Context: Approaching primary care organizations as complex, adaptive systems brings into focus continual adaptation to pressures internal and external to the organization, such as from health systems, guideline developers, disease organizations, researchers, and most recently, a pandemic. Change involves agents within the organization mutually adjusting their actions to achieve some sort of ongoing ‘order’; in complexity theory, this is called self-organization. With increasing investment in primary care transformation, understanding self-organization in response to change attempts can inform future efforts. Objective: The objectives are to (1) test and refine methods to study multiple, co-existing change pressures operating in primary care clinics and (2) describe how a Canadian primary care clinic self-organizes in response to various and potentially conflicting pressures to change their clinical routines. Study Design: Pilot of a multi-method, longitudinal qualitative case study methodology, involving document review, meeting observation, interviews, and tracking of different requests or initiatives to change practice retrospectively since the start of the pandemic and prospectively over a six-month period in 2021. Setting or Dataset: One primary care organization in Canada. Population studied: An interprofessional primary care team. Outcome Measures: n/a – qualitative observational study. Anticipated Results: If the piloted methodology works well, findings will demonstrate how a primary care organization navigated changes during the first 18 months of a pandemic. In particular, the results will highlight how many and which change agents worked to transform clinical practice, who was involved in each change over time, what self-organization activities occurred in response, and the paths through which different changes were achieved or ceased. Expected outcomes: The study will inform the development of rigorous methods to study the elusive concept of ‘self-organization’ in healthcare, and generate a conceptualization of how a primary care organization copes with and self-organizes in response to multiple, co-existing change pressures.