Jon Engström, Olof Norin, Serge de Gosson de Varennes and Aku Valtakoski
The study aims to explore how segmentation as a methodology can be adapted to the healthcare context to provide a more nuanced understanding of the served population and to…
Abstract
Purpose
The study aims to explore how segmentation as a methodology can be adapted to the healthcare context to provide a more nuanced understanding of the served population and to facilitate the design of patient-centric services.
Design/methodology/approach
The study was based on a collaborative project with a national healthcare organization following the principles of action design research. The study describes the quantitative segmentation performed during the project, followed by a qualitative interview study of how segments correspond with patient behaviors in an actual healthcare setting, and service design workshops facilitated by segments. A number of design principles are outlined based on the learnings of the project.
Findings
The segmentation approach increased understanding of patient variability within the service provider organization and was considered an effective foundation for modular service design. Patient characteristics and life circumstances were related to specific patterns of health behaviors, such as avoidance or passivity, or a persistent proactivity. These patterns influenced the patients' preferred value co-creation role and what type of support patients sought from the care provider.
Practical implications
The proposed segmentation approach is immediately generalizable to further healthcare contexts and similar services: improved understanding of patients, vulnerable patients in particular, improves the fit and inclusivity of services.
Originality/value
The segmentation approach to service design was demonstrated to be effective in a large-scale context. The approach allows service providers to design service options that improve the fit with individual patients' needs for support and autonomy. The results illuminate how patient characteristics influence health and value co-creation behaviors.
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The purpose of this paper is to explore what motivates patients to participate in service development and how participation may influence their well-being. Health-care providers…
Abstract
Purpose
The purpose of this paper is to explore what motivates patients to participate in service development and how participation may influence their well-being. Health-care providers are increasingly adopting practices of customer participation in such activities to improve their services.
Design/methodology/approach
This paper builds on an analysis of data from a service development project in which lung cancer patients contributed by sharing their ideas and experiences through diaries. Out of the 86 lung cancer patients who were invited to participate, 20 agreed to participate and 14 fully completed the task. The study builds on participants’ contributions, in-depth interviews with six participants and the reasons patients gave for not participating.
Findings
This paper identifies a number of motives: non-interest in participating, restitution after poor treatment, desire for contact with others, volunteerism, desire to make a contribution and the enjoyment of having a task to complete. A self-determination theory perspective was adopted to show how the need to satisfy basic human needs for autonomy, competence and relatedness determines if and how patients participate. Participation may have important benefits for patients, especially an improved sense of relatedness.
Practical implications
Service providers must be prepared to meet different patient needs in service development, ranging from the need to express strong distress to expressing creativity. By understanding the dynamics of motivation and well-being, organizers may achieve better results in terms of improved services and in patient well-being.
Originality/value
This study makes a significant contribution to the study of customer participation in service development, especially in relation to health care, by offering a self-determination-based typology for describing different styles of patient participation.
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Mattias Elg, Lars Witell, Bozena Poksinska, Jon Engström, Su Mi Dahlgaard‐Park and Peter Kammerlind
The purpose of this paper is to develop an understanding of how patients experience their health problems and how they can generate innovative ideas about health care services…
Abstract
Purpose
The purpose of this paper is to develop an understanding of how patients experience their health problems and how they can generate innovative ideas about health care services. The research questions that guide the present study are: how can solicited diaries be used for capturing patient ideas? What type of data is generated from solicited diaries used for generating patient ideas? And what are the potential benefits and shortcomings of using patient diaries in generating ideas for improvement of health care services?
Design/methodology/approach
The paper is based on an exploratory case study using patient diaries to solicit ideas about how health care services in Sweden can be improved. From the methodological viewpoint, the diaries are used as a tool for patient co‐creation of health care services.
Findings
When analyzing dairies written by patients four different types of diaries emerged from the study: brief, reporting, descriptive and reflective diaries. Furthermore, 102 ideas for improvements within nine areas were identified from the contents of dairies.
Research limitations/implications
Adopting patients' diaries as a way to activate and promote co‐creation of values is at an embryo stage, and hence more research is needed.
Originality/value
One of the strengths of the paper includes its potential for practical implications, either clinical or methodological, by using patients' dairies. It focuses both on the content generated from the diaries for improving health services, as well as the use of the diaries for practicing the idea of patients as co‐creators in health care service.
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Mattias Elg, Jon Engström, Lars Witell and Bozena Poksinska
The purpose of this study is to develop and evaluate a model for patient co‐creation and learning based on diaries for use in health‐care service development. In particular, the…
Abstract
Purpose
The purpose of this study is to develop and evaluate a model for patient co‐creation and learning based on diaries for use in health‐care service development. In particular, the study aims to investigate the process of patient co‐creation and different mechanisms through which health‐care service providers can learn from the patient.
Design/methodology/approach
The study is based on an action research approach. First, a development phase for patient co‐creation and learning leading to a proposed model was conducted. Second, a test phase of the diary‐based method was performed on 53 patients in three cases: orthopaedic care, rehabilitation care and gastroenterology care.
Findings
The study suggests a model for co‐creation and learning in health‐care service development through three learning methods. First, the model may be used as a means for generating and collecting patient ideas; second, a single patient's story can be illustrated and can serve as incentive for health‐care service development and creation of patient‐centred care; finally, a larger number of diaries can be analysed and combined with patient surveys to provide a deeper understanding of how the patient experiences health care services.
Originality/value
This study extends the research on diary‐based methods as an operationalisation of co‐creation in two ways. First, the study offers new and more diverse ways of using the rich material provided by customer diaries in the development of services. Second, the study suggests a co‐creation approach of involving patients in health‐care service development through patient diaries.
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This paper aims to show agential realism as the basis for a pertinent framework with regard to the entwined, on-going and interpretative aspects of knowledge.
Abstract
Purpose
This paper aims to show agential realism as the basis for a pertinent framework with regard to the entwined, on-going and interpretative aspects of knowledge.
Design/methodology/approach
The knowledge flow phenomenon in the form of entanglement and agential “cuts” within the workplace is studied and described across a phenomenological ethnographic case study of two workgroups within an aircraft engine manufacturing context.
Findings
The boundary construction phenomenon is a key process helping us to depict knowledge entanglement (tacit and explicit) across dialogue and non-verbal actions. Dialogue brings forth the aspect of knowledge as interpretations or “cuts.” A phenomenological analysis allows us to identify and describe various levels of tacit–explicit knowledge entanglement depending on the mode of coping at hand. Also highlighted was the importance of heuristics carried out by knowledge experts, often in the form of abduction (i.e. leading to rules of thumb).
Research limitations/implications
It is acknowledged that the relatively narrow context of the empirical work limits the ability to generalize the findings and arguments. As such, additional work is required to investigate the validity of the findings across a wider spectrum of workgroup contexts.
Practical implications
Agential realism allows for the analysis of organizations as a world of practice and actions, whereby long-established categories can be requestioned and challenged with the aim of sharing the full richness and benefit of embodied knowledge between human actors.
Originality/value
Ethnographic descriptions of the entwined nature of tacit and explicit knowledge, the embodied and activity-based dimension of knowledge and learning, as well as the characteristic of knowledge as possession, correspond well to an agential realist concept of phenomenon, entanglement and cuts. Furthermore, agential realism offers the opportunity to view the workplace as individuals (or groups) who act out embodied tacit-explicit knowledge in conjunction with non-human entities (such as objects, as well as communication and information technologies), with the latter acting as enhancers of knowledge creation and sharing.
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Manisha Kumar, Nicholas Rich, Maneesh Kumar and Ying Liu
This paper aims to explore patient to care provider reverse exchanges to improve the care processes and service supply chain using an online feedback platform. This paper…
Abstract
Purpose
This paper aims to explore patient to care provider reverse exchanges to improve the care processes and service supply chain using an online feedback platform. This paper demonstrates how a better understanding of timely and unsolicited feedback (“voice of the patient as a customer”) stimulates local interventions to improve service delivery and enact the essential characteristics of highly reliable organisations (HRO).
Design/methodology/approach
A realist approach involving an exploratory hospital case study using user feedback from an IT patient feedback platform. The methodology included interviews, secondary data and access to thousands of patient feedback narratives.
Findings
The findings show that a systems approach to the supply chain, using real-time feedback to enact process improvement is beneficial and a fruitful source of innovation for professional services staff. The setting of the improvement focusses on a true “voice of the customer” rather than attempting to improve arbitrarily internal process efficiency has major benefits for staff and their engagement with the right interventions to support higher performance.
Practical implications
The findings show major positive benefits for the adaptation and constant reflection of staff on the service provided to patients. The approach provides a means of reflecting as to whether the current supply chain and service provision are fit for purpose, as well as reliable, efficient and of value to the consumer.
Originality/value
This study is one of a few that adopt the consumer orientation needed to fully exploit the concepts of patient-centric improvement by including dynamic feedback in the supply chain and systems approach to care.
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Mattia Rapa, Marco Ferrante, Ilia Rodushkin, Cora Paulukat and Marcelo Enrique Conti
World imports of Italian sparkling wines fell by 9% in value and 5% in quantities. In view of this, the quality characterisation of these products is desirable to increase their…
Abstract
Purpose
World imports of Italian sparkling wines fell by 9% in value and 5% in quantities. In view of this, the quality characterisation of these products is desirable to increase their market value and restore their global visibility.
Design/methodology/approach
For this purpose, in this paper, heavy metals (Cd, Co, Cr, Cu, Fe, Ga, Hf, Hg, Mn, Mo, Nb, Ni, Pb, Re, Sb, Sn, Ta, Th, Tl, U, W, V, Zn, Zr), rare Earth elements (REEs) (Ce, Dy, Er, Eu, Gd, Ho, La, Lu, Nd, Pr, Sm, Tb, Tm, Yb) and isotopes ratio (208Pb/206Pb, 207Pb/206Pb, 206Pb/204Pb, 208Pb/207Pb, 87Sr/86Sr) were analysed in Italian sparkling wines with Protected Designation of Origin (PDO) certification by High Resolution Inductively Coupled Plasma Mass Spectrometry (HR-ICP-MS) and MultiCollector Inductively Coupled Plasma Mass Spectrometer (MC-ICP-MS). The samples were produced in the Veneto region, and they were compared to white and red wines from the same area.
Findings
Sparkling wines present a characteristic elemental pattern compared to white and red ones, with lower content of heavy metals and higher content in REEs. The ratio 87Sr/86Sr resulted in a powerful micro-scale geographical origins marker while Pb ratios as winemaking process one, both useful to prevent possible frauds. Multivariate data analyses, such as PCA and PLS-DA, were used to develop a model of recognition of Venetian sparkling wines.
Originality/value
The good classification of sparkling wines was achieved (95%), proving the suitable use of these analytes as markers for recognising sparkling wines and their geographical origin verification. To the best of the authors’ knowledge, this is the first study investigating heavy metals, REEs and isotopes in Venetian sparkling wine for their recognition.