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Codification was shown to support learning related to patient safety at the micro (front-line service) level by structuring the sharing of tacit knowledge, but the presence of professional and managerial boundaries at the organisational level affected the codification initiatives' implementation.
The involvement of a variety of different stakeholders has made it difficult for CHA supervisors to define managerial boundaries.
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Summarizing the findings, the task of transferring parts has proved to be a complex issue with many cross-boundaries and managerial concerns within the company, and the responsibilities need to be made clear.
By examining non-managerial workers, and boundary management during work time the paper addresses a significant gap in knowledge.
45 Boundaries between professional, disciplinary and managerial groups present important obstacles to change, and consensus within one profession is not always shared by others.
In other studies, it has been noted that networks that are most successful have been observed to effectively reach beyond clinical and organisational boundaries and link across policy, managerial and clinical sectors [ 7, 9].
"We certainly heard about situations where there was agreement about sharing across boundaries, but then somebody in a managerial position would decide that the systems were not giving enough protection of confidentiality and the agreement was stood down," she says.
Tie-creating executives have been blamed to derive mainly personal advantages from outside directorships (e.g., Yermack 2004; Zajac 1988) and to use their boundary-spanning connections as means for managerial entrenchment (Davis 1991; Wade et al. 1990).
1. Freedom to manage - hospitals and primary care bodies should be set up as free-standing trusts with full managerial freedom, able to innovate and to break down current boundaries.
In Afghanistan, interviewees indicated that the HR boundaries between NGOs and the MoPH are fuzzy; managerial staff members switch between both during their career.
Within this system of regulation and governance, clinical leaders will need to balance between managerial and professional interests, encourage collaboration and knowledge exchange and reduce boundaries between practitioners, institutions and other organisations.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com