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This paper explores how service design can contribute to the evolution of health service systems, moving them toward people-centered, integrated and technology-enabled care; the paper develops a research agenda to leverage service design research for healthcare transformation.

This conceptual study starts by analyzing healthcare challenges in terms of demographic trends and economic constraints, along with the problems of lack of people-centricity, dispersion of care and slowness in incorporating emerging technologies. Then, it examines the theoretical underpinnings of service design to develop a framework for exploring how a human-centered, transformative and service systems approach can contribute to addressing healthcare challenges, with illustrative cases of service design research in healthcare being given.

The proposed framework explores how a human-centered service design approach can leverage the potential of technology and advance healthcare systems toward people-centered care; how a transformative service design approach can go beyond explanatory research of healthcare phenomena to develop innovative solutions for healthcare change and wellbeing; and how a service systems perspective can address the complexity of healthcare systems, hence moving toward integrated care.

This paper systematizes and develops a framework for how service design can contribute to healthcare transformation. It identifies key healthcare application areas for future service design research and pathways for advancing service design in healthcare by using new interdisciplinary bridges, methodological developments and theoretical foundations.

Most successful companies have adopted some type of improvement methodology to achieve optimum performance, high quality, lower costs and productivity. Some of the structured methodologies employed indiscriminately are total quality management, quality control, agile, lean and Six Sigma which yield varied results. The purpose of this paper is to explore how to harness the power of an integrated system of quality tools and techniques to create operational excellence. An integrated framework involves matching quality tools and techniques to the multi-phases (input, transformation and output) of lean manufacturing or service ecosystem.

Current research of lean quality systems provides a conceptual understanding of core tools employed by manufacturing and service organizations. Interviewing domain experts from a series of manufacturing and service organizations highlighted a common challenge. The challenge was lean tools and methodologies were selected and employed arbitrarily for the different operational phases, which resulted in selective synergies of tools between operational phases. This limitation resulted in rework and duplication of quality efforts through the diverse phases of the transformation system. This study is based on the hypothesis that all phases of an operational system must be linked by common tools and methodologies which enables harnessing quality benefits and synergies throughout the entire operational system. The study methodology trailed through cooperative inquiry using a case study approach to design an integrated framework of tools that facilitates a common platform for manufacturing or service ecosystems.

This study suggests that quality systems in a complex competitive environment must consider an integrated iterative approach. An iterative development of lean quality tools for multiple phases produces an integrated quality system. Such systems employ blending and extending of lean quality tools to multiple phases of the transformation system to synthesize agile and versatile quality system.

A limitation of this study is that the research of integrated framework is based on repertory grid technique only; it should be supplemented by other methods. Second, the proposed framework does not consider the complexity added by the internal and external stakeholders as they interface with the integrated system at different points with reference to phases of the system.

One of the advantages of this method is its generality, instead of delivering a monolithic system at the culmination of long transformation process we rely on smaller quality sprints which are implemented sequentially at each stage or phase of the transformation system. The phenomena of incremental clustering of time-series of quality sprints for different phases results in true integration from end to end for a transformation system.

This study helps investigate the personal constructs that users and managers employ to interpret and select quality tools or methodologies for the different phases of lean transformational system.

This study aims to understand the impact of blending quality and business process improvement tools and methodologies to enhance outcomes. The basis of this study is “the power of multiplicity” through which a diverse collection of improvement paths is pooled into an integrated framework of quality tools for lean and efficient operations.

Since January 2015, the Dutch youth care system has been under construction. Its focus has shifted from the problematic to the normal development of children. Emphasis on the capacities of both youths and parents, on customized care and on better cooperation between professionals should decrease the use of specialized services. This reconstruction of the youth care system not only appeals to the competencies and skills of professionals, but also requires innovations in terms of leadership. The purpose of this paper is to describe the struggle managers face when working to transform the youth care system, and to provide some suggestions for how managers can be supported.

This paper is based on the results of two empirical, qualitative studies that were recently conducted by the Research Institute Youth, which is part of the Health Care and Social Work Research Centre of Windesheim University of Applied Sciences in Zwolle, the Netherlands. Over the course of a preliminary study, executive managers of five youth care organizations were interviewed on the ongoing transformations of their organizations and the changing roles and needs of managers within these transformations. Subsequently, 13 middle- and first-line managers of 3 youth care organizations were interviewed about their experiences and the ways in which they have handled the new roles they have taken on in transforming their organizations.

The management of youth care organizations is responsible for facilitating professionals in taking on and shaping their new roles, thus affecting not only the structure but also the culture and practices of youth care organizations and of management itself. This research shows that managers are struggling with these changes in their own ways. While youth care managers are struggling with their new roles and responsibilities, the intended transformation of the youth care system lags behind. Appropriate support of managers is essential, but is currently lacking. This paper provides some suggestions for how managers can be supported.

This paper identifies and explains the challenges that top-, middle- and lower-level managers face in current transformation processes in social service organizations, and provides some suggestions for how managers can be supported in these processes.

Transformative service research (TSR) and social marketing share a common goal, which is to institute social change that improves individual and societal well-being. However, the mechanism via which such improved well-being results or so-called “transformation” occurs, is not well understood. The purpose of this paper is to examine the claims made in the TSR literature to identity the themes and scholarly meaning of “transformative” service exchange; ascertain the mechanisms used in service contexts to realize transformation, including to motivate long-term, sustainable societal change; and develop a transformative service exchange continuum to guide research and managerial approaches that aim to create uplifting social change. The authors recommend their continuum as a framework to inform how social marketing and service scholars design service solutions to address wicked social problems.

This paper presents a qualitative study where Leximancer, a text-mining tool, is used to visualize the structure of themes and concepts that define transformative service exchanges as explained and applied in the literature. Additionally, a profiling analysis of transformation as it is discussed in the TSR literature is used to identify the mechanisms that service marketers have developed to establish current theorization of service thinking for social change. These qualitative phases of analysis then inform the development of the transformative service exchange continuum.

A scoping review identified 51 articles across 12 journals, based on this study’s selection criteria for identifying transformative service exchanges. The Leximancer analysis systematically and efficiently guided the authors’ interpretation of the large data corpus and was used in the identification of service themes. The use of text-mining software afforded a detailed lens to enrich the authors’ interpretation and clarification of six high-level concepts for inclusion on a transformative service exchange continuum.

This paper aims to unpack the meaning of transformative service exchange by highlighting the mechanism(s) used by researchers when designing social change outcomes. It contributes to TSR via the development of the continuum across micro, meso and macro levels. The temporal nature of transformative service exchanges is also elucidated. This continuum integrates current TSR studies and can guide future service studies in the TSR and social marketing domains.

The purpose of this paper is to examine the role of proto-institutions that are new institutional subsystems that subsequently affect the current institutional arrangements in the evolution of service ecosystems.

To shed light on the mode of action of proto-institutions, the authors investigate the changes of three service ecosystems in Italy: the health care ecosystem, the food-supply ecosystem and the urban mobility ecosystem.

First, the paper elucidates how changes of service ecosystems are triggered by megatrends that are external to specific service ecosystems. Second, the study empirically shows how service ecosystems and their institutional settings change through the establishment of proto-institutions.

Responding to recent calls to investigate in more detail how actors challenge dominant social patterns and to conduct research to better understand how changes at the level of individual actors may lead to shifts within overall service ecosystems, this paper is one of the first to empirically study the relationships between phenomena that are external to service ecosystems, the emergence of proto-institutions and the resulting changes of institutional arrangements.

Theoretical generalisation provides the basis for tackling problems of service complexity, fragmentation and disrupted care pathways.

Recent mental health service transformation in Wales, United Kingdom, has been stimulated by a policy programme underpinned by person-centred recovery values. This paper offers analysis informed by the perspectives of Niklas Luhmann and other noted theorists to examine escalating service system complexity related to this transformation. Analysis builds upon the findings of a qualitative study employing thematic discourse analysis of talk of people with mental illness and associated workers.

In total, three themes were constructed in participants' talk: “Competing versions of recovery”, “Misaligned service expectations” and “Disrupted care pathways.” Recovery may be understood as a form of moral communication and autopoietic meaning-making activity, according to Luhmann's radical constructionist epistemology. This has the potential to generate competing versions of recovery, a key contributor to escalating complexity.

Findings could be developed further by continued investigation of the relationship between recovery implementation and service fragmentation.

A more judicious, balanced policy-implementation may cultivate optimal conditions for recovery pluralism by avoiding polarisation towards either top-down, policy-based recovery implementation or a proliferation of approaches at the grassroots level. Findings have implications for healthcare settings beyond the scope of mental healthcare, given the prevalence of person-centred care internationally.

A simplistic view of recovery implementation should be challenged. Recovery should not be considered a “magic bullet” for mental healthcare delivery. Haphazard recovery-implementation may have detrimental effects of escalating complexity, service fragmentation and disrupted care pathways.

The paper aims to conceptualize how behavioral shifts in times of crisis drive the transformation of value co-creation.

Referencing two empirical contexts, the paper explores how digital service platforms facilitate changes in actors’ mental models and institutional arrangements (legal, social, technological) that drive transformation of value co-creation in service ecosystems.

The proposed conceptual framework contributes to existing research by identifying micro-level changes in actors’ mental models and macro-level changes in institutional arrangements enabled by digital service platforms in service ecosystems. In particular, the framework identifies motivation, agility and resistance as moderators of behavioral shifts in times of crisis. This account offers a finer-grained theorization of the moderating factors and underlying mechanisms of service ecosystem transformation but does not extend to the ensuing “new normal.”

The proposed framework indicates how digital platforms support shifts in actors’ behavior and contribute to the transformation of value co-creation. While the enablers are situation-specific and may therefore vary according to the prevailing conditions, the actor-related concepts advanced here seem likely to remain relevant when analyzing the transformation of value co-creation in other crisis situations.

The new conceptual framework advanced here clarifies how behavioral shifts during a crisis drive the transformation of value co-creation and suggests directions for future research.

Following publication of a new vision for the English National Health Service (NHS) in 2014, known as the NHS Five-Year Forward View, a Vanguard programme was introduced by NHS England charged with the task of designing and delivering a range of new care models (NCMs) aimed at tackling deep-seated problems of a type facing all health systems to a greater or lesser degree. Drawing upon recent theoretical developments on the multilevel nature of context, we explore factors shaping the implementation of five NCM initiatives in the North East of England.

Data collection was based on semi-structured interviews (66 in total) between December 2016 and May 2017 with key informants at each site and a detailed review of Trusts' internal documents and policies related to the implementation of each NCM. Our analysis explores factors shaping the implementation of five NCM pilot sites as they touched on the multiple levels of context ranging from the macro policy level to the micro-level setting of workforce redesign.

It is far too early to conclude with any confidence that a successful outcome for the NCM programme will be forthcoming although the NHS Long-Term Plan seeks to build on the earlier vision set out in the Five-Year Forward View. Early indications show some signs of promise, especially where there is evidence of the ground having been prepared and changes already being put in place prior to the official launch of NCM initiatives. At the same time our findings demonstrate that all five pilot sites experienced, and were subject to, unrealistic pressure placed upon them to deliver outcomes.

Our findings demonstrate the need for a deeper understanding of the multilevel nature of context by exploring factors shaping the implementation of five NCMs in the North East of England. Exploring the wider national policy context is desirable as well as understanding the perceptions of front-line staff and service users in order to establish the degree of alignment or, conversely, to identify where policy and practice are at risk of pushing and pulling against each other.

The paper attempts to address the following research questions (RQs): RQ1: What are the main research topics within PSS research? RQ2: What are future trends for PSS research?

Twenty years of research (1999–2018) on product-service systems (PSS) produced a significant amount of scientific literature on the topic. As the PSS field is relatively new and fragmented across different disciplines, a review of the prior and relevant literature is important in order to provide the necessary framework for understanding current developments and future perspectives. This paper aims to review and organize research contributions regarding PSS. A machine-learning algorithm, namely Latent Dirichlet Allocation, has been applied to the whole literature corpus on PSS in order to understand its structure.

The adopted approach resulted in the definition of eight distinct and representative topics able to deal adequately with the multidisciplinarity of the PSS. Furthermore, a systematic review of the literature is proposed to summarize the state-of-the-art and limitations in the identified PSS research topics. Based on this critical analysis, major gaps and future research challenges are presented and discussed.

On the basis of the results of the topic landscape, the paper presents some potential research opportunities on PSSs. In particular, challenges, transversal to the eight research topics and related to recent technology trends and digital transformation, have been discussed.

The purpose of this paper is to develop a coherent theory and strategy for the achievement of quality outcomes that is meaningful and relevant to people at all levels of society. These should help the quality professional engage with people at all levels of society in the development of a culture that appreciates quality, systems and excellence. The research draws on the work of the community quality councils movement in the USA and sought to build on this experience in a village in northwest Ireland.

Action research employing an ethnographic type approach to a four year immersion period in a small industrious community. Its inductive nature and naturalist mode of enquiry did not lend itself to either the generation or analysis of quantitative data. Nevertheless it yielded many rich complex pictures or patterns of qualitative information requiring long periods of reflection to decipher the sense and meaning in them.

The findings can be encapsulated in one sentence “To achieve quality outcomes we must practise excellence and maintain systems that are fit for purpose”. This requires a radical reworking of Deming’s system of profound knowledge (SoPK) to make it relevant to the human complex adaptive systems that permeate the twenty-first century. These operate as autonomous service providers in a rapidly changing environment.

The findings of this research have transferability to all sectors in society pursuing purposeful activity. It is relevant at individual, interest-group, industry, institution and community level. It should make the development of a “quality culture” more attainable at all levels.

Provides quality professionals with new terminology and imagery to engage with, analyse and help autonomous human activity systems in the twenty-first century. It moves Deming’s SoPK to a new level more suited to human systems.

By explaining quality, excellence and systems in easily understood and accepted terms the Grange Excellence Model allows every individual, interest-group, industry and institution share the same language and images as they pursue quality outcomes. This unified approach could transform communities and society in general.

The research generates a seismic shift in the appreciation of quality, excellence and systems making them relevant and meaningful to people at all levels of society. This provides quality professionals with a methodology, images and vocabulary that will facilitate productive engagement with purposeful systems at all levels of complexity.