title: Micro practices of coordination based on complex adaptive systems: user needs and strategies for coordinating public health in Denmark.
abstract: BACKGROUND
  Many highly formalised approaches to coordination poorly fit public health and recent studies call for coordination based on complex adaptive systems. Our contribution is two-fold. Empirically, we focus on public health, and theoretically we build on the patient perspective and treat coordination as a process of contingent, two-level negotiations of user needs.
  
  
  METHODS
  The paper draws on the concept of user needs-based coordination and sees coordination as a process, whereby needs emerging from the life world of the user are made amenable to the health system through negotiations. The analysis is based on an explorative case study of a health promotion initiative in Denmark. It adopts an anthropological qualitative approach and uses a range of qualitative data.
  
  
  RESULTS
  The analysis identifies four strategies of coordination: the coordinator focusing on the individual user or on relations with other professionals; and the manager coaching the coordinator or providing structural support. Crucially, the coordination strategies by management remain weak as they do not directly relate to specific user needs.
  
  
  CONCLUSIONS
  In process of bottom-up negotiations user needs become blurred and this is especially a challenge for management. The study therefore calls for an increased focus on the level nature of negotiations to bridge the gap that currently weakens coordination strategies by management.
authors.affiliation: CFK - Public Health and Quality Improvement, Central Denmark Region/Interacting Minds Centre, Aarhus University, Aarhus, Denmark.
authors.forename: Morten Deleuran
authors.initials: MD
authors.lastname: Terkildsen
authors.affiliation: CFK - Public Health and Quality Improvement, Central Denmark Region/Department of Public Health, Aarhus University, Aarhus, Denmark.
authors.forename: Inge
authors.initials: I
authors.lastname: Wittrup
authors.affiliation: CFK - Public Health and Quality Improvement, Central Denmark Region/Department of Political Science, Aarhus University, Aarhus, Denmark.
authors.forename: Viola
authors.initials: V
authors.lastname: Burau
keywords: Denmark; anthropological qualitative approach; complex adaptive systems; micro practices; public health; user needs-based coordination