The use of boundary objects to enhance interprofessional collaboration: integrating complementary medicine in a...

Because of the inherent complexity of human health, the provision of good quality patient care requires collaboration in multidisciplinary teams. Integrative healthcare provides a unique setting for the study of interprofessional collaboration in the context of power disparities. The research objective was to examine which means and mechanisms were used to facilitate interprofessional collaboration when integrating complementary medicine (CM) into a hospital's surgical department. Throughout 2010 we conducted a qualitative study in an Israeli public hospital's surgical department, using observations and 30 in-depth interviews with managers, surgeons, physicians, nurses, patients and CM practitioners. The sociological concepts of boundary actor and boundary object and the context of power relations served as a framework for this research. This article contributes to the field of interprofessional collaborative care research by: analysing types of collaboration inhibitors--epistemological and social-structural gaps; pointing to boundary actors who establish interprofessional collaboration in an integrative hospital setting and noting the boundary objects they use; and comparing collaboration levels. The collaboration between CM practitioners and the department's staff is a loosely coupled system. When coordination was achieved, reaching profound agreements seemed of lesser importance to the parties. Closer collaboration and cross-fertilisation were found among CM practitioners.