Cregård Anna
School of Business, Engineering and Science, Halmstad University , Halmstad, Sweden.
J Health Organ Manag. 2018 Aug 20;32(5):658-673. doi: 10.1108/JHOM-10-2016-0188. Epub 2018 Jul 26.
Purpose The purpose of this paper is to add a little piece to the research on boundary work and inter-occupational cooperation by addressing two questions: how do actors perform boundary work in an inter-occupational cooperation project that seeks to improve the personnel health work in a hospital setting? What impact does the boundary work have on such cooperation in the personnel health project? Design/methodology/approach The study is based on individual, in-depth interviews and participative observations of focus group discussions conducted at a regional municipal organization in Sweden. Respondents are hospital line managers, experts and strategists in the HR departments, and experts from the internal occupational health service. Findings The concepts on boundary work, which include closing/opening boundary strategies, provide the framework for the empirical illustrations. The cooperation runs smoothly in the rehabilitation work because of an agreed upon process in which the professionals' jurisdictions are preserved through closing strategies. Illness prevention and health promotion are not areas of inter-occupational cooperation because the stronger actors use closing strategies. While the weaker actors, who try to cooperate, use opening boundary strategies in these areas, they are excluded or marginalized. Research limitations/implications The empirical investigation concerns one cooperation project and was completed at one data collection point. Originality/value No similar study of boundary work and inter-occupational cooperation in a hospital setting is available despite the frequency of this professional group configuration in practice. A more inclusive concept of professionalism may facilitate the study of boundary work and inter-occupational cooperation among actors with different professional authority.
目的 本文旨在通过回答两个问题,为边界工作和跨职业合作的研究增添一些内容:在一个旨在改善医院环境中人员健康工作的跨职业合作项目中,行动者如何开展边界工作?边界工作对人员健康项目中的这种合作有何影响?设计/方法/途径 该研究基于对瑞典一个地区市政组织进行的个人深度访谈以及焦点小组讨论的参与观察。受访者包括医院一线管理人员、人力资源部门的专家和战略家,以及内部职业健康服务的专家。研究结果 包括封闭/开放边界策略在内的边界工作概念为实证例证提供了框架。由于有一个商定的流程,在康复工作中合作进展顺利,在这个流程中,通过封闭策略保留了专业人员的管辖权。疾病预防和健康促进不是跨职业合作的领域,因为较强势的行动者采用封闭策略。而试图合作的弱势行动者在这些领域采用开放边界策略时,会被排除或边缘化。研究局限/启示 实证调查涉及一个合作项目,且在一个数据收集点完成。原创性/价值 尽管这种专业群体配置在实践中很常见,但尚无关于医院环境中边界工作和跨职业合作的类似研究。一个更具包容性的专业主义概念可能有助于研究具有不同专业权威的行动者之间的边界工作和跨职业合作。