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Focal service providers increasingly involve customers in the decision-making about outsourcing parts of the service delivery process to third parties. The present study investigates how customers' outsourcing decisions affect the formation of the waiting experience with the focal service provider, by which the objective waiting time, environmental quality and interactional quality act as focal drivers.

To test our hypotheses in the context of cancer care, we gathered process data and experience data by means of a patient observation template (n = 640) and a patient survey (n = 487). The combined data (n = 377) were analyzed using Bayesian models.

This study shows that opting for a service triad (i.e. outsourcing non-core services to a third party) deduces customers' attention away from the objective waiting time with the focal service provider but not from the environmental and interactional quality offered by the focal service provider. When the type of service triad coordination is considered, we observe similar effects for a focal service provider-coordinated service triad while in a customer-coordinated service triad the interactional quality is the sole experience driver of waiting experiences that remains significant.

By investigating the implications of customer participation in the decision-making about outsourcing parts of the service delivery process to third parties, this research contributes to the service design, service triad and service operations literature. Specifically, this study shows that customer outsourcing decisions impact waiting experience formation with the focal service provider.

Nurses are capable of acting as advocates for patients since they hold valuable knowledge on patient preferences and their psychosocial needs. Yet, in practice they tend to contribute little to multidisciplinary team meetings (MDTMs). This study analyses the factors that influence whether or not nurses will speak up and increase patient-centred decision-making in MDTMs.

A multiple case study with cross-case comparison of twelve tumour groups across two Belgian hospitals was conducted. Data collection involved fifty structured non-participant observations and 41 semi-structured interviews with participants from the twelve tumour groups.

This study yields factors that increase the opportunities for nurses to speak up in MDTMs to enhance patient-centred decision-making. The findings help in the design of future interventions concerning multidisciplinary teamwork, that address nurses’ contributions to augment patient-centred care.

Process management approaches all pursue standardization, of which evidence-based medicine (EBM) is the most common form in healthcare. While EBM addresses improvement in clinical performance, it is unclear whether EBM also enhances operational performance. Conversely, operational process standardization (OPS) does not necessarily yield better clinical performance. The authors have therefore looked at the relationship between clinical practise standardization (CPS) and OPS and the way in which they jointly affect operational performance. The paper aims to discuss this issue.

The authors conducted a comparative case study analysis of a cataract surgery treatment at five Belgium hospital sites. Data collection involved 218 h of observations of 274 cataract surgeries. Both qualitative and quantitative methods were used.

Findings suggest that CPS does not automatically lead to improved resource or throughput efficiency. This can be explained by the low level of OPS across the five units, notwithstanding CPS. The results indicate that a wide range of variables on different levels (patient, physician and organization) affect OPS.

Considering one type of care treatment in which clinical outcome variations are small complicates translating the findings to unstructured and complex care treatments.

With the introduction of OPS as a complementary view of CPS, the study clearly shows the potential of OPS to support CPS in practice. Operations matters in healthcare standardization, but only when it is managed in a deliberate way on a hospital and policy level.

The purpose of the paper is to evaluate the development and use of service level agreements (SLAs) in a Belgian hospital from a client's point of view.

The paper is based on a theoretical framework indicating the variables that influence the relationship between the use of a specific governance mechanisms and performance, a new instrument was developed and applied on a convenience sample of 107 SLA clients from a Belgian hospital.

SLAs are useful for hospitals, as they improve people's insight into processes, stimulate people to think about performance measurement and, in some cases, also lead to improved services. The main advantages of SLAs do not really lie in improved relationships and better fits with clients' needs, but in improved process mapping and improved performance measurement. The questionnaire from this research study proves to be a useful and reliable instrument for evaluating internal SLAs from a client's point of view.

The results of this study are limited, as they are only based on one Belgian institution. Other limitations include the posttest‐only research design and the unequal distribution of the respondents over the different SLAs. Recommendations for future research include applying the questionnaire in other Belgian hospitals and in settings where both a pretest and posttest can be conducted.

As far as known, no other studies have yet evaluated the effectiveness of SLAs in the healthcare sector. While a fairly‐substantial amount of scientific literature deals with SLAs in the world of ICT, this literature is often very specific and cannot always be applied to other service sectors.

This paper proposes and empirically tests a theoretical model on how different customer engagement behaviors (CEBs), such as giving feedback and helping other customers, affect the role stress–job strain relationship among frontline employees.

Drawing from the job demands-resources model, this paper hypothesizes that some CEBs weaken the role stress–job strain relationship among frontline employees, whereas the opposite holds for other CEBs. To test these hypotheses, the study involved a survey among 279 frontline employees in 20 nursing home teams in Belgium.

The results reveal that the impact of role stress on job strain is stronger when frontline employees notice more helping behaviors among customers and weaker when frontline employees receive more customer feedback or notice that customers spread positive word of mouth about the nursing home.

This research contributes to the customer engagement and frontline employee literature by showing that CEBs can act as both job demands and job resources for frontline employees.

Admission scheduling is identified as an important strategy to match supply and demand in acute care hospitals. During the last decades, many different theoretical models of admission scheduling have been developed, but only a few of them have reached the stage of implementation. Several authors have given some indication that there may be a gap between theory and practice of admission scheduling. In this study we try to describe this gap using a two‐stage research methodology: an extensive literature review in order to determine the theoretical functional requirements for a system that supports the admission scheduling decision and a telephone survey in order to learn more about the admission scheduling practice in Belgian hospitals. The study finds a large gap between the theoretical requirements and the practical application of admission scheduling in hospitals. In summary, most hospitals have not worked out an admission scheduling policy indicating which resources are critical in the scheduling process and how information on the availability of these resources can be captured.