As knowledge specialization increases, organizations need to find ways to integrate knowledge from different domains. Modern healthcare is a case in point. With increasingly complex patient conditions, hospitals need to create treatment routines which integrate knowledge from several different medical domains. However, such integration is inhibited by the boundaries resulting from disciplinary knowledge specialization, an aspect largely unexplored in theory on routine formation. Drawing on theory on routines and epistemic communities, this study investigates the dynamics involved in forming routines across disciplinary boundaries. An exploratory case study of the creation of new routines spanning different medical disciplines in breast cancer care is performed. The results indicate an iterative process of boundary spanning, internal analysis, and subsequent synthesis to form routines consistent with the practices of different disciplines.

This thesis deals with routines for collaboration among specialists from different domains in healthcare. Healthcare policy is increasingly directed at transforming clinical healthcare into an interdisciplinary organization where diverse medical specialists collaborate in delivering complete treatments to the patient. However, as both practice and research repeatedly reports, achieving interdisciplinary collaboration is difficult. Due to the divides in knowledge and practice which exist between the medical disciplines, multidisciplinary clinics do not automatically lead to collaboration involving integration of disciplinary knowledge. Based on recent conceptualizations of organizational routines as sources of both stability and flexibility, this thesis concentrates on the type of routines that enable collaboration across domain boundaries. Collaboration routines, as they are called here, are suggested to support the interdisciplinary clinic in making use of its diversity in knowledge and practice. The thesis is comprised of four papers, including three empirical case studies of clinical healthcare. The combined findings indicate that collaboration routines support idea generation, testing of new joint practices and trial-and-error learning. Contrary to the common underlying conception of routines as blueprints, these findings bring to the surface an underlying logic of shared learning. Collaboration routines continuously support the formation and maintenance of shared cognition and shared motivation among different domain specialists, thereby assuming a function of continuous routinizing. The thesis contributes to the literature on routines by advancing research on how routines can support collaboration across domain boundaries within an organization.

Routines allow organisations to perform basic functional activities and to continuously adapt through innovation. To understand how the search for new knowledge occurs, this paper explores how knowledge is integrated in search routines for innovation, and how search routines differ between contexts. Becker's (2005) general model, based on the notions of antecedents and routine characteristics, is adapted to develop a framework for analysing search routines for innovation. The framework is then applied in two case studies of healthcare clinics employing iterative and sequential modes of healthcare, respectively. The cases illustrate how the context affects the form of the search routine. The study demonstrates the viability of empirically investigating routines using a coherent framework, to understand how contextual factors affect routines at the operational level.