This paper proposes that boundary work is inherent to leadership practices in healthcare settings, and explores this phenomenon in interprofessional healthcare teams. Specifically, the study focuses on leading through and across boundaries in four interprofessional healthcare teams operating in the area of mental health services. We give special consideration to the specific contexts of these teams, and address the boundaries that are constructed and managed in interactions. Our qualitative study revealed that leadership can be exercised by different members and at different levels within the teams, and that it involves managing the boundaries between (a) roles of different members of the leadership constellation, (b) leadership and clinical roles, (c) formal leaders and other members of the team, (d) different professions, (e) personal life experiences and professional work, and (f) the team and what members consider to be the environment. We identify different types of boundary work tactics that involve opening, closing, and contesting/ negotiating boundaries. In addition, we address the potential consequences of each of these tactics. We consider the implications of our findings to leadership research and practice in healthcare contexts and beyond.

The challenges of managing interprofessional boundaries within multidisciplinary teams are well known. However, the role of intraprofessional relations in influencing the dynamics of interprofessional collaboration remain underexplored. Our qualitative study offers a fine-grained analysis of the interplay between inter- and intraprofessional boundary work among three professional groups in a multidisciplinary team over a period of two years. Our contribution to the literature is threefold. First, we identify various forms of “competitive” and “collaborative” boundary work that may occur simultaneously at both inter- and intraprofessional levels. Second, we reveal the dynamic interplay between inter- and intraprofessional boundary negotiations over time. Third, we theorize relationships between the social position of professional groups, and the uses and consequences of competitive and collaborative boundary work tactics at intra- and interprofessional levels. Specifically, we show how intraprofessional conflict within high-status groups may affect interprofessional dynamics, we reveal how intraprofessional and interprofessional boundaries may be mobilized positively to support collaborative relations, and we show how mobilization within lower-status groups around interprofessional boundary grievances can paradoxically lead to further marginalization.

This article analyses an alliance between a public utility company and a consortium of Associations upholding consumer rights. The project consists of developing means in order to help customers with very low income in a collection situation by suggesting payment arrangements that would take account of their financial situation. Inter-organizational collaboration is a way to increase the capacities of organizations and to apply leverage to existing resources so as to solve social problems more effectively by pooling together resources, skills and knowledge. We examine the making of this social innovation through the arrangements taking in three institutional dimensions: cognitive, normative and regulative. The case study shows that the legitimacy of the agreement was based on recombining the values of fairness and solidarity. The innovation process was rooted in the exchange of knowledge and access to resources based on the expertise of actors. The agreement moved beyond the experimental framework when it was diffused as a newly learned procedure which became an organizational routine.Alianza intersectorial e innovación social: ¿ Cuándo la empresa comercial se cruza con la sociedad civil ?El artículo examina la alianza entre una empresa de servicios públicos y un consorcio formado por asociaciones de defensa de los derechos de los consumidores. El proyecto consiste en desarrollar medios para ayudar a los clientes con menores rentas y dificultades de pago. Se trata de proponer modalidades de pago que tengan en cuenta su situación financiera. La colaboración interorganizativa es una forma de incrementar las capacidades de las organizaciones para una puesta en común de las competencias, * The authors thank the editor of the journal and anonymous reviewers for their helpful comments throughout the review process. We also appreciate the comments on an earlier draft from our colleagues and students of Centre de recherche sur les innovations sociales (CRISES).

While there is growing recognition of leadership as a collective phenomenon, the question of how leadership is shared in the context of hierarchical asymmetry has been neglected in the collective leadership literature. Our article addresses this gap by examining how sharing leadership is negotiated in team interactions that are steeped in asymmetry deriving from the professional hierarchy. Adopting a leadership-in-interaction approach, we draw on fine-grained analysis of observed interactions on interprofessional teams from two health care organizations to compare the discursive strategies used by professionals in a superior hierarchical position to the ones used by those in inferior positions to share leadership. These strategies are organized into a matrix of interactional moves that resist or enact the professional hierarchy. Empirical vignettes are provided to demonstrate how sharing leadership and hierarchical leadership can be co-present and even intertwined in an interaction. We show that leadership is shared (or not) as a result of how the professional hierarchy gets negotiated in interactions. More specifically, we conclude that the sharing of leadership in this context tends to occur prior to decision making, especially around problem formulation, if the interactional climate allows. Furthermore, it requires concrete effort: Those in superior positions of influence mindfully relax the hierarchy whereas those in inferior positions create moments of sharing leadership through resistance and struggle.

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This article suggests including drawing, a participative visual method, when designing organizational change research. It is based on a comparative analysis of three research protocols that have integrated drawing as a data collection method. Examining how drawing has been used in these studies leads to the identification of four elicitation processes—contextualizing, exemplifying, focusing, and reflecting—by which drawing gives access to data that would be more challenging to collect with conventional research methods alone. The article shows that these processes bring the participants’ emotions, lived experiences, and cultural influences to light in ways that may considerably enrich organizational change research. It ends by providing a set of guidelines on how to employ drawing in triangulation with other data collection methods.

The literature on paradoxes and pluralism has grown over the last decade. Although both concepts refer to multiplicity in or around organizations, they have been explored in parallel and have rarely been juxtaposed. The aim of this chapter is to discuss the possible interrelations between these concepts and their implications for the study of paradox within organizations. The chapter further seeks to contrast current notions of paradox and pluralism, and expand understanding of these phenomena by looking at them through two alternate theoretical prisms, namely Critical Management Studies (CMS) and complexity theory. In so doing, new lines of inquiry are opened up around paradoxical situations in pluralistic organizations. These alternate prisms invite further exploration into the interface between paradoxes and pluralism, and highlight the potential of performativity without instrumentality to guide strategies for balancing and benefiting from these important dimensions of contemporary organizations.

Résumé -L'article examine une alliance entre une entreprise de service publique et des associations de défense des droits des consommateurs. Le projet de l'alliance consiste à développer un service régi conjointement pour aider les clients à faible revenu en situation de recouvrement. Ce projet met en oeuvre un type de coopération original et inédit entre des organisations provenant de secteurs d'activités distincts. Le projet est conçu comme une innovation sociale, soit une initiative qui émane des acteurs locaux et qui forment une alliance avec des acteurs provenant d'autres milieux d'intervention afin de résoudre un problème. Ce type de relations repose sur la coopération entre une variété d'acteurs lorsque les institutions existantes ne peuvent fournir les ressources afin de résoudre le problème à la satisfaction des personnes impliquées. Le partenariat constitue l'une des configurations organisationnelles propices à l'innovation sociale. nous proposons une analyse du cas sous les angles suivants essentiels à la compréhension du processus d'innovation sociale: le contexte, la problématisation, les acteurs collectifs, les échanges et la coalition, avant de commenter le résultat de cette innovation sociale entrainant sa pérennisation. Mots-clés: innovation sociale, institution, processus, réseau d'innovation, organisation.Resumo -anáLise De uMa prática intersectoriaL inovaDora. eMpresas púBLicas e associações De DeFesa Dos Direitos Dos consuMiDores. este artigo foca a aliança entre uma empresa pública e associações de defesa dos direitos dos consumidores, centrando-se num projecto que visa desenvolver uma cooperação original e inédita entre sectores distintos, para ajudar clientes com baixos rendimentos em situação de incumpri- mento. O projecto está concebido como uma inovação social, ou seja, uma iniciativa que parte de actores locais para criar alianças com outros meios de intervenção, tendo em vista resolver um problema. este tipo de relações baseia-se na cooperação entre diversos actores, quando as instituições se revelam incapazes de resolver uma situação a contento dos interessados. estas parcerias representam configurações organizacionais propícias à inovação. neste artigo analisa-se um caso sob as seguintes perspectivas, essenciais para a compreensão do processo de inovação social: o contexto, a problematização, os actores, as permutas e a coligação.Palavras-chave: inovação social, instituição, processo, rede de inovação, organização.abstract -anaLysis oF an innovative cross-sectoriaL practice. puBLic enterprises anD associations For tHe protection oF consuMer rigHts. this article focuses on the alliance between a public company and associations for the protection of consumer rights, focusing on a project that aims to develop a unique and unprecedented cooperation between different sectors to help low-income customers in default. the project is conceived as a social innovation, i.e., an initiative involving local actors to create alliances with other means of intervention in order to solve a problem. ...