Care pathways as boundary objects between primary and secondary care: Experiences from Norwegian home care services

Health (London). 2015 Nov;19(6):635-51. doi: 10.1177/1363459314567789. Epub 2015 Jan 26.


The need for integration of healthcare services and collaboration across organisational boundaries is highlighted as a major challenge within healthcare in many countries. Care pathways are often presented as a solution to this challenge. In this article, we study a project of developing, introducing and using a care pathway across healthcare levels focusing on older home-dwelling patients in need of home care services after hospital discharge. In so doing, we use the concept of boundary object, as described by Star and Griesemer, to explore how care pathways can act as tools for translation between specialist healthcare services and home care services. Based on interviews with participants in the project, we find that response to existing needs, local tailoring, involvement and commitment are all crucial for the care pathway to function as a boundary object in this setting. Furthermore, the care pathway, as we argue, can be used to push boundaries just as much as it can be used as a tool for bridging across them, thus potentially contributing to a more equal relationship between specialist healthcare services and home care services.

Keywords: boundary objects; care pathways; health service research; home care services; integrated care.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Continuity of Patient Care*
  • Cooperative Behavior
  • Critical Pathways
  • Female
  • Health Services Research
  • Home Care Services / organization & administration*
  • Humans
  • Male
  • Norway
  • Primary Health Care*
  • Qualitative Research
  • Secondary Care*