Department of Public Health, Aarhus University, Aarhus, Denmark.
Health Promotion Unit, Steno Diabetes Center Copenhagen, Gentofte, Denmark.
J Health Organ Manag. 2024 May 28;ahead-of-print(ahead-of-print). doi: 10.1108/JHOM-03-2023-0063.
The purpose of this paper is to rethink the concept of organizational culture as something that emerges bottom-up by using the sociological concepts of boundary object and boundary work as an analytical lens and to show how this approach can help understand and facilitate intersectoral coordination.
DESIGN/METHODOLOGY/APPROACH: We used observations and qualitative interviews to develop "deep" knowledge about processes of intersectoral coordination. The study draws on a conceptual framework of "boundary work" and "boundary objects" to show how a bottom-up perspective on organizational culture can produce better understanding of and pave the way for intersectoral coordination. We use a case of health professionals engaged in two Danish intersectoral programs developing and providing health promotion services for women with gestational diabetes mellitus (GDM).
The study showed how boundary work revolves around negotiations on how to define, understand and act on the diagnosis of GDM. This diagnosis has the characteristics of a "boundary object", being more loosely structured in general terms, but strongly structured in local settings. Boundary objects help connect different professionals and facilitate coordination. The analysis showed how the introduction of time and the concept of "lifelong health promotion" helped to transgress existing organizational and professional boundaries.
RESEARCH LIMITATIONS/IMPLICATIONS: The findings contribute to the literature on organizational culture and intersectoral coordination. We highlight the benefits of a practice-oriented, bottom-up perspective for a better understanding of how shared meaning is produced in cross professional coordination and collaboration. While the theoretical implications will be general applicable when studying organizational culture, the implications for practice are sensitive to context and the processes we have described as the outcomes of boundary work are generated from cases that were most likely to provide deep insight into our research topic.
For practice this can build bridges between organizational and professional boundaries.
ORIGINALITY/VALUE: The findings contribute to the literature on organizational culture and intersectoral coordination. We highlight the benefits of a practice-oriented, bottom-up perspective for a better understanding of how shared meaning is produced in cross professional coordination. This may build bridges between organizational and professional boundaries in practice settings.
本文旨在重新思考组织文化的概念，认为组织文化是自下而上产生的，使用社会学中的边界对象和边界工作的概念作为分析视角，并展示这种方法如何帮助理解和促进跨部门协调。
设计/方法/途径：我们使用观察和定性访谈来深入了解跨部门协调的过程。该研究借鉴了“边界工作”和“边界对象”的概念框架，展示了自下而上的组织文化视角如何更好地理解和为跨部门协调铺平道路。我们使用了一个案例，即从事两项丹麦跨部门计划的卫生专业人员，为患有妊娠糖尿病（GDM）的女性开发和提供健康促进服务。
该研究表明，边界工作围绕着如何定义、理解和处理 GDM 诊断的协商展开。该诊断具有“边界对象”的特征，总体上结构较为松散，但在局部设置中结构较强。边界对象有助于连接不同的专业人员并促进协调。分析表明，引入时间和“终身健康促进”的概念如何帮助跨越现有的组织和专业边界。
研究局限性/影响：研究结果对组织文化和跨部门协调的文献做出了贡献。我们强调了一种面向实践、自下而上的视角对于更好地理解跨专业协调和合作中共享意义是如何产生的益处。虽然理论意义将普遍适用于研究组织文化时，但实践意义对上下文敏感，并且我们描述为边界工作结果的过程是从最有可能深入了解我们研究主题的案例中产生的。
对于实践，这可以在组织和专业边界之间架起桥梁。
原创性/价值：研究结果对组织文化和跨部门协调的文献做出了贡献。我们强调了一种面向实践、自下而上的视角对于更好地理解跨专业协调和合作中共享意义是如何产生的益处。这在实践中可以在组织和专业边界之间架起桥梁。
