Investigating the use of actor-network theory in healthcare: a protocol for a systematic review

Healthcare systems are confronted with constant challenges and new crisis waves necessitating a transformation of current approaches to healthcare delivery. Transformation calls for integration, partnerships, interprofessional teamwork and collaboration between all healthcare stakeholders to create improved access and more personalised healthcare outcomes for patients. However, healthcare organisations are complex systems, comprising multiple stakeholders, and the existence of professional silos and functions which have varying degrees of interaction hampering the delivery of effective integrated healthcare. Research investigating the underpinning operations of how the various healthcare stakeholders integrate is lacking. To address this gap, the use of actor-network theory (ANT) can provide insight into underlying dynamics, interactions, interdependencies, governance processes and power dynamics of stakeholders in healthcare. ANT represents a suitable theoretical lens as it helps to appreciate the dynamics and underpinning behaviours of complex organisations and explains how networks are developed and how actors join networks and form associations. Our systematic review will identify and evaluate available evidence to understand the interplay between stakeholders and all associated entities that impact collaboration and integration in healthcare delivery.

Using the Population-Intervention-Comparison-Outcome framework, the databases MEDLINE, CINAHL Complete, SCOPUS, PubMed, APA PsycINFO, Business Source Complete and Academic Search Complete will be searched using Boolean terms to identify peer-reviewed literature concerning ANT in healthcare. All relevant articles published between January 2013 and September 2023 will be eligible for inclusion. A thematic approach will be employed to appraise and analyse the extracted data to assess the various definitions of ANT and the use of ANT in healthcare settings, interactions and collaboration.

Given that no primary data will be captured, ethical approval will not be required for this study. Findings will be shared and ultimately published through open access peer-reviewed journals and reports.

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