The article examines the process of innovation and knowledge sharing from a perspective that focuses on the influence that local circumstances can have. In particular, it looks at the problems of knowledge sharing between groups of professionals. It presents a comparative analysis of two studies, one involving two groups of IT professionals; the other a network of healthcare professionals. The data was collected in two sets. The first set consisted of the results from two earlier, independent studies; the second was collected specifically for this article. We investigate the role played by boundary objects and brokers. Through an analysis of the interplay between boundary object and broker, we uncover the dynamics of the innovation process and show that the role played by the broker can be political. We identify two strategies that are used by brokers in the selection of a boundary object. The first is directed towards achieving a balance between the actors involved and the second is directed towards controlling their activities. We conclude by suggesting that other researchers should also consider the interplay between broker and boundary object when examining cross boundary knowledge sharing.

Research question: We are looking at the process of structuring an integrated care system as an innovative process that swings back and forth between the diversity of the actors involved, local aspirations and national and regional regulations. We believe that innovation is enriched by the variety of the actors involved, but may also be blocked or disrupted by that diversity. Our research aims to add to other research, which, when questioning these integrated systems, analyses how the actors involved deal with diversity without really questioning it.Case study: The empirical basis of the paper is provided by case study analysis. The studied integrated care system is a French healthcare network that brings together healthcare professionals and various organisations in order to improve the way in which interventions are coordinated and formalised, in order to promote better detection and diagnosis procedures and the implementation of a care protocol. We consider this case as instrumental in developing theoretical proposals for structuring an integrated care system in light of the diversity of the actors involved. Results and discussion:We are proposing a model for structuring an integrated care system in light of the enacted diversity of the actors involved. This model is based on three factors: the diversity enacted by the leaders, three stances for considering the contribution made by diversity in the structuring process and the specific leading role played by those in charge of the structuring process. Through this process, they determined how the actors involved in the project were differentiated, and on what basis those actors were involved. By mobilising enacted diversity, the leaders are seeking to channel the emergence of a network in light of their own representation of that network. This model adds to published research on the structuring of integrated care systems.

No abstract

Dougherty et al. posit that production of complex innovations requires that ecologies be organized, involving three activities: orchestrating knowledge capabilities, ongoing strategizing to frame and direct continuous innovation, and developing public policy to embrace ambiguity. Our study aims to understand how such ecologies emerge. Based on a longitudinal case study, performed in the context of the Quebec health system, our results suggest (a) that the emergence of innovations in highly institutionalized fields requires an additional activity, namely, working on boundaries to make actors perceive their interdependences (b) some levers that can foster the implementation of the model.

We mobilize the organizational and practice-based literature to determine the mechanisms enabling a social collective to introduce innovation in public rescue. The case highlights how this collective acquired characteristics of a partial organization by: (1) emergent characteristics reacting to critical incidents, (2) an overarching agenda supporting actors participation, (3) complementarity of exclusion and inclusion membership practices to enforce collective identity and reach a critical mass, (4) recognition of collective actorhood through reification practices, (5) the role of a secretariat through theorizing and developing close but discrete relationships with an external actor with critical expertise and resources.