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Co-creation in Healthcare Service Development: A Diary-based approach
Linköping University, Department of Management and Engineering, Quality Technology and Management. Linköping University, The Institute of Technology.
2012 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

The patient is the only person who experiences the complete course of a healthcare problem, from first symptom to any contacts with the healthcare system to examination, treatment, follow-up activities and rehabilitation. The aim of this thesis is to explore how caregivers, together with patients, can draw on the knowledge patients acquire from their experiences in healthcare service development. This represents a break with the traditional role of the patient, which has been one of a passive receiver of care, following a supplier-centered view on value creation, which has increasingly been challenged both in the healthcare management discourse and in service research. Instead it is argued that value can only be co-created with customers, or patients in the case of healthcare. This means that the patients’ value-creating processes and contexts need to be emphasized and that patients are seen as a possible resource in their own care but also in the development of services and products. Despite this change in discourse, practical methods and empirical studies concerning patient involvement are scarce. This thesis adds to the field through an empirical exploration of co-creation in the development of healthcare. Through an action research approach, researchers and healthcare personnel have collaborated to develop a model for involving patients in service development, by inviting patients to share ideas and experiences through diaries.

A workable, three-phase (preparation, execution and learning) model for patient involvement through diaries has been developed, and applied in three clinics (orthopedic, rehabilitation, gastro). A total of 53 patients from the different care processes have contributed ideas and experiences using paper and pen diaries or blogs, or by calling an answering machine. By doing so for a period of 14 days, the patients have submitted a total of 360 ideas.

Three ways are proposed for utilizing the rich data submitted by the patients in service development. First, ideas from diaries can be used as input for service development. Second, a larger sample of diaries can be used to create a report of patient experiences, in which problem areas in the care process can be identified, and combined with other statistics. Third, individual patients’ stories can be highlighted and serve as a basis for discussion in the organization to shift the focus to the patient’s experience, serving as a motivator for change within the caregiving organization.

The study shows that patients can share ideas and experiences regarding a range of topics, including clinical, organizational, social, informational, and practical issues and attitudes among healthcare staff. The contexts to which these ideas and experiences applied were caregiver, home, extended caregiver, and work, and often concerned topics and aspects of the patient’s care process that are invisible to the caregiver.

Although healthcare organizations should be aware of the limitations to participation an illness may imply among some patients, patient co-creation in service development provides several important benefits. Acquiring knowledge regarding the parts of the patient’s care process that are invisible to the caregiver is key to improving care and supporting patients’ work of healing and managing life. Patients’ insights and creativity are an untapped resource for development of many aspects of the healthcare process.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2012. , 54 p.
Series
Linköping Studies in Science and Technology. Thesis, ISSN 0280-7971 ; 1539
National Category
Engineering and Technology
Identifiers
URN: urn:nbn:se:liu:diva-78717Local ID: LiU-TEK-LIC 2012:24ISBN: 978-91-7519-864-4 (print)OAI: oai:DiVA.org:liu-78717DiVA: diva2:535113
Presentation
2012-06-12, ACAS, A-huset, Campus Valla, Linköpings universitet, Linköping, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2012-06-19 Created: 2012-06-19 Last updated: 2012-06-19Bibliographically approved
List of papers
1. Quality Management in Health Care: A Literature Review
Open this publication in new window or tab >>Quality Management in Health Care: A Literature Review
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Purpose – The purpose of this article is to provide input to the discussion of quality management (QM) research in health care through a problematization of its defining characteristics, and to identify historical and contemporary trends regarding QM in the scientific discourse on health care.

Design/methodology/approach – This article is based on a literature review of leading journal articles concerning quality management in health care. Articles have been selected based on citation in Scopus and ISI/Web of Science, with a total of 36 articles.

Findings – The review has shown that there are two logics to quality management and improvement work in health care. Dominating the field is an ambition to standardize the provision of health care through an evidence based approach. The other approach is based on a system based logic, aiming to enforce organizational competence and system wide improvement. Unlike the general discourse on quality management is the customer perspective is rather weakly represented in the reviewed literature.

Research limitations/implications – This article provides some insights that may contribute to a better understanding of the conditions for doing research and improvement in health care.

Originality/value – The article provides an overview of the defining characteristics of Quality Management in health care, along with a historical perspective on the theoretical development of Quality related topics in health care research. This provides important input to management researchers entering the health care field. To the authors’ knowledge, this is the first review on this topic.

Keyword
Quality management, health care, core principles
National Category
Engineering and Technology
Identifiers
urn:nbn:se:liu:diva-78714 (URN)
Available from: 2012-06-19 Created: 2012-06-19 Last updated: 2015-02-05Bibliographically approved
2. Solicited Diaries as a Means of Involving Patients in Development of Healthcare Services
Open this publication in new window or tab >>Solicited Diaries as a Means of Involving Patients in Development of Healthcare Services
Show others...
2011 (English)In: International Journal of Quality and Service Sciences, ISSN 1756-669X, E-ISSN 1756-6703, Vol. 3, no 2, 128-145 p.Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Emerald Group Publishing Limited, 2011
Keyword
Diaries, Health care, Knowledge transfer, Quality improvement, Sweden, Users' experiences
National Category
Other Engineering and Technologies not elsewhere specified
Identifiers
urn:nbn:se:liu:diva-77457 (URN)10.1108/17566691111146050 (DOI)
Available from: 2012-05-17 Created: 2012-05-17 Last updated: 2017-12-07Bibliographically approved
3. Patient Ideation in Service Innovation
Open this publication in new window or tab >>Patient Ideation in Service Innovation
2011 (English)Conference paper, Published paper (Other academic)
Abstract [en]

Customer involvement in the ideation of service innovation is generally considered a means for the service provider to find original ideas, which result in high impact on customer satisfaction. In this study patients record ideas using a diary over a course of two weeks, capturing ideas “in situ” at the hospital or in the home environment. The study shows that patients can provide valuable ideas from the customer perspective and that they often wish to be more active participants.

National Category
Engineering and Technology
Identifiers
urn:nbn:se:liu:diva-78715 (URN)
Conference
QUIS12. The 12th International Research Symposium on Service Excellence in Management, Cornell, NY, USA, June 2-5
Available from: 2012-06-19 Created: 2012-06-19 Last updated: 2012-06-19Bibliographically approved
4. Co-­‐creation and learning in healthcare service development
Open this publication in new window or tab >>Co-­‐creation and learning in healthcare service development
2012 (English)In: Journal of Service Management, ISSN 1757-5818, E-ISSN 1757-5826, Vol. 23, no 3, 328-343 p.Article in journal (Refereed) Published
Abstract [en]

Purpose - This study has the purpose of developing and evaluating a model for patient cocreation and learning based on diaries for use in healthcare service development. In particular, we investigate the process of patient co-creation and different mechanisms through which healthcare 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 – We suggest a model for co-creation and learning in healthcare service development with three ways of learning. Firstly, the model may be used as a means for generating and collecting patient ideas; secondly, a single patient’s story can be illustrated, and serve as an incentive for healthcare 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. Firstly, the study offers new and more diverse ways of using the rich material provided by customer diaries in the development of services. Secondly, the study suggests a co-creation approach of involving patients in healthcare service development through patient diaries.

Place, publisher, year, edition, pages
Emerald Group Publishing Limited, 2012
Keyword
Co-creation, service development, healthcare, action research
National Category
Engineering and Technology
Identifiers
urn:nbn:se:liu:diva-78716 (URN)10.1108/09564231211248435 (DOI)000308627000003 ()
Available from: 2012-06-19 Created: 2012-06-19 Last updated: 2017-12-07Bibliographically approved

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