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Boundary breaking in a hospital: Expansive learning between the worlds of evaluation and frontline work

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Purpose ‐ The aim of this article is to examine whether the boundary between the separate worlds of evaluation and frontline work in a hospital can be overcome. The study provides an example of a rare, innovative creation process of an assessment tool in which the tool users and the tool producer participated. The article aims to widen the understanding of employee initiated organizational change efforts, co-creation of boundary objects and organizational boundary breaking, which may lead to expansive learning. Design/methodology/approach ‐ The article takes an activity-theoretical approach to organizational boundaries, viewing them as tension-laden triggers for learning and change. The analysis of expansive learning actions is based on longitudinal ethnographic field data on a collaboration effort between nurses and evaluation professionals in a Finnish hospital. Findings ‐ The collaboration effort between two organizational worlds led to boundary breaking. Initially, expansive learning actions were taken, but then obstacles started to emerge, and the collaboration between the two worlds was not sustained. To be sustainable, the collaboration would have required both a shared assessment tool (i.e. a boundary object) and management support. In this case the latter was missing. Originality/value ‐ The study analyzes a solid boundary, which delimited organizational learning and development. Rather than boundary crossing, as understood in the current literature, the challenging collaboration effort took the shape of conflictual boundary breaking. The study contributes to the literature on organizational boundaries and learning and has implications on management of employee initiated change efforts, collective tool creation processes and development of quality work in the public sector.
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Keywords: Assessment tools; Boundary breaking; Boundary object; Change management; Conflict; Expansive learning; Finland; Hospitals; Management

Document Type: Research Article

Publication date: July 19, 2011

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