'Trying to patch a broken system’: Exploring institutional work among care professions for interprofessional collaboration

TY - JOUR

T1 - 'Trying to patch a broken system’: Exploring institutional work among care professions for interprofessional collaboration

AU - Hald, Andreas Nielsen

AU - Bech, Mickael

AU - Enemark, Ulrika

AU - Shaw, Jay

AU - Burau, Viola

PY - 2024/2/1

Y1 - 2024/2/1

N2 - There is a growing interest in understanding when and why interprofessional collaborations are well functioning, especially within healthcare systems. However, more knowledge is needed about how professionals affect and contribute to these collaborations when they engage in them. To address this shortcoming, this study aims to contribute to professional and organizational studies of interprofessional collaboration by providing novel insights into how professionals engage in and contribute to interprofessional collaborations. It builds on a theoretical perspective of examining professionals' everyday collaboration practices through the interplay between temporal-oriented agency and institutional work. It applies this perspective to a case study of interprofessional collaboration between personal workers (PWs), nurses, and therapists in the home care sector in Denmark. Overall, the findings show that the professionals engaged in and contributed to the interprofessional collaboration by 'trying to patch a broken system'. All three professional groups did this primarily by 'adopting new practices to deal with inept institutionalized practices' to maintain collaboration. Additionally, some PWs 'failed to enact institutionalized practices' to disrupt the collaboration, and some nurses and therapists 'invented and established mechanisms' to create new arrangements for the collaboration. Based on the findings, the study demonstrates that certain dimensions of agency are associated with certain types of institutional work. Furthermore, the study suggests that the interplay between agency and institutional work varies between professional groups, influenced by their relative autonomy.

AB - There is a growing interest in understanding when and why interprofessional collaborations are well functioning, especially within healthcare systems. However, more knowledge is needed about how professionals affect and contribute to these collaborations when they engage in them. To address this shortcoming, this study aims to contribute to professional and organizational studies of interprofessional collaboration by providing novel insights into how professionals engage in and contribute to interprofessional collaborations. It builds on a theoretical perspective of examining professionals' everyday collaboration practices through the interplay between temporal-oriented agency and institutional work. It applies this perspective to a case study of interprofessional collaboration between personal workers (PWs), nurses, and therapists in the home care sector in Denmark. Overall, the findings show that the professionals engaged in and contributed to the interprofessional collaboration by 'trying to patch a broken system'. All three professional groups did this primarily by 'adopting new practices to deal with inept institutionalized practices' to maintain collaboration. Additionally, some PWs 'failed to enact institutionalized practices' to disrupt the collaboration, and some nurses and therapists 'invented and established mechanisms' to create new arrangements for the collaboration. Based on the findings, the study demonstrates that certain dimensions of agency are associated with certain types of institutional work. Furthermore, the study suggests that the interplay between agency and institutional work varies between professional groups, influenced by their relative autonomy.

KW - agency

KW - care professions

KW - healthcare

KW - institutional work

KW - interprofessional collaboration

KW - practices

UR - http://www.scopus.com/inward/record.url?scp=85188161454&partnerID=8YFLogxK

U2 - 10.1093/jpo/joad027

DO - 10.1093/jpo/joad027

M3 - Journal article

SN - 2051-8803

VL - 11

SP - 47

EP - 60

JO - Journal of Professions and Organization

JF - Journal of Professions and Organization

IS - 1

ER -