The coordination of distributed activities is central to organizational work. The effective functioning of organizations hinges on their ability to manage interdependencies both within (intra-) and between (inter-) various departments. However, more than just the management of these individual interdependencies is required for smooth work system coordination. Organizations must also manage the interactions between intra- and inter-departmental activities. To investigate how these interactions manifest in organizational work, we conducted a field study examining patient transfer process. We highlight the cross-boundary breakdowns that occur when intra-departmental and inter-departmental activities related to patient transfers negatively affect each other. We then describe the re-coordinating activities performed to mitigate the effects of cross-boundary breakdowns. We discuss a framework of inter-departmental coordination work that describes the relationship between cross-boundary breakdowns and re-coordinating activities. Furthermore, we classify the re-coordinating activities as a type of articulation work performed by hospital staff. This research can help us develop empirically-driven and theoretically-based design guidelines for coordination tools to maintain overall organizational workflow by balancing the goals and requirements of the various departments.