The Coproduction of Health Framework: Seeking Instructive Management Models and Theories.

At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public health) and other industry sectors, began to recognize the limitations of the current fragmented healthcare system paradigm. Primary stakeholders, including employers, insurance companies, and healthcare professional organizations, also voiced dissatisfaction with unacceptable health outcomes and rising costs. Grand challenges and wicked problems threatened the viability of the health sector. American health systems responded with innovations and advances in healthcare delivery frameworks that encouraged shifts from intra- and inter-sector arrangements to multi-sector, lasting relationships that emphasized patient centrality along with long-term commitments to sustainability and accountability. This pathway, leading to a population health approach, also generated the need for transformative business models. The coproduction of health framework, with its emphasis on cross-sector alignments, nontraditional partner relationships, sustainable missions, and accountability capable of yielding return on investments, has emerged as a unique strategy for facing disruptive threats and challenges from nonhealth sector corporations. This chapter presents a coproduction of health framework, goals and criteria, examples of boundary spanning network alliance models, and operational (integrator, convener, aggregator) strategies. A comparison of important organizational science theories, including institutional theory, network/network analysis theory, and resource dependency theory, provides suggestions for future research directions necessary to validate the utility of the coproduction of health framework as a precursor for paradigm change.

Managers as peer workers' allies: A qualitative study of managers' perceptions and actions to involve peer workers in Norwegian mental health and substance use services.

BACKGROUND: Citizens with experience and knowledge about what it is like to use mental health and substance use services are increasingly employed within similar services as peer workers. Peer workers are portrayed as achieving societal obligations and help ensure that the outputs from service provision are more effective. Even though peer workers have worked in mental health and substance use services for a while, few studies have focused on exploring managers' experiences and perspectives about involving peer workers. This knowledge is needed because these managers can enable and hinder equitable involvement and collaboration with peer workers. METHODS: A qualitative explorative study was chosen to explore the following research question: How do managers in Norwegian mental health and substance use services experience, relate to, and embrace peer workers as assets in these services? A researcher (Ph.D. student) and a coresearcher (peer worker) conducted four online focus groups with a strategic selection of 17 Norwegian mental health and substance use services managers who had some experience with the involvement of peer workers in their organizations. RESULTS: The results identified using systematic text condensation are as follows: [1] Peer workers boost the ongoing shift toward increased service user involvement. [2] Peer workers are highly valued in the service transformation process. [3] Managers involve peer workers as partners in co-creation. The results show that managers connect with peer workers and facilitate their involvement in collaborative activities across the service cycle. Peer workers' proximity to service users and bridging capacity is highlighted as the reasons for their involvement. Thus, peer workers are involved in co-defining challenges, co-designing potential solutions, co-delivering those service solutions, and, sometimes, co-assessing service solutions to rethink and improve services. As such, peer workers are considered partners in co-creation. CONCLUSION: As managers involve peer workers, they increasingly discover peer workers' value, and because peer workers are involved, they increase their skills and capacity for collaboration. This research strengthens the knowledge base of the perceived value of peer workers' roles, bringing in new perspectives from management about utilizing and evaluating peer worker roles.

A dynamic framework for making sense of partnerships between universities and informal education providers.

We present a conceptual framework rooted in the practices and experiences of nine collaborative partnerships between universities and informal science education organizations. Our analysis and resulting framework aim to support those brokering, designing, and evaluating partnerships in making sense of the dynamism of interorganizational efforts to collaborate in achieving broader impacts of research. We highlight the critical role of brokers in modulating attentions between interorganizational, intraorganizational, and networked dimensions of their collaborations to maintain partnership health and continue progress toward shared goals.

Mitigating Moral Injury for Palliative Care Clinicians.

Palliative care clinicians (PCCs) in the United States face the combination of increasing burnout and a growing need for their services based on demographic changes and an increasing burden of serious illness. In addition to efforts to increase the number of PCCs and to train other clinicians in "primary palliative skills," we must address the burnout in the field to address the growing gap between need for this care and capacity to provide it. To address burnout in PCCs, we must develop solutions with the unique contributors to burnout in this field in mind. PCCs are particularly susceptible to moral distress and moral injury faced by all clinicians, and these states are inextricably linked to burnout. We propose three solutions to address moral distress and moral injury in PCCs to reduce burnout. These solutions are grounded in the dilemmas particular to palliative care and in best evidence: first, to create space for PCCs to confront moral challenges head-on; second, to integrate ethics consultations into care of some patients cared for by PCCs; and third, to reassess care models for PCCs. These approaches can mitigate burnout and thus address the growing gap in our ability to provide high-quality palliative care for those patients in need.

Leader Boundary-Spanning Behavior and Employee Voice Behavior: The Job Demands-Resources Perspective.

Drawing on the job demands-resources model, we suggest and test a motivational mechanism that underlies the relationship between leader boundary-spanning behavior and employee voice behavior. Based on the field survey data of 383 leader-employee pairs collected from various organizations in South Korea, the results of our mediation model showed that leader boundary-spanning behavior, as a potential job resource, enhances employee voice behavior by increasing employee self-efficacy. The results of our moderated mediation model also showed that the focal leader's abusive supervision, as a potential job demand, could attenuate the beneficial effect of leader boundary-spanning behavior on employee voice behavior by diminishing employee self-efficacy. These findings highlight the importance of leader boundary-spanning behavior in enhancing employee voice behavior, the roles of employee self-efficacy as a key mediating mechanism, and the focal leader's abusive supervision as a preventable boundary condition within these relationships. Theoretical and practical implications are discussed.

First responder perceptions of the system of care and people who use drugs: Spanning boundaries.

Addressing the beliefs of first responders about people who use drugs and the system of care with which they interact must be part and parcel to addressing the opioid crisis. Using a boundary spanning framework, we examine how first responders perceive community behavioral health. With qualitative methods, we asked: What are first responders' lived experiences on the frontlines of the opioid crisis? In sum, it is important to consider that there is a critical role that first responders could play in brokering services when they are not themselves behavioral health practitioners but are, importantly, boundary spanners.

The role of brokers in cultivating an inter-institutional community around open educational resources in higher education.

Brokers are individuals who facilitate transfer of knowledge and resources, and coordinate efforts across boundaries of organizations. They are defined by their role rather than their organizational position. Brokers might be imperative for the formation and maintenance of inter-institutional relationship as they have the responsibility and the necessary structural position to connect otherwise separate groups. In the context of this study, brokers had the role to cultivate an inter-institutional community around open educational resources (OER) by connecting groups of teachers across higher education institutes. OER provide higher education institutes with an aid to face the challenges of improving teaching and learning. Yet most OER users encounter challenges that relate to finding resources that are relevant, up-to-date, and of good quality. Communities could minimize this issue, but many OER initiatives fizzle out as expanding their impact is an arduous task. This qualitative descriptive study draws upon cultural-historical activity theory to understand the complexities associated with the role of brokers in creating sustainable collaboration on OER across 15 higher education institutes in the Netherlands. Data was collected from project documents, process reports, reflections reports, and a retrospective focus group. The findings show that brokers engaged in a wide variety of actions but that a small-scale, personal, and content-oriented approach to encourage teachers to engage with the OER repository and the online community was perceived as the most valuable. Brokers also experienced conflicts due to the demanding context they were operating in, the ambiguity of their role, and the organizational constraints they were confronted with. Practical implications refer to supporting higher education institutes that wish to initiate sustainable collaboration across institutes. Supplementary Information: The online version contains supplementary material available at 10.1007/s10734-022-00876-y.

Peer Workers in Co-production and Co-creation in Mental Health and Substance Use Services: A Scoping Review.

People with lived experience of mental health challenges are extensively employed as peer workers within mental health and substance use services worldwide. Research shows that peer workers benefit individuals using such services and can have essential roles in developing recovery-oriented services. However, understanding how peer workers' contributions, by their role, functions, and input can be better used remains a critical challenge. Research on public sector innovation has focused on relevant actors collaborating to tackle complex demands. Co-production and co-creation are concepts used to describe this collaboration. Co-production refers to the collaboration between providers and users at the point of service delivery, whereas co-creation refers to collaboration starting in the early service cycle phases (e.g., in commissioning or design), including solution implementation. We overviewed research literature describing peer workers' involvement in mental health and substance use services. The research question is as follows: How are peer workers involved in co-production and co-creation in mental health and substance use services, and what are the described outcomes? A literature search was performed in 10 different databases, and 13,178 articles were screened, of which 172 research articles describing peer workers' roles or activities were included. The findings show that peer workers are involved in co-production and function as providers of pre-determined services or, most often, as providers of peer support. However, they are rarely engaged as partners in co-creation. We conclude that the identified peer worker roles have different potential to generate input and affect service delivery and development.

Five approaches to producing actionable science in conservation.

The knowledge produced by conservation scientists must be actionable in order to address urgent conservation challenges. To understand the process of creating actionable science, we interviewed 71 conservation scientists who had participated in 1 of 3 fellowship programs focused on training scientists to become agents of change. Using a grounded theory approach, we identified 16 activities that these researchers employed to make their scientific products more actionable. Some activities were more common than others and, arguably, more foundational. We organized these activities into 3 nested categories (motivations, strategies, and tactics). Using a co-occurrence matrix, we found that most activities were positively correlated. These correlations allowed us to identify 5 approaches, framed as profiles, to actionable science: the discloser, focused on open access; the educator, focused on science communication; the networker, focused on user needs and building relationships; the collaborator, focused on boundary spanning; and the pluralist, focused on knowledge coproduction resulting in valuable outcomes for all parties. These profiles build on one another in a hierarchy determined by their complexity and level of engagement, their potential to support actionable science, and their proximity to ideal coproduction with knowledge users. Our results provide clear guidance for conservation scientists to generate actionable science to address the global biodiversity conservation challenge.

Cinco estrategias para producir ciencia práctica en la conservación Resumen El conocimiento producido por los científicos de la conservación debe ser práctico para poder abordar los obstáculos urgentes que enfrenta la conservación. Entrevistamos a 71 científicos de la conservación que participaron en uno de los tres programas de becas enfocados en la formación de científicos como agentes de cambio para entender el proceso de creación de la ciencia práctica. Usamos una estrategia de teoría fundamentada para identificar 16 actividades empleadas por estos investigadores para hacer más prácticos sus productos científicos. Algunas actividades fueron más comunes que otras y, probablemente, más fundamentales. Organizamos estas actividades en tres categorías anidadas: motivaciones, estrategias y tácticas. Con una matriz de co-ocurrencia, encontramos que la mayoría de las actividades estaban correlacionadas positivamente. Estas correlaciones nos permitieron identificar cinco estrategias, encuadradas como perfiles, para la ciencia práctica: la reveladora, enfocada en el acceso abierto; la educativa, enfocada en la comunicación de la ciencia; la interconectora, enfocada en las necesidades del usuario y en construir relaciones; la colaborativa, enfocada en la expansión de las fronteras; y la pluralista, enfocada en la coproducción del conocimiento como el origen de resultados valiosos para todas las partes. Estas estrategias se apoyan entre sí en una jerarquía determinada por su complejidad y el nivel de compromiso, su potencial para apoyar la ciencia práctica y su proximidad a la coproducción ideal con los usuarios del conocimiento. Nuestros resultados proporcionan directrices claras para que los científicos de la conservación generen ciencia práctica para abordar los retos de conservación que enfrenta la biodiversidad mundial.

Spanning the boundaries between policy, politics and science to solve wicked problems: policy pilots, deliberation fora and policy labs.

Current crises have highlighted the importance of integrating research, politics and practice to work on solutions for complex social problems. In recent years, policy deliberation fora,  policy pilots and policy labs have increasingly been deployed to mobilise science to produce solutions, help create popular support and guide implementation of policies addressing major public policy problems. Yet, we know little about how these approaches manage to transcend the boundaries between research, politics and practice. By systematically comparing policy deliberation fora, policy pilots and policy labs, this paper explores their mechanisms of boundary spanning including relationship and trust building, knowledge translation and developing solutions. We situate our analysis in healthcare policy and climate change policy in Germany, two contrasting policy fields that share a perpetual and escalating sense of crisis. Our findings suggest that deliberation fora, policy pilots and policy labs address different dilemmas of policymaking, namely the idea dilemma, the implementation dilemma and the legitimacy dilemma. All three approaches reduce wicked problems to a manageable scale, by grounding them in local decision-making, reducing their scope or reducing the problem analytically. We argue that despite their ambition to modernise democratic practices, unless they are institutionally well embedded, their effects are likely to be small scale, local and temporary. Supplementary Information: The online version contains supplementary material available at 10.1007/s11625-022-01187-y.

Green entrepreneurial orientation, boundary-spanning search and enterprise sustainable performance: The moderating role of environmental dynamism.

As an important strategic decision for enterprise sustainability, the green entrepreneurial orientation can facilitate boundary-spanning search for external knowledge and resources to achieve triadic sustainable economic, environmental, and social performance. Based on organizational search theory and dynamic capability theory, this study introduces environmental dynamism into the model of the relationship between green entrepreneurial orientation, boundary-spanning search and enterprise triadic sustainable performance. By analyzing the questionnaire data from 202 managers of manufacturing SMEs, the study explores the internal and external influences of green entrepreneurial orientation on the enterprise sustainable performance. The results show that: green entrepreneurial orientation has a positive impact on enterprise economic, environmental and social performance; boundary-spanning search plays a fully mediating role between green entrepreneurial orientation and enterprise economic, environmental and social performance; environmental dynamism, as a key external environmental factor, positively regulates the relationship between boundary-spanning search and enterprise economic performance and environmental performance, and negatively regulates the relationship between boundary-spanning search and social performance. This study clearly demonstrates how green entrepreneurial orientation in the environmental era can drive triadic sustainable performance improvement of enterprises. In addition, this study argues that boundary-spanning search is an important tool that enables manufacturing SMEs to achieve a triad of coordinated sustainable development of economic, environmental and social benefits in a dynamic environment.

Influences of Boundary-Spanning Leadership on Job Performance: A Moderated Mediating Role of Job Crafting and Positive Psychological Capital.

Due to the pursuit of a flexible organization, the interest in internal as well as external boundary management has increased as a key to achieve high performance. This study identified boundary-spanning leadership (BSL) as a critical factor enhancing job crafting and job performance of subordinates. By examining the mediating effect of job crafting and the moderating effect of positive psychological capital (PsyCap), the authors aimed to present the effects of BSL assimilating job resources, such as external information and knowledge into organization. Data were collected from 238 workers of 11 companies using questionnaires in South Korea to test the moderated mediation model. The results of regression analysis using LISREL and SPSS, revealed that the manager's BSL provoked job crafting, which in turn achieved job performance of subordinates. Moreover, PsyCap positively moderated the effect of BSL on job crafting of subordinates. The findings suggested, therefore, in order to maximize the positive effects of BSL in an organization, it should also be necessary to understand and boost PsyCap along with enhancing job crafting.

How leader humor stimulates subordinate boundary-spanning behavior: A social information processing theory perspective.

Based on social information processing theory, we provide a novel theoretical account of how and when leader humor influences subordinate boundary-spanning behavior. We develop a moderated mediation model explicating the mechanism of psychological safety and the boundary condition of subordinate interpersonal influence. Using multiwave data, we tested our research hypotheses with a sample of 452 members from 140 teams in a Chinese information technology (IT) company. Results showed that leader humor positively affects subordinate boundary-spanning behavior via increased psychological safety. Moreover, this mediated effect is stronger when subordinates have high interpersonal influence. These findings offer theoretical and practical insights into boundary-spanning activities and leader humor, which we discuss.

The impact of policy perception on technology transfer from boundary-spanning perspective-empirical evidence from Chinese technological enterprises.

Technology transfer is an essential source of technological innovation for enterprises, which is conducive to the market transformation of patent achievements and the commercial application of new technologies. Building upon social capital theory, all data analyses were performed using SPSS 22.0 and Amos software with the multiple linear regression method. The study explores the mechanism of policy perception to obtain the technical resources needed for enterprise development through boundary-spanning behavior, with a moderating effect of inter-organizational trust and technological potential gap. The study uses survey data from 125 enterprise teams of 42 technology-based enterprises in China. The results show that policy perceived usefulness and usability significantly promote technology transfer performance and boundary-spanning behavior plays a mediating role between them. Speaking of the influencing factors of technology transfer, technological potential gap significantly moderates the relationship between boundary-spanning and technology transfer performance. In contrast, inter-organizational trust positively moderates the relationship between boundary-spanning and technology transfer performance. The research provides theoretical reference and guidance for enterprises on using policy perception better to improve technology transfer performance in the institutional environment. It also helps inspire enterprises to better deal with the cooperative relationship between relevant stakeholders and achieve win-win cooperation.

Innovation in Boundary-Spanning Technology M&A: A Fuzzy-Set Analysis of Diversity Dynamics.

The growing literature on organizational innovation has drawn attention from net effect and contingent effect of diversity-related factors in the context of top management teams (TMTs) to their complementarity and interaction in the form of configurations. In post-boundary-spanning technology mergers & acquisitions (M&A), the integration between multi-boundary knowledge and resources necessitates effective communication and cooperation within TMTs that display heterogeneous attributes. Therefore, this study integrates two popular theoretical perspectives from the diversity literature (social categorization perspectives and information/decision-making perspectives) in order to explore the configurational patterns of factors stimulating innovation in boundary-spanning technology M&A (BTM&A). In accordance with this theoretical objective, this study adopts fuzzy-set qualitative comparative analysis for the purpose of examining the complex combinations of five antecedent conditions (functional experience diversity, boundary-spanning experience diversity, faultline strength, number of subgroups, and subgroup balance) based on a BTM&A sample of firms in the Chinese A-share market during the period 2007-2018. Findings from this analysis indicates four configurations of diversity-related factors (the dominated multiple diversities; the non-aligned multiple diversities; the balanced similarity; and the aligned single diversity) which lead to superior innovation in BTM&A. This study fills a gap in the literature vis-à-vis the causes of innovation in BTM&A and provides novel insights for management practitioners to take appropriate countermeasures with regard to TMT diversity.

Why serendipitous informal knowledge sharing interactions are key to boundary spanning and creativity.

BACKGROUND: Informal Knowledge Sharing Interactions (IKSI) are particularly valuable for innovation projects if they connect partners who are categorically, socially and formally distant from each other. Then the chances are higher that partners possess non-redundant knowledge and can thus open up new perspectives. By improving their knowledge supply, IKSI enhance the success, job satisfaction and well-being of employees in knowledge-intensive industries. So far, however, it is unclear how such interactions between heterogeneous partners emerge. OBJECTIVE: The paper examines the formation of IKSI and develops the argument that serendipitous IKSI are more likely than planned IKSI to connect heterogeneous partners and open up new perspectives. METHODS: The paper develops the argument in detail and empirically grounded by drawing together the unconnected literatures on the formation and impact of IKSI. Furthermore, the argument is empirically tested using 132 IKSI from developers collected with event-based diaries. RESULTS: In line with the conceptual work, the empirical analysis shows that serendipitous IKSI are more likely than planned ones to open up new perspectives. CONCLUSION: Serendipitous IKSI are of particular significance and require appropriate promotion in order to enhance innovative capability. The increasing virtualization of work is creating opportunities and challenges in this regard.

Top management team boundary-spanning leadership: Measurement development and its impact on innovative behavior.

With the advancement of digital economy, organizations around the world need to stretch the boundaries of their strategy, business, and knowledge to gain a competitive advantage and achieve sustainable growth. Although boundary-spanning leadership, with a set of practical tools developed by the Center for Creative Leadership (CCL), has been explored over the past 10 years, the comprehensive understanding of top management team boundary-spanning leadership has still reached no consensus. This research focuses on the concept of top management team boundary-spanning leadership (TMTBSL) and its effect on employees' innovative behavior. Study 1 comprises the concept of TMTBSL and the measurement of its development. The classical grounded theory was used to analyze biographical texts and in-depth interview data from local Chinese organizations. We developed a 5-dimension scale with14 items for TMTBSL. In Study 2, we empirically examined the impact of TMTBSL on employees' innovative behavior. The results demonstrate that TMTBSL can promote employee innovative behavior through perceived motivational climate. The theoretical and practical implications are also outlined.

Mobilising urban knowledge in an infodemic: Urban observatories, sustainable development and the COVID-19 crisis.

Along with disastrous health and economic implications, COVID-19 has also been an epidemic of misinformation and rumours - an 'infodemic'. The desire for robust, evidence-based policymaking in this time of disruption has been at the heart of the multilateral response to the crisis, not least in terms of supporting a continuing agenda for global sustainable development. The role of boundary-spanning knowledge institutions in this context could be pivotal, not least in cities, where much of the pandemic has struck. 'Urban observatories' have emerged as an example of such institutions; harbouring great potential to produce and share knowledge supporting sustainable and equitable processes of recovery. Building on four 'live' case studies during the crisis of institutions based in Johannesburg, Karachi, Freetown and Bangalore, our research note aims to capture the role of these institutions, and what it means to span knowledge boundaries in the current crisis. We do so with an eye towards a better understanding of their knowledge mobilisation practices in contributing towards sustainable urban development. We highlight that the crisis offers a key window for urban observatories to play a progressive and effective role for sustainable and inclusive development. However, we also underline continuing challenges in these boundary knowledge dynamics: including issues of institutional trust, inequality of voices, collective memory, and the balance between normative and advisory roles for observatories.

Supporting the vital role of boundary-spanning physician researchers in the advancement of medical innovation.

A wide range of stakeholders recognise that physicians play a vital role in medical innovation and, in particular, the importance of boundary-spanning engagement between physicians and industry in clinical research. While UK physicians are keen to take part in research, this article draws on a range of literature to identify apparent and anticipated challenges that discourage or prevent cross-sector engagement by physician researchers. To encourage greater interaction and exploration of associated support mechanisms, we present a full spectrum of engagement modes, funding opportunities and illustrative initiatives, showing how different stakeholders (from government institutions, charities, professional bodies and industry) can contribute to improving the engagement of physicians in boundary spanning research. We emphasise the importance of mutual understanding, trust and commonly shared practices, as well as adequate resources, to encourage these vital interactions.

Boundary spanning and identity work in the clinical research delivery workforce: a qualitative study of research nurses, midwives and allied health professionals in the National Health Service, United Kingdom.

BACKGROUND: Research nurses, midwives and allied health professionals are members of an important emergent profession delivering clinical research and, in the United Kingdom, have been the focus of considerable investment by the National Institute for Health Research (NIHR). This paper considers the experiences of research nurses, midwives and allied health professionals in relation to professional identity work, recognizing these are coproduced alongside others that they interact with (including patients, clinical staff and other research staff). METHODS: Semi-structured interviews were conducted with 45 nurses, midwives and allied health professionals in the UK about their experiences of working in research delivery. Interviews were transcribed verbatim and thematically coded and analysed. RESULTS: Our analysis highlights how research nurses, midwives and allied health professionals adjust to new roles, shift their professional identities and undertake identity work using uniforms, name badges and job titles as they negotiate complex identities. CONCLUSIONS: Research nurses, midwives and allied health professionals experience considerable challenges as they enter and transition to a research delivery role, with implications for their sense of professional identities. A change in the work that they undertake and how they are (or perceive they are) viewed by others (including clinical non-research colleagues and patients) has implications for their sense of professional and individual identity. The tensions involved extend to their views on symbols of professional identity, such as uniforms, and as they seek to articulate and demonstrate the value of their conjoined role in research and as a healthcare professional, within the unfolding landscape of health research. We embed our study findings in the context of the newly emerging clinical research practitioner workforce, which further exacerbates and complicates the role and identity complexity for nurses, midwives and allied health professionals in research delivery.