Cathy Qin is an organisational development consultant at Ko Awatea. She has over seven years’ experience of delivering psychological interventions for behavioural change in a variety of settings, including clinical, prisons, tertiary education and with children. She is currently undertaking a PhD in psychology at the University of Auckland.
Boundary spanning is a leadership capability that creates direction, alignment, and commitment across the organisation to achieve a higher goal or vision.
The current literature generally characterises boundary spanners as individuals who engage with others outside of their own circle of networks, and sustain effective personal relationships. For example, boundary spanners are good at understanding individual differences in culture, roles, professional standards and underlying values. They are motivated to pursue mutually beneficial outcomes.
The practices of boundary spanning involve implementing tactics that span organisational ‘silos’, and facilitate interdependent decision making and collaboration. This extends beyond familiar professional relationships to broaden networks, which increases information sharing activities. Boundary spanners bridge healthcare silos by using their networks to collaborate across five boundary types:
1. Vertical: Rank, seniority, authority
2. Horizontal: Expertise, profession, function, peers
3. Stakeholder: Partners, communities
4. Demographic: Gender, age, culture, sexuality
5. Geographic: Location, region, markets
Boundary spanners support collaboration by exchanging information, knowledge and resources with staff from other units; making connections across boundaries; managing conflict and building trust. Greater collaboration benefits patient care, particularly for patients who need input from more than one specialty, by enabling healthcare staff to communicate effectively and work together cohesively. For example, information shared with patients is more consistent across professions, resulting to less contradictory information.
In addition, boundary spanners support organisational change initiatives by engaging others in the change process, creating effective and efficient outcomes.
Boundary spanning roles
There are several boundary spanning roles that are critical to the design and implementation of organisational change. These roles are not assigned; they do not appear on any formal chart. Only those who work directly with these people understand the impact they can have on the process of change:
• Connectors have high trust from others and are good at establishing and maintaining relationships. They support a large number of colleagues in various ways.
• Experts act as a source of specific expert knowledge. They provide direction and efficiency and eliminate confusion.
• Brokers are great negotiators. They focus on the needs of the group and are a natural conduit for communication to implement plans.
• Energisers create the enthusiasm and positive energy to drive change.
• Resisters can stall momentum and de-energise others.
Boundary spanners identify potential areas for communality, interconnections, and interdependency. They demonstrate a willingness to step outside of their comfort zones; actively practise empathy; hold versatile cultural skills; have the capability to communicate effectively with people from different backgrounds; and have a mindset that challenges personal cognitive biases.
Encouraging boundary spanning
In healthcare, deep-seated professional identities, traditional ‘silo’ work practices and concern about change (e.g. being perceived as a generalist) are some of the barriers to boundary spanning.
Organisations that want to encourage more boundary spanning will need to re-examine team norms created by the professional cultures and infrastructures. For change to be successful, reshaping organisational policies, systems and processes that enable the use of more boundary spanning behaviours is critical. These changes must be collaborative and require considered decision making across the organisation. Excessive inappropriate boundary spanning can lead to chaos, and there may be certain clinical situations where a set procedure must be followed.
On an individual level, healthcare professionals who are focused on providing the best possible patient outcomes are more inclined to span boundaries. They view boundary spanning behaviours as an essential part of their professional responsibilities. Often, the first step is to reflect on the density and diversity of your existing working relationships and networks. For example, if you are a nurse or doctor, does your professional network consist mainly of other nurses or doctors in the organisation?
Ko Awatea is currently developing a framework and social network analysis tool to help Counties Manukau Health staff better understand their boundary spanning practices. This initiative will build capability and capacity for interdisciplinary collaboration among staff.
The pilot is due for completion around February 2017.
For more information, please contact Cathy Qin.