JMIR Publications

ABSTRACT

Background:

Boundary objects can be of added value for innovative design and implementation research in Health through their organizational focus and the dynamic structure between ill-structured and tailored use. Four dialogical learning mechanisms are described in the literature that can occur at boundaries: identification, coordination, reflection, and transformation. These mechanisms seem to be of added value for integration in innovative design and implementation research in health.

Objective:

Focusing on innovation in health, this study aimed to (1) find out whether the different learning mechanisms can be linked to studies on health innovation that mention boundary objects as a concept, and (2) assess whether the related mechanisms provide insight into the stage of the design and implementation or change process.

Methods:

Six databases were searched for potentially relevant abstracts: PubMed, Scopus, ERIC, PsycINFO, Information Science & Technology Abstracts, and EMBASE. These databases covered a wide range of published research from the field of Health.

Results:

Our initial search yielded 3102 records. After removing the duplicates, 2186 records were screened on title and abstract. Next, of 65 records we screened the full-text, 25 papers were included. One or more mechanisms were identified in each included study.

Conclusions:

The concept of boundary objects has found its way into healthcare and health contexts. Although the idea of a boundary object was introduced to describe how specific artefacts can fulfil a bridging function between different sociocultural sites and thus has a social focus, the focus in the included papers was often on the boundary object itself rather than the social effect. The reflection and transformation mechanisms are underrepresented in the included studies, but based on the findings in this review, pursuing to trigger the reflective mechanism in design, development, and implementation projects can have benefits for a more fluid and smooth integration of innovation into practice.