Coordinating Care Paths: The Patient as a Boundary Object

Abstract

Health care has traditionally been organized on the basis of a division along the lines of medical specializations, and characterized by clear demarcations between organizations as well as between units within organizations. These demarcations have largely been based on professional and knowledge-related foundations. The health care reforms of recent decades (i.e., the introduction of New Public Management) have contributed towards strengthening the boundaries, but they have increasingly come to be based on administrative and financial foundations. In the society of today, demands are also being placed on organizations, causing them to become clearly demarcated units, for example in terms of them having to be accountable and transparent. This is causing a refinement of the operational units, for instance through a narrower assessment of the duties falling within the framework of the organization’s tasks. As a consequence of this trend towards clear demarcations, and as an alternative to the traditional organization, process and collaboration as principles for organizing have been put forward in the debate.