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Service ecosystems are gaining credence among management scholars. However, there is still little agreement about the distinguishing attributes of service ecosystems in both the public and the private sectors. The purpose of this paper is to focus on the health care service system, suggesting a “recipe” for the implementation of a sustainable and innovative health care service ecosystem.

A mixed methodology was used. First, a critical literature review was conducted to lay the conceptual foundations of this study. Then a theory about the institutional, organizational and managerial requisites for the implementation of a health care service ecosystem was developed.

The health care sector is appropriate for the core tenets of the service ecosystem perspective. Tailored interventions aimed at improving the functioning of the health care service ecosystem should be implemented at the micro, meso, macro and mega levels. Patient empowerment, patient-centered care and integrated care are the fundamental ingredients of the recipe for effective health care service ecosystems.

The ecosystem approach provides health policy makers with interesting insights to help shape the health care service system of the future. The paper also contributes to the innovation of managerial practices emphasizing the role of patient involvement in the design and delivery of health care.

This is one of the first attempts to systematize scientific knowledge about service ecosystems in the health care sector. An agenda for further research is suggested, in order to further advance the establishment of an effective and innovative health care service ecosystem.

Healthcare delivery faces increasing pressure to move from a provider-centered approach to become more consumer-driven and patient-centered. However, many of the actions taken by clinicians, patients and organizations fail to achieve that aim. This paper aims to take a paradox-based perspective to explore five specific tensions that emerge from this shift and provides implications for patient experience research and practice.

This paper uses a conceptual approach that synthesizes literature in health services and administration, organizational behavior, services marketing and management and service operations to illuminate five patient experience tensions and explore mitigation strategies.

The paper makes three key contributions. First, it identifies five tensions that result from the shift to more patient-centered care: patient focus vs employee focus, provider incentives vs provider motivations, care customization vs standardization, patient workload vs organizational workload and service recovery vs organizational risk. Second, it highlights multiple theories that provide insight into the existence of the tensions and how they may be navigated. Third, specific organizational practices that engage the tensions and associated examples of leading organizations are identified. Relevant measures for research and practice are also suggested.

The authors develop a novel analysis of five persistent tensions facing healthcare organizations as a result of a shift to a more consumer-driven, patient-centered approach to care. The authors detail each tension, discuss an existing theory from organizational behavior or services marketing that helps make sense of the tension, suggest potential solutions for managing or resolving the tension and provide representative case illustrations and useful measures.

Nurses have been called to be leaders in the transformation of health care and to help improve health-care access for the nation’s most vulnerable populations. However, to lead health-care transformation, the profession of nurses must first see themselves as leaders. Unfortunately, nursing has been described as lacking cohesiveness and failing to communicate a consistent brand image. No empirically tested quantitative tools exist to measure the brand identity of nursing, making it difficult to assess where the profession stands in regard to the mantel of leadership. The purpose of this study was to develop empirically sound instruments which could measure nurses’ perceptions of their professional brand image. A total of three scales were developed and then tested: The Nursing Brand Image Scale, Nursing’s Current Brand Position Scale and Nursing’s Desired Brand Position Scale.

The factor structure and internal consistency reliability of each scale were examined following survey administration to a national sample of registered nurses. Principal component analyses were used to explore the factor structure of each scale. Item reduction was achieved through examination of the loading of items across the factors and the impact of the item on internal consistency reliability.

Respondents to the survey were nursing alumni who received a baccalaureate or master’s degree in nursing at a private, mid-western university, and nursing faculty affiliated with a private, collegiate network (n = 286). For all scales, principal component analysis showed no inter-item correlations >0.9 or <0.1. The Kaiser–Meyer–Olkin measure for sampling adequacy was high and Bartlett’s test of sphericity was significant (p < 0001). The internal consistency reliability of each of the three scales was good to excellent. Current brand position mean scores were highest for the factor “caring advocates for patients/public”, and lowest on “influential leaders”. The most desired brand position mean scores were highest and rated similarly for factors “influential leaders” and “patient-centered caregivers”.

This study provides strong preliminary evidence for the factor structure and internal consistency reliability for each of the three scales and represents an important first step toward quantitatively measuring the brand image of nursing. However, results suggest there is work to be done if nursing is to formulate and adopt a brand image that consistently reinforces their role as leaders. Further testing of the scales with other nursing populations, the general public and with larger sample sizes is recommended.

Knowledge integration is the process of building shared mental models. The integration of the diverse knowledge of the health professions in shared mental models is a precondition for effective teamwork and team performance. As it is known that different groups of health care professionals often tend to work in isolation, the authors compared the perceptions of knowledge integration. It can be expected that based on this isolation, knowledge integration is assessed differently. The purpose of this paper is to test these differences in the perception of knowledge integration between the professional groups and to identify to what extent knowledge integration predicts perceptions of teamwork and team performance and to determine if teamwork has a mediating effect.

The study is a multi-center cross-sectional study with a descriptive-explorative design. Data were collected by means of a staff questionnaire for all health care professionals working in the rehabilitation clinics.

The results showed that there are significant differences in knowledge integration within interprofessional health care teams. Furthermore, it could be shown that knowledge integration is significantly related to patient-centered teamwork as well as to team performance. Mediation analysis revealed partial mediation of the effect of knowledge integration on team performance through teamwork.

In practice, the results of the study provide a valuable starting point for team development interventions.

This is the first study that explored knowledge integration in medical rehabilitation teams and its relation to patient-centered teamwork and team performance.

This empirical study aims to explore sufficiency conditions for patient loyalty to a hospital.

The study collected 645 self-administered questionnaires from patients in a major medical center in Taiwan and applied fuzzy set qualitative comparative analysis (fs/QCA) to explore the sufficiency conditions for patient loyalty.

The findings support the conclusion that the three conditions (patient satisfaction, patient participation in the process of diagnosis, and patient participation in treatment decision-making) in combination are sufficient for high patient loyalty to the hospital but high patient satisfaction alone is insufficient. While the three conditions in configural algorithm are sufficient, this expression is not necessary, which means the findings do not reject possible alternative conditions for high patient loyalty.

The study applies a relatively new method, fuzzy set qualitative comparative analysis (fs/QCA) to test the sufficiency proposition of the theory. This method enables researchers to focus on examining sufficient conditions without worrying about various confounding factors and informs this study ' s conclusion that patients exhibiting high scores in all three conditions mentioned above constitute a near-perfect subset of highly loyal patients. Hospitals thus should provide their satisfied patients opportunities to share a role in the process of diagnosis and treatment decision-making.

Along with patient satisfaction, this study clearly identifies two important stages of patient participation (i.e., participation in the process of diagnosis and treatment decision-making) that are important in forming patient loyalty to a hospital. Prior studies do not present empirical evidence to this proposition.

Healthcare policies around the globe are aimed at achieving patient-centeredness. The patient is understood as a prosumer of healthcare, wherein healthcare service co-production and value co-creation take center stage. The article endeavors to unpack the state of the literature on the innovations promoting the transition toward patient-centeredness, informing policy and management interventions fostering the reconceptualization of the patient as a prosumer of healthcare services.

A hybrid review methodology consisting of a bibliometric-interpretive review following the Scientific Procedures and Rationales for Systematic Literature Reviews (SPAR-4-SLR) protocol is used. The bibliometric component enabled us to objectively map the extant scientific knowledge into research streams, whereas the interpretive component facilitated the critical analysis of research streams.

Patient-centeredness relies on a bundle of innovations that are enacted through a cycle of patients' activation, empowerment, involvement and engagement, wherein the omission of any steps arrests the transition toward service co-production and value co-creation. Institutional, organizational and cognitive barriers should be overcome to boost the transition of patients from consumers to prosumers in a patient-centered model of healthcare.

The article delivers the state of the art of the scientific literature in the field of innovations aimed at sustaining the transition toward patient-centeredness and provides some food for thoughts to scholars and practitioners who wish to push forward service co-production and value co-creation in healthcare.

The purpose of this paper is to demonstrate how a learning centre can be designed as a transformational vehicle to align the culture with the organization's mission and vision to achieve competitive advantage.

In the setting of international clinical development in a major pharmaceutical company, this paper first describes the change strategy and tactics used in designing a learning centre. Then, the overall framework for integrating learning into day‐to‐day work is described as well as the specific methods used for bringing about this integration.

The patient‐centered approach and continuous learning and improvement environment result in exploring, managing, and mitigating risks and optimizing benefits to the patient. Clearly, this change strategy is pivotal to achieving the company mission, and it enables international clinical development to exceed industry standards.

The paper shows how to design and implement a learning centre as a vehicle for culture change.

The purpose of this paper is to explore educators’ experiences of putting a participatory and patient-centered education model, “The Health Education Juggler,” into practice after having attended a one-day seminar. The model consists of four educator roles in participatory group-based patient education in chronic illness: embracer (takes care of the group), facilitator (generates dialogue and participation), translator (communicates professional knowledge) and initiator (motivates action in patients).

Qualitative analysis of observations of eight group-based patient education sessions and seven in-depth semi-structured interviews with 11 educators.

Educators find it difficult to include disease-specific knowledge when working with a flexible patient-centered approach. They tend to stay in the role they find most comfortable during education sessions (most often that of embracer), rather than adopting new and more challenging roles in the teaching process. Educators theoretically understand the role of facilitator, but they do not know how to perform in this role in practice. The ability to juggle all educator roles depends on the ability to master each.

The Health Education Juggler model shows promise in promoting participation and patient-centeredness and as a reflection tool for educators and an analytic tool for quality assessment of patient education. These findings support further development of model use.

This model of educator roles in group-based patient education in chronic illness provides a new approach to patient education. It indicates the need for various professional competencies among educators to provide patient-centered education in a flexible way, with a strong focus on patient-identified problems and challenges, social learning processes and generation of internal motivation in patients.

Providing care that is patient-centered is an important objective in the modern healthcare industry. Despite this objective, hospital inpatient case managers and the services they provide are evaluated routinely without including patients' perspectives. Therefore, the purpose of this study is to fill this research gap by using patient expectations and perceptions to assess the overall quality of and patient satisfaction with hospital case management services.

This paper investigates five dimensions of case management services – reliability, responsiveness, assurance, empathy and tangibles – and how they affect overall quality and patient satisfaction. Study surveys are based on the SERVQUAL instrument. Survey data from a cross-sectional sample of 67 inpatients are analyzed using principal component analysis, confirmatory factor analysis, GAP analysis and a predictive model.

The preliminary part of the study identifies “tangibles” and “nontangibles” – reliability, responsiveness, assurance and empathy – as the main components. Among these two components, only nontangibles have a positive and significant effect on both quality and patient satisfaction according to patient perspectives. GAP analysis indicates that gaps between patient expectations and perceptions of reliability and assurance are significant. Finally, the proposed predictive model reveals that gaps in assurance have a significant impact on both overall quality and satisfaction, while gaps in empathy have a significant impact on satisfaction, but not overall quality.

Studies on service quality at the case manager level are limited. This study is the first in this domain to evaluate quality and satisfaction from the patient perspective.