Leadership as boundary work in healthcare teams

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.