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The purpose of this paper is to develop a conceptual model of carnivalization. The paper aims to widen the understanding of client initiated attempts to break away from a conflict of motives between conventional models and new ways of acting in service provision. Carnivalization emerges when the standard script falls apart and the actors start to construct unexpected meanings for the activity and create innovative solutions for the conflict of motives, which leads to new mode of collaboration.

The study analyzed the key features and significance of carnivalization in home care service encounters. The theoretical–methodological framework of the study draws on Bakhtin’s dialogical theorizing and cultural–historical activity theory. The analysis traces the processual movement from standard script toward carnivalization.

The key features of carnivalization involve conflict of motives between the actors, client initiatives, multiple chronotopes, artifact and role mediation, different modes of collaboration and the intertwinement of seemingly disconnected objects of collaboration. The findings indicate that carnivalization can enhance a new type of client–service provider collaboration. It can become an especially significant mode of collaboration for transforming an activity in which a historically established, stabilized script dominates the interaction. This paper suggests that the carnivalization type of collaboration should be deliberately fostered via organizational interventions to develop client-centered services.

As a consequence of the study, a new conceptual model is proposed for the analysis and promotion of carnivalization that can be applied in different organizational contexts.

This study seeks to challenge the notions of the standardized care pathway and patient‐centred care, both of which provide only a partial view of care as a complex system. In exploring and contrasting the care pathway protocol and an actual care pathway, the study aims to analyze the conceptualizations of care that actors involved in the actual care pathway have. The study makes suggestions on how to expand care pathways and thereby improve patient care.

A care pathway protocol is contrasted with the actual care pathway of a patient at a university hospital in Finland. Observational ethnography is combined with a narrative approach and activity‐theoretical ideas.

The study depicts the gap between the care pathway protocol and an actual care pathway. The actual care pathway, rather than being a clear‐cut process, is ruptured and unpredictable. The conceptualizations of care (i.e. care‐objects) held by the doctors, nurses and the patient were fragmented and clashed in their practical work activity. The main message to hospital management is that in order to expand care pathways, the multiple care‐objects need to be placed in constructive interplay.

A single actual care pathway is presented and the results are interpreted accordingly.

The study explores the idea of a care pathway and patient‐centred care in the analysis of care‐objects. A new discursive model is introduced that places different care‐objects into interplay and opens up the possibilities for the expansion of care pathways.

The aim of this article is to examine whether the boundary between the separate worlds of evaluation and frontline work in a hospital can be overcome. The study provides an example of a rare, innovative creation process of an assessment tool in which the tool users and the tool producer participated. The article aims to widen the understanding of employee initiated organizational change efforts, co‐creation of boundary objects and organizational boundary breaking, which may lead to expansive learning.

The article takes an activity‐theoretical approach to organizational boundaries, viewing them as tension‐laden triggers for learning and change. The analysis of expansive learning actions is based on longitudinal ethnographic field data on a collaboration effort between nurses and evaluation professionals in a Finnish hospital.

The collaboration effort between two organizational worlds led to boundary breaking. Initially, expansive learning actions were taken, but then obstacles started to emerge, and the collaboration between the two worlds was not sustained. To be sustainable, the collaboration would have required both a shared assessment tool (i.e. a boundary object) and management support. In this case the latter was missing.

The study analyzes a solid boundary, which delimited organizational learning and development. Rather than boundary crossing, as understood in the current literature, the challenging collaboration effort took the shape of conflictual boundary breaking. The study contributes to the literature on organizational boundaries and learning and has implications on management of employee initiated change efforts, collective tool creation processes and development of quality work in the public sector.