, process and developmental approaches to evaluating complex interventions to determine how to best test this mess.

This viewpoint draws on the evaluation and complex intervention literatures to describe the advantages and disadvantages of different methods. The evaluation of the electronic patient reported outcomes (ePRO) mobile application and portal system is presented as an example of how to evaluate complex interventions with critical lessons learned from this ongoing study.

Although favored in the literature, summative and process evaluations rest on two problematic assumptions: it is possible to clearly identify stable mechanisms of action; and intervention fidelity can be maximized in order to control for contextual influences. Complex interventions continually adapt to local contexts, making stability and fidelity unlikely. Developmental evaluation, which is more conceptually aligned with service-design thinking, moves beyond these assumptions, emphasizing supportive adaptation to ensure meaningful adoption.

Blended approaches that incorporate service-design thinking and rely more heavily on developmental strategies are essential for complex interventions. To maximize the benefit of this approach, three guiding principles are suggested: stress pragmatism over stringency; adopt an implementation lens; and use multi-disciplinary teams to run studies.

This viewpoint offers novel thinking on the debate around appropriate evaluation methodologies to be applied to complex interventions like models of integrated care.

The purpose of this paper was to develop deeper insights into the practices enacted by entrepreneurial healthcare managers to enhance the implementation of a partnership logic in integrated care models for older adults.

A multiple case study design in two urban centres in two jurisdictions in Canada, Ontario and Quebec. Data collection included 65 semi-structured interviews with policymakers, managers and providers and analysis of key policy documents. The institutional entrepreneur theory provided the theoretical lens and informed a reflexive iterative data analysis.

While each case faced unique challenges, there were similarities and differences in how managers enhanced a partnership’s institutional logic. In both cases, entrepreneurial healthcare managers created new roles, negotiated mutually beneficial agreements and co-located staff to foster inter-organisational partnerships between public, private and community organisations in the continuum of care for older adults. In addition, managers in Ontario secured additional funding, while managers in Quebec organised biannual meetings and joint training to enhance inter-organisational partnerships.

This study has two main implications. First, efforts to enhance inter-organisational partnerships should strategically include institutional entrepreneurs. Second, successful institutional changes may be supported by investing in integrated implementation strategies that target roles of staff, co-location and inter-organisational agreements.

Communications regarding this column should be addressed to Mrs. Cheney, Peabody Library School, Nashville, Term. 37203. Mrs. Cheney does not sell the books listed here. They are available through normal trade sources. Mrs. Cheney, being a member of the editorial board of Pierian Press, will not review Pierian Press reference books in this column. Descriptions of Pierian Press reference books will be included elsewhere in this publication.

Communications regarding this column should be addressed to Mrs. Cheney, Peabody Library School, Nashville, Tenn. 37203. Mrs. Cheney does not sell the books listed here. They are available through normal trade sources. Mrs. Cheney, being a member of the editorial board of Pierian Press, will not review Pierian Press reference books in this column. Descriptions of Pierian Press reference books will be included elsewhere in this publication.

SEPTEMBER is the month when, Summer being irrevocably over, our minds turn to library activities for the winter. At the time of writing the international situation is however so uncertain that few have the power to concentrate on schemes or on any work other than that of the moment. There is an immediate placidity which may be deceptive, and this is superficial even so far as libraries are concerned. In almost every town members of library staffs are pledged to the hilt to various forms of national service—A.R.P. being the main occupation of senior men and Territorial and other military services occupying the younger. We know of librarians who have been ear‐marked as food‐controllers, fuel controllers, zone controllers of communication centres and one, grimly enough, is to be registrar of civilian deaths. Then every town is doing something to preserve its library treasures, we hope. In this connexion the valuable little ninepenny pamphlet issued by the British Museum on libraries and museums in war should be studied. In most libraries the destruction of the stock would not be disastrous in any extreme way. We do not deny that it would be rather costly in labour and time to build it up again. There would, however, be great loss if all the Local Collections were to disappear and if the accession books and catalogues were destroyed.

BOURNEMOUTH fulfilled some of the high expectations of those who attended it. The welcome was cordial, the local arrangements good, as we were entitled to expect from so proved an organizer as Mr. Charles Riddle and from his committee and staff, and, when fine, the town was most attractive. The weather, however, was bad, and too warm at the same time for most of us. One thing that certainly emerged from this experience was the real need to change the time of the conference. Only librarians among similar bodies appear to meet in the summer season. The accountants, engineers and other professional people confer in late May or in June, when they do not compete with holiday‐makers for accommodation and attention. The Council might well consider the re‐arrangement of its year with such a change in view.