Anna-Leena Kurki, Elina Weiste, Hanna Toiviainen, Sari Käpykangas and Hilkka Ylisassi
The involvement of clients in service encounters and service development has become a central principle for contemporary health and social care organizations. However, in…
Abstract
Purpose
The involvement of clients in service encounters and service development has become a central principle for contemporary health and social care organizations. However, in day-to-day work settings, the shift toward client involvement is still in progress. We examined how health and social care professionals, together with clients and managers, co-develop their conceptions of client involvement and search for practical ways in which to implement these in organizational service processes.
Design/methodology/approach
The empirical case of this study was a developmental intervention, the client involvement workshop, conducted in a Finnish municipal social and welfare center. The cultural-historical activity theory (CHAT) framework was used to analyze the development of client involvement ideas and the modes of interaction during the intervention.
Findings
Analysis of the collective discussion revealed that the conceptions of client involvement developed through two interconnected object-orientations: Enabling client involvement in service encounters and promoting client involvement in the service system. The predominant mode of interaction in the collective discussion was that of “coordination.” The clients' perspective and contributions were central aspects in the turning points from coordination to cooperation; professionals crossed organizational boundaries, and together with clients, constructed a new client involvement-based object. This suggests that client participation plays an important role in the development of services.
Originality/value
The CHAT-based examination of the modes of interaction clarifies the potential of co-developing client-involvement-based services and highlights the importance of clients' participation in co-development.
Details
Keywords
Elina Weiste, Melisa Stevanovic, Inka Koskela, Maria Paavolainen, Eveliina Korkiakangas, Tiina Koivisto, Vilja Levonius and Jaana Laitinen
An “open communication culture” in the workplace is considered a key contributor to high-quality interaction and providing means to address problems at work. We study how the…
Abstract
Purpose
An “open communication culture” in the workplace is considered a key contributor to high-quality interaction and providing means to address problems at work. We study how the ideals of “open communication” operate in healthcare.
Design/methodology/approach
We use discourse analysis to investigate the audio-recorded data from 14 workshop team discussions in older people services.
Findings
We found four imperatives concerning the interactional conduct of their colleagues in problematic situations that nursing professionals prefer: (1) Engage in direct communication and avoid making assumptions, (2) Address problems immediately, (3) Deal directly with the person involved in the matter and (4) Summon the courage to speak up. Through these imperatives, the nursing professionals invoke and draw upon the “open communication” discourse. Although these ideals were acknowledged as difficult to realize in practice and as leading to experiences of frustration, the need to comply with them was constructed as beyond doubt.
Practical implications
Workplace communication should be enhanced at a communal level, allowing those with less power to express their perspectives on shaping shared ideals of workplace interaction.
Originality/value
The expectation that an individual will simply “speak up” when they experience mistreatment by a colleague might be too much if the individual is already in a precarious position.