title: The challenges of boundary spanners in supporting inter-organizational collaboration in primary care--a qualitative study of general practitioners in a new role.
abstract: BACKGROUND
  The visions of more integrated care have created new roles and accountabilities for organizations and professionals. Thus, professionals are increasingly expected to engage in boundary spanning activities in order to facilitate inter-organizational and inter-sectoral collaboration. However, this task can be difficult for individual actors and it is important to investigate the work and challenges of boundary spanners in various settings. This study explores the challenges related to a new boundary spanning role for general practitioners employed to facilitate collaboration between the municipalities and general practice.
  
  
  METHODS
  The study is based on semi-structured interviews with ten general practitioners acting as municipal practice consultants in the Capital Region of Denmark. The transcribed interviews were analyzed in several steps organizing the material into a set of coherent and distinct categories covering the different types of challenges experienced by the informants.
  
  
  RESULTS
  The main challenges of the general practitioners acting as boundary spanners were: 1) defining and negotiating the role in terms of tasks and competencies; 2) representing and mobilizing colleagues in general practice; 3) navigating in an unfamiliar organizational context.
  
  
  CONCLUSIONS
  The results support previous studies in emphasizing the difficult and multifaceted character of the boundary spanning role. While some of these challenges are not easily dealt with due to their structural causes, organizations employing boundary spanners should take note of these challenges and support their boundary spanners with matching resources and competencies.
authors.affiliation: The Research Unit for General Practice and Section of General Practice, Department of Public Health, Faculty of Health Sciences, University of Copenhagen, Øster Farimagsgade 5, PO Box 2099, Copenhagen, DK-1014, Denmark. marbro@sund.ku.dk.
authors.forename: Marius Brostrøm
authors.initials: MB
authors.lastname: Kousgaard
authors.affiliation: The Research Unit for General Practice and Section of General Practice, Department of Public Health, Faculty of Health Sciences, University of Copenhagen, Øster Farimagsgade 5, PO Box 2099, Copenhagen, DK-1014, Denmark. asjacobsen_2000@yahoo.com.
authors.forename: Anne Sofie Kjær
authors.initials: AS
authors.lastname: Joensen
authors.affiliation: The Research Unit for General Practice and Section of General Practice, Department of Public Health, Faculty of Health Sciences, University of Copenhagen, Øster Farimagsgade 5, PO Box 2099, Copenhagen, DK-1014, Denmark. snm985@sund.ku.dk.
authors.forename: Thorkil
authors.initials: T
authors.lastname: Thorsen
mesh_terms: D002170:Canada; D003299:Cooperative Behavior; D003718:Denmark; D017598:Efficiency, Organizational; D058005:General Practitioners / Q000458:organization & administration*; D006801:Humans; D009111:Local Government; D017146:Models, Organizational; D009937:Organizational Objectives; D011320:Primary Health Care / Q000458:organization & administration*; D024382:Professional Role; D012017:Referral and Consultation / Q000458:organization & administration