Boundary-spanning in academic healthcare organisations

Abstract

Policy makers view academic healthcare organisations as important to healthcare innovation because they act as boundary-spanning organisations that integrate science and care institutional logics. Institutional logics are implicit and socially shared rules of the game that prescribe behaviour within a social group. This paper explores how individuals affiliated with academic healthcare organisations negotiate science and care institutional logics within their day-to-day work through a qualitative case study of research and healthcare within academic healthcare organisations in Vancouver, Canada. It highlights that there is less hybridisation of institutional logics than policy makers might hope: some researchers hosted in academic healthcare organisations are not part of the care institutional logic, others are not well integrated with the research institutional logic. Clinician–scientists often struggle to integrate the science and care institutional logics in their day-to-day work; other workers do integrate science and care institutional logics through experiments of nature but their research may not be viewed as high quality science. Because of poor hybridisation, academic healthcare organisations may not be as effective in facilitating healthcare innovation as policy makers assume.