Previous versions of this chapter, which featured different conceptual frameworks, were presented during conferences as:
Patru, D., Lauche, K., van Kranenburg, H., Ziggers, G.W. (2014) Integrating materials,
meanings and competences: A practice perspective on developing inter-organizational coordination. Paper presented at the 6th PROS Conference, Rhodes, 19-21 Au-gust 2014.
Patru, D., Lauche, K., van Kranenburg, H. and Ziggers, G.W. (2014) Integrating
materials, meanings and competences: A practice perspective on developing inter- organizational coordination. Paper presented at the European Group of Organizational
106
Inside the black box
This chapter uses a practice perspective to unpack the development of boundary spanning skills in the context of inter-organizational collaboration in a Dutch healthcare network. I examined data collected through interviews, documents, and observations by framing the nominated boundary spanners’ skill development as the progressively skilful enactment of the network’s designed patient handover practice. I found that the nominated boundary spanners developed their skills through a new form of apprenticeship, where they learned not from experts within their own community, but from the partners’ boundary spanners. Moreover, I found that the nominated boundary spanners developed their skills by progressively acquiring and developing the designed practice’s elements: its teleo-affective structures, its practical understandings and rules, and finally its general understandings. In the process, I show that the successful development of boundary spanners-in-practice depends both on the nominated boundary spanners themselves, and the organizational actors that create and implement the structures within which the boundary spanners develop.
Introduction
Research on inter-organizational collaboration has so far mainly focussed on its structures, antecedents, and outcomes rather than the dynamic processes through which it develops (de Rond & Bouchikhi, 2004). Moreover, few studies examine the processes and practices through which partners align their operations – that is, how inter-organizational collaboration is set up, implemented, and adjusted (Gulati et al., 2012). Aligning operations inter-organizationally typically involves an attempt to pre-specify collaboration practices when shaping the inter-organizational workflow: actors are nominated, forms and procedures are outlined. These attempts rarely proceed as planned, but they can act as a starting point for new collaboration practices to emerge around. Based on this premise, my study aims to understand the development of inter-organizational collaboration by examining how the organizational actors nominated to carry out collaboration practices become increasingly skilful at doing so.
I frame the development of inter-organizational collaboration by drawing on two spheres of research. First, I approach collaboration from the boundary spanning research tradition, where studies have concerned themselves with the key actors through which communities of individuals can successfully interact
across a variety of boundaries (organizational (Tushman & Scanlan, 1981), geographical (Nicholson & Sahay, 2004), cultural (Gopal & Gosain, 2010), etc.). Thus, I conceptualize collaboration as the synergistic integration of key actors’ expertise and concerns (Levina & Vaast, 2008), and its inter-organizational development as the process through which these key actors become boundary spanners-in-practice (Levina & Vaast, 2005).
Second, I examine this process of becoming from a practice perspective. Following Levina and Vaast (2005), I conceptualize the boundary spanners nominated to engage in inter-organizational collaboration as legitimate peripheral participants (Lave & Wenger, 1991), who develop their boundary spanning skills through apprenticeship. I then frame this apprenticeship process as the acquisition of a practice, and draw on Schatzki (2002, 2012) to conceptualize practices as consisting of four organizing elements: practical understandings, teleo-affective structures, rules, and general understandings. In so doing, I gain the analytical tools needed to track the nominated boundary spanners’ gradual development from novices to experts. Ultimately, by combining these different theoretical lenses, I unpack a process which has yet to be empirically investigated in depth, namely: the development of effective (inter-organizational) boundary spanning.
I pursue this issue by analysing data from interviews, documents, and observations on the development of inter-organizational collaboration in a Dutch healthcare network between a hospital and the aftercare organizations in its region. My findings explain both the development of the healthcare network’s main boundary spanning practice – inter-organizational patient handovers – and how the actors nominated to enact it learned to do so in practice. I first address the designed aspects of the patient handover practice, and show that the nominated boundary spanners’ problematic start resulted from two miscalculations on the part of the practice designers. On the one hand, they made incorrect assumptions about the elements required to create the practice; on the other, they underestimated the resources that the nominated boundary spanners would need to acquire these elements. I then explore the practice’s emergent development, leading to two major findings. First, I found that, in my empirical setting – the inter-organizational development of a new practice – the nominated boundary spanners’ apprenticeship process took a different turn. While they still developed their skills through practising and feedback as proposed by Lave and Wenger (1991), they did so by interacting not
108
Inside the black box
with experts within their own community, but with their boundary spanning counterparts across the organizational boundary. Second, I found that these interactions revolved around the progressive acquisition and development of the designed practice’s elements: first its teleo-affective structures, then its practical understandings and rules, and finally its general understandings. This finding further unpacks the apprenticeship process, by revealing the successive points of focus in the novices’ skill acquisition process.
My study contributes to the debate on boundary spanning by systematically showing how nominated boundary spanners develop into boundary spanners- in-practice. Having examined this process in an inter-organizational context, I also contribute to the knowledge on legitimate peripheral participation by showing how this learning model applies in cross-community settings. Furthermore, I contribute to the inter-organizational collaboration literature, by offering a clear, operationalizable approach to studying how partners align their operations in order to work together in practice. In so doing, I add to the current research on post-formation dynamics (Reuer et al., 2002). Applied to practice, my findings provide healthcare managers with a number of insights on designing and readjusting the inter-organizational enactment of patient handovers.
The remainder of this chapter is organized as follows. First, I address my conceptual framework by expanding on the research streams outlined above. I then introduce my empirical case and describe my data collection and analysis methods. Finally, I present and discuss my findings.