IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v366y2025ics0277953625000218.html
   My bibliography  Save this article

Frontline professionals’ experiences of navigating boundaries in a layered care and support system for individuals with complex care needs in the Netherlands

Author

Listed:
  • van Muijden, Teyler
  • Petit-Steeghs, Violet
  • Aspria, Marcello
  • Bal, Roland
  • van de Bovenkamp, Hester

Abstract

Fragmented care systems, characterized by horizontal and vertical boundaries, hinder interprofessional collaboration for individuals with complex care needs. This study explores how frontline professionals navigate these boundaries to foster collaboration within a national program promoting integrated care for individuals with ‘misunderstood behaviour’ in the Netherlands. Using a boundary work lens, we analysed 44 semi-structured interviews with frontline professionals from the social, care, and safety domains. Our findings reveal that frontline professionals employ a multifaceted repertoire of collaborative boundary work strategies. These strategies include adjusting boundaries (expanding roles and tasks to address individuals' needs), spanning boundaries (creating boundary spanners, co-locations, and boundary objects), and working around boundaries (finding creative solutions to overcome financial and legislative limitations). The choice of strategy deployed depended on the agency professionals experienced in relation to specific types of boundaries. Professionals' limited agency regularly constrained the effectiveness of strategies. In these cases, professionals relied on interventions of higher-level actors. This reliance involved both direct interventions by managers and administrators to rearrange boundaries and indirect support, empowering frontline professionals with the flexibility and autonomy to navigate boundaries themselves. These findings introduce a power dimension to the conceptualization of boundary work and underscore the importance of addressing the interconnectedness of different types of boundaries at various levels.

Suggested Citation

  • van Muijden, Teyler & Petit-Steeghs, Violet & Aspria, Marcello & Bal, Roland & van de Bovenkamp, Hester, 2025. "Frontline professionals’ experiences of navigating boundaries in a layered care and support system for individuals with complex care needs in the Netherlands," Social Science & Medicine, Elsevier, vol. 366(C).
    • Handle: RePEc:eee:socmed:v:366:y:2025:i:c:s0277953625000218
    DOI: 10.1016/j.socscimed.2025.117692
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953625000218
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2025.117692?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Fleming, Mark D. & Safaeinili, Nadia & Knox, Margae & Hernandez, Elizabeth & Brewster, Amanda L., 2023. "Between health care and social services: Boundary objects and cross-sector collaboration," Social Science & Medicine, Elsevier, vol. 320(C).
    2. Silke Bucher & Ann Langley, 2016. "The Interplay of Reflective and Experimental Spaces in Interrupting and Reorienting Routine Dynamics," Organization Science, INFORMS, vol. 27(3), pages 594-613, June.
    3. Wanda J. Orlikowski, 2002. "Knowing in Practice: Enacting a Collective Capability in Distributed Organizing," Organization Science, INFORMS, vol. 13(3), pages 249-273, June.
    4. Bishop, Simon & Waring, Justin, 2019. "From boundary object to boundary subject; the role of the patient in coordination across complex systems of care during hospital discharge," Social Science & Medicine, Elsevier, vol. 235(C), pages 1-1.
    5. Nolte, Ellen & Knai, Cécile & Hofmarcher, Maria & Conklin, Annalijn & Erler, Antje & Elissen, Arianne & Flamm, Maria & Fullerton, Brigit & Sönnichsen, Andreas & Vrijhoef, Hubertus J. M., 2012. "Overcoming fragmentation in health care: chronic care in Austria, Germany and the Netherlands," Health Economics, Policy and Law, Cambridge University Press, vol. 7(1), pages 125-146, January.
    6. Dowrick, Anna & Kelly, Moira & Feder, Gene, 2020. "Boundary spanners: Negotiating connections across primary care and domestic violence and abuse services," Social Science & Medicine, Elsevier, vol. 245(C).
    7. Pedersen, Pia Vivian & Hjelmar, Ulf & Høybye, Mette Terp & Rod, Morten Hulvej, 2017. "Can inequality be tamed through boundary work? A qualitative study of health promotion aimed at reducing health inequalities," Social Science & Medicine, Elsevier, vol. 185(C), pages 1-8.
    8. Stoopendaal, Annemiek & Bal, Roland, 2013. "Conferences, tablecloths and cupboards: How to understand the situatedness of quality improvements in long-term care," Social Science & Medicine, Elsevier, vol. 78(C), pages 78-85.
    9. Allen, Davina, 2009. "From boundary concept to boundary object: The practice and politics of care pathway development," Social Science & Medicine, Elsevier, vol. 69(3), pages 354-361, August.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Fleming, Mark D. & Safaeinili, Nadia & Knox, Margae & Hernandez, Elizabeth & Brewster, Amanda L., 2023. "Between health care and social services: Boundary objects and cross-sector collaboration," Social Science & Medicine, Elsevier, vol. 320(C).
    2. Davina Allen & Carl May, 2017. "Organizing Practice and Practicing Organization: An Outline of Translational Mobilization Theory," SAGE Open, , vol. 7(2), pages 21582440177, June.
    3. Skovgaard, Anna Louise & Jørgensen, Marianne Johansson & Tjørnhøj-Thomsen, Tine & Høybye, Mette Terp, 2022. "Discharge readiness as an infrastructure: Negotiating the transfer of care for elderly patients in medical wards," Social Science & Medicine, Elsevier, vol. 312(C).
    4. Verena Brinks, 2016. "Situated affect and collective meaning: A community perspective on processes of value creation and commercialization in enthusiast-driven fields," Environment and Planning A, , vol. 48(6), pages 1152-1169, June.
    5. Gilstrap, J. Bruce & Hart, Timothy A., 2020. "How employee behaviors effect organizational change and stability," Journal of Business Research, Elsevier, vol. 109(C), pages 120-131.
    6. Niki A. den Nieuwenboer & João Vieira da Cunha & Linda Klebe Treviño, 2017. "Middle Managers and Corruptive Routine Translation: The Social Production of Deceptive Performance," Organization Science, INFORMS, vol. 28(5), pages 781-803, October.
    7. Genevieve Musca, 2007. "La construction de compétences dans l'action," Post-Print hal-01517916, HAL.
    8. Emmanuelle Vaast & Geoff Walsham, 2009. "Trans-Situated Learning: Supporting a Network of Practice with an Information Infrastructure," Information Systems Research, INFORMS, vol. 20(4), pages 547-564, December.
    9. Josefin Borg & Anna Yström, 2020. "Collaborating for energy efficiency in Swedish shipping industry: interrelating practice and challenges," Environment, Development and Sustainability: A Multidisciplinary Approach to the Theory and Practice of Sustainable Development, Springer, vol. 22(5), pages 4289-4310, June.
    10. Susanne Schnitzer & Raphael Kohl & Hella Fügemann & Kathrin Gödde & Judith Stumm & Fabian Engelmann & Ulrike Grittner & Nina Rieckmann, 2022. "Patient Navigation—Who Needs What? Awareness of Patient Navigators and Ranking of Their Tasks in the General Population in Germany," IJERPH, MDPI, vol. 19(5), pages 1-13, March.
    11. Swan, Jacky & Goussevskaia, Anna & Newell, Sue & Robertson, Maxine & Bresnen, Mike & Obembe, Ademola, 2007. "Modes of organizing biomedical innovation in the UK and US and the role of integrative and relational capabilities," Research Policy, Elsevier, vol. 36(4), pages 529-547, May.
    12. Beth A. Bechky, 2006. "Gaffers, Gofers, and Grips: Role-Based Coordination in Temporary Organizations," Organization Science, INFORMS, vol. 17(1), pages 3-21, February.
    13. Markku Sotarauta & Nina Mustikkamäki, 2015. "Institutional Entrepreneurship, Power, and Knowledge in Innovation Systems: Institutionalization of Regenerative Medicine in Tampere, Finland," Environment and Planning C, , vol. 33(2), pages 342-357, April.
    14. List, Henriette & Kristensen, Dorthe Brogård & Graumann, Ole, 2025. "“The highest decision-making level” – Multidisciplinary team meetings as boundary spaces," Social Science & Medicine, Elsevier, vol. 371(C).
    15. Dragos Vieru & Pierre-Emmanuel Arduin, 2016. "Sharing Knowledge in a Shared Services Center Context: An Explanatory Case Study of the Dialectics of Formal and Informal Practices," Post-Print hal-01458031, HAL.
    16. Simon Colnar & Ivan Radević & Nikola Martinović & Anđelko Lojpur & Vlado Dimovski, 2022. "The role of information communication technologies as a moderator of knowledge creation and knowledge sharing in improving the quality of healthcare services," PLOS ONE, Public Library of Science, vol. 17(8), pages 1-24, August.
    17. Zec, Dejan & Rüling, Charles-Clemens & Wang, Tao, 2020. "Parliament in action: Drug withdrawals and policy changes in the U.K," Health Policy, Elsevier, vol. 124(9), pages 984-990.
    18. Mohajan, Haradhan, 2016. "Sharing of Tacit Knowledge in Organizations: A Review," MPRA Paper 82958, University Library of Munich, Germany, revised 15 Jun 2016.
    19. Ladds, Emma & Greenhalgh, Trisha & Byng, Richard & Rybczynska-Bunt, Sarah & Kalin, Asli & Shaw, Sara, 2023. "A contemporary ontology of continuity in general practice: Capturing its multiple essences in a digital age," Social Science & Medicine, Elsevier, vol. 332(C).
    20. Anca Metiu, 2006. "Owning the Code: Status Closure in Distributed Groups," Organization Science, INFORMS, vol. 17(4), pages 418-435, August.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:366:y:2025:i:c:s0277953625000218. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.