Practicing ‘boundarylessness’

Last month, we were fortunate to be able to attend an event hosted by the Health Innovation Network – together with the NHS London Leadership Academy and NHS Kent, Surry and Sussex Leadership Collaborative – on the development of ‘Communities of Practice’.

A community of practice is a concept that is not as complicated as it sounds.  It is simply a way of bringing people together, who have a passion to make change and improvements in a particular area, and to learn from each other in a voluntary and informal way.  Rather than forcing people together to react to problems, using this approach harnesses intrinsic motivation and creates energy to drive change and innovation.

You can see a short video of the NHS communities of practice learning workshop below (or follow this link)

There is a lot of energy currently going into developing ‘system leadership skills’ in the NHS and pressure on all organisations to be thinking about their challenges in a ‘system-way’.  But some of the strategies and principles of system working can be quite daunting and can feel remote from the day-to-day challenges we face.

A community of practice, or more informal collaboration, is a simpler way to think about how people can come together to make improvements for patients, carers and staff. You can read more about communities of practice here

The term ‘boundarylesboundarysness’ is also really helpful in describing a way of working and an attitude that we need more of in working between organisations.

Back in 2004, Don Berwick described some of the values of the Institute for Healthcare Improvement (IHI):

“The cultural issues of honesty and openness, of course, are important. But I think, hopefully, you’d see here in action a set of values that we really want to carry forward. The values are of boundarylessness, which means everyone connects to everyone else and you don’t own data or competence or knowledge.”

We see boundarylessness in action all the time within our organisation, as we see people reaching out to others in different teams and different disciplines to work together on improvement.  This is a characteristic of a mature organisation but also quite normal in an acute care setting where speed and agility are part of the skills and values that we need  just to keep up.

Maybe encouraging everyone, not just leaders, to think less about systems (which suggests complexity) and to think more about boundarylessness would help organisations to work together at all levels and would mean that more innovative changes could be made faster.

The main lessons we took from the communities of practice workshop were:

  • Don’t leave it to the leaders, everyone can and should be working across boundaries to make improvements
  • Get people together to work on something specific, a common problem or goal, rather than just generic ‘system-working’
  • Just start – don’t wait for permission!

Let us know what you think in the comments section below.


Mark – @MarkH_Work

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