The purpose of this paper is to support the ongoing dialogue and shed light on the different views on integrated care. An overarching definition of integrated care is proposed combining the ways of thinking of the four quality paradigms the authors identify. The idea of epistemic fluency offers a way-out of ongoing discussions about “what integration is”.
Four paradigms of quality are presented and applied to healthcare. Epistemic fluency is proposed as the capacity to understand, switch between and combine different kinds of knowledge. The authors compare previously developed definitions of integrated care to the various combinations of paradigms.
All four paradigms of care quality are present in healthcare and in the most used definitions of integrated care. The Reflective Paradigm and the Emergence Paradigm receive least attention. Some definitions combine more than one paradigm. An overarching definition of integrated care is proposed.
In this paper, only the most prominent definitions of integration have been considered.
Integration research and practice requires a widely accepted definition of integrated care, embracing all four paradigms of care quality. Our suggestion provides a common foundation that may prevent misunderstanding.
The use of quality management paradigms to frame the debate on defining integrated care is new and leads to new insights for teaching, research and practice.
