Introduction Research suggests that successful integration of PCC depends essentially on the routines and attitudes of frontline staff, especially in their relationships and interdependent teamwork [1-4]. This is consistent with the positive results of Etxean Ondo, an experimental project [15] that aimed to provide adequate support for the elderly living at home or in nursing homes, as well as for their families and care professionals. This support and care were based on a coherent set of methods designed to improve communication and collaboration within and between the healthcare system, long term care-systems and the community. Hence, any attempt to progress towards generalization and consolidation in line with PCC [6, 7] requires not only clinical and professional integration but also organisational and systemic integration [8]. According to Leutz [1] "full integration" implies building a new relational framework [2] based on the concepts of interdependence and decentralized teamwork [9, 10]. These statements are consistent with relevant models such as DMIC, RAINBOW, PRISMA, KAISER, PACE, CCM, or MBQA, which recognise the centrality of a bottom-up logic, micromanagement flexibility, and close case management [11]. Successful integration of PCC also depends on informal aspects [8, 12] that are directly influenced by the recognition of the subjectivity and diversity of persons, as well as intangible factors like knowledge and personal motivation [13]. These experiences generate learning [14-17] and changes in personal beliefs and values, leading to changes in people's criteria for decision-making [18] which can foster or impede the process of change [15]. When managers try to integrate these "informal" and relationship-oriented realities in practice [2] using the revised models [19, 20], they frequently encounter difficulties which arise from contemporary organisational culture. The current organisational paradigm bases its quality, wellbeing, and security exclusively on the stability and static control of formal structures and protocols that use top-down approaches and avoid all these intangible realities that are tough to manage and measure [12, 21]. However, managers ignore the dynamic nature of the process of change at their peril, as any management response which focuses purely on static protocols will be unable to respond to the changing needs of stakeholders [22]. Research consistently highlights management as either an enabler or barrier to successful integration of these "soft" and spontaneous realities and the generation of integrated organisations [23-30]. According to Miller and Stein [12], management for integrated care remains
