There is a vast array of new innovations available to the health and care system. However, the evidence base is often lacking, with traditional research studies taking years to produce robust results. In the interim, the clinical or system need and/or the innovation itself may have evolved. This is partly driven by the nature of what constitutes good research. But it also reflects differences between a risk-averse mindset versus permission to fail and fail fast.
Boundary spanning is a concept coined to describe individuals within a system who have, or adopt, the role of linking the organisation’s internal networks with external sources of information to share knowledge and benefit from new ideas and ways of working. It’s particularly important in research, innovation and improvement projects. Kitson, Brook, Harvey et al. (2018) say that boundary spanning is crucial in capitalising on opportunities to ‘think differently and deeply‘ where ‘innovation comes from thinking in complex and systemic ways about issues”1.
A key part of our role is to convene industry, citizens, health and care partners and academia to facilitate the piloting and evaluation of innovation at pace. In healthcare these relationships can be complicated due to sometimes conflicting priorities, accountability or funding streams, which is where integrated care systems can have a key role in identifying the key priorities which need to be addressed at a system-wide level. But how can this boundary spanning mindset be applied across these systems?
Here we offer 3 key opportunities for boundary spanning to address the challenges for organisations and the workforce across health and care.
Ensuring our projects facilitate meaningful patient and public involvement (PPI) helps ensure we focus on the real needs of patients, building on their lived experience to ensure we are implementing and evaluating innovations to make the biggest possible impact on outcomes and health inequalities. This co-design of innovation needs to be at the centre of healthcare transformation. Eastern AHSN work with partners across academia and healthcare to build patient voice into programmes, including hosting the East of England Citizen Senate, a group of patient leaders and representatives who have the experience and expertise to contribute to a wide range of projects, whilst UEA Health and Social Care Partners develops collaborative research to address health inequalities in the local populations to drive service developments, innovation and improvements.
Hand in hand with citizen driven innovation is the need to collaborate and translate knowledge across sectors – industry, academia, policy makers, clinicians and citizens, and education and research2 – to drive sustainable improvements. Successful boundary spanning is facilitated by close collaboration and partnerships ‘it is a team sport that is enabled by shared playing fields’3 and has the potential to reap new rewards by pooling the talents and skills of people who might not formerly have worked together.
Eastern AHSN continues to strengthen collaborations across industry, academia and health and care even further – particularly with existing evaluation groups and research hubs as well as East of England Applied Research Collaboration (ARC) – in order that innovations can be piloted and evaluated nimbly and at pace. Our aim is to ensure the consistent generation of robust evidence to inform commissioning and decision-making across the region and beyond.
Organisations don’t talk, people do. We need to encourage the health and care workforce and leaders to develop the skills to boundary span effectively, building relationships and knowing who to involve and how to do so. However, these skills are useless if people don’t have the confidence, mindset or authority to engage groups outside of their own organisation. Enabling cross-boundary cooperation – whether through formal arrangements, peer support or public engagement – helps our workforce develop new skills, understand broader perspectives and develop a deeper understanding of the issues faced and how they might be addressed. Buy-in from all the key stakeholders is crucial, and it’s vital that leaders see the value to build an open and engaged culture.
By taking a boundary spanning approach to innovation and healthcare planning, we can achieve better insight, shared responsibility and ensure the best chance of success in our programmes whilst empowering voices to make sure we are addressing the right issues. If a problem is systemic, how can you solve it on your own?
Citizens, academia, health services and industry will achieve more working together than they will in isolation. Our job is to make this happen. We convene people to develop and deliver breakthrough products, processes and technologies.
If you want to learn more about our work or need help with a challenge you face in delivering health and care services, get in touch.
Sophie leads the local, regional and commissioned portfolio for the Delivery Team, with particular oversight over the organisation’s evaluations. Prior to joining Eastern AHSN in September 2019, Sophie worked in health policy research at Nuffield Trust and RAND Europe. Sophie gained her MPhil from the University of Cambridge in 2011.
Carrie is the Research Director at UEA Health and Social Care Partners as well as Director of the ImpACT Research Group. She is also the Associate Professor of Practice Transformation at the School of Health Sciences, Faculty of Medicine and Health Sciences at University of East Anglia.
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