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Taking the dialogic organizational development perspective, this study aims to investigate the framing processes when engaging in dialogue for strategy implementation and how these enable the evolution of implementation opportunities.

Through a qualitative exploratory study conducted in a large multinational, the authors analyse the dialogue and interactions among 25 dyads when identifying opportunities to contribute to strategy implementation. The data analysis relies on a process-coding approach and linkography, a valuable protocol analysis for identifying recursive interaction schemas in conversations.

The authors identify four main framing processes – shaping, unveiling, scattering and shifting – and provide a framework of how these processes affect individuals’ mental models through increasing the tangibility of opportunities or elevating them to new value hierarchies.

From a theoretical perspective, this study contributes to the strategy implementation and organizational development literature, providing a micro-perspective of how dialogue allows early knowledge structures to emerge and shape the development of opportunities for strategy implementation.

From a managerial perspective, the authors offer insights to trigger action and change in individuals to contribute to strategy when moving from formulation to implementation.

Rather than focusing on the structural control view of strategy implementation and the role of the top management team, this study considers strategy implementation as a practice and what it takes for organizational actors who do not take part in strategy formulation to enact and shape opportunities for strategy implementation through constructive dialogue.

Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide insights into patients' perceptions of satisfaction, experience and self-reported outcomes. However, little attention has been devoted to questions about factors fostering the use of patient-reported information to create value at the system level.

Action research design is carried out to elicit possible triggers using the case of patient-reported experience and outcome data for breast cancer women along their clinical pathway in the clinical breast network of Tuscany (Italy).

The case shows that communication and engagement of multi-stakeholder representation are needed for making information actionable in a multi-level, multispecialty care pathway organized in a clinical network; moreover, political and managerial support from higher level governance is a stimulus for legitimizing the use for quality improvement. At the organizational level, an external facilitator disclosing and discussing real-world uses of collected data is a trigger to link measures to action. Also, clinical champion(s) and clear goals are key success factors. Nonetheless, resource munificent and dedicated information support tools together with education and learning routines are enabling factors.

Current literature focuses on key factors that impact performance information use often considering unidimensional performance and internal sources of information. The use of patient/user-reported information is not yet well-studied especially in supporting quality improvement in multi-stakeholder governance. The work appears relevant for the implications it carries, especially for policymakers and public sector managers when confronting the gap in patient-reported measures for quality improvement.