Search results

The increasing financial burden and complexity of health-care services, exacerbated by factors such as an ageing population and the rise of chronic conditions, necessitate comprehensive and integrated care approaches. While co-created service design has proven valuable in transforming some service industries, its application to the health-care industry is not well understood. This study aims to examine how health consumers are involved in health-care service co-creation.

The study searched 11 electronic databases for peer-reviewed articles published between 2010 and 2019. Additionally, hand searches of reference lists from included studies, Google^© citation searches and searches for grey literature were conducted. The Whittemore and Knafl integrative framework guided the systematic review, and Callahan’s 6 Ws framework was used to extract data from the included articles, facilitating comparisons.

The authors identified 21 articles, mainly from the UK, North America and Australia. Despite the need for more research, findings reveal limited and geographically narrow empirical studies with restricted theory and method applications. From these findings, the authors constructed a conceptual model to enhance nuanced understanding.

This study offers four contributions. First, it introduces the Health Service Design Transformation Model for Comprehensive Consumer Co-Creation, illustrating health consumers’ multifaceted roles in shaping services. Second, consumer vulnerabilities in co-creating services are identified, linked to diverse consumer groups, power dynamics and decision complexity. Third, this study suggests broadening participant inclusion may enhance consumer-centricity, inclusivity and innovation in service design. Finally, the research agenda explores consumer experiences, organizational dynamics, value outcomes and co-creation theory for health-care service advancement.

The structure of health care financing, the lack of vertical and horizontal integration, and the slow translation of basic research into meaningful health outcomes for the population conspire to make innovation in health service delivery a difficult task. However, health service organizations that can more effectively and systematically understand patient needs – needs that are now poorly understood and often unarticulated – have an intrinsic advantage in delivering high value care. This ‐paper aims to describe a program for translating those needs into health services innovations.

The Mayo Clinic, a large integrated multispecialty medical group based in Rochester, Minnesota developed an in‐house design program, the SPARC Innovation Program, to bring design thinking and business analysis together to develop innovations in care delivery. A project example is described to illustrate how designers, business strategists, health care professionals, and patients create new high‐value health care experiences.

The paper finds that health service organizations need to pay more attention to the patient experience if they are to meet patient needs. The design program described here is one approach that organizations can take if they are serious about deeply understanding patient needs and developing innovations to address them.

While the discipline of design is the core of innovation in many industries, it is not widely known or practiced in health service organizations despite a natural affinity between design and medicine. Understanding and employing the power of design in health services will allow medical institutions to develop more effective health services, enhance patient satisfaction, and meet important human needs.

The purpose of this paper is to investigate the relationships between two dimensions of servicescape (i.e. substantive and communicative servicescape), health care travelers’ emotions, perceived value and word-of-mouth intentions. It also assesses the moderating effects of accommodation type (i.e. hotel and Airbnb) and interior design styles (i.e. traditional and modern) on the relationship between the two servicescape dimensions and travelers’ emotions.

Using a sample from a survey of 692 health care travelers who stayed at either a peer-to-peer accommodation (i.e. Airbnb) or a hotel, a multi-step structural equation model analysis tested the relationships among variables. It examined the moderating effects of accommodation type and interior design style.

The relationships between servicescape, emotions, perceived value and word-of-mouth were significant. Also, the two moderators affected how servicescape influenced the emotions of health care travelers. For Airbnb guests, communicative servicescape had a more substantial effect on enhancing their positive emotions than hotel guests. For health care travelers who stayed at an accommodation with a traditional interior design style, in addition to enhancing positive emotions of health care travelers, substantive servicescape significantly reduced their negative emotions.

The findings suggest the need for the lodging industry to examine how health care travelers perceive and experience their accommodations with unique interior design characteristics. Also, stakeholders in the lodging industry should leverage the aspects of substantive servicescape in terms of relevant interior design styles, which, in turn, influence health care travelers’ positive word-of-mouth intentions. Given the increase in medical mobility and demand for accommodations by those traveling to receive health care services, understanding the lodging environment and how it affects travelers in this segment is essential.

This research develops a comprehensive servicescape model with a focus on the communicative dimension. Moreover, this study significantly contributes to the hospitality literature regarding how the core experience and various interior design styles influence a rapidly growing segment of health care travelers. Health care travelers’ emotions are essential to consider given the propensity to experience stress related to travel situational health factors.

Purpose – This chapter argues that the concept of agility is an effective robust framework for designing sustainable health care systems.

Design/methodology/approach – This case study of Alegent Health was based on 7 years of data collection. It includes observations of meetings, large-group interventions, and other activities; site visits to different hospitals in the system to observe changes in practice; interviews with Alegent Health executives, primary care physicians, hospital presidents, specialist physicians and physician groups, and health systems staff and nurses; and a variety of archival data including meeting minutes, video tapes, conference proceedings, and web site material.

Findings – The Alegent Health system has evolved over time according to the principles of agility. It built a series of new capabilities that contribute to improved clinical outcomes, sustained financial results, and more socially and ecologically responsible results. Designing health care systems based on agility is a more effective and sustainable approach than relying on legislative or other criteria.

Originality/value – The discussion of sustainability in health care has focused primarily on specific projects or how to respond to specific technological, regulatory, or clinical changes. Alegent Health's experience provides important lessons, opportunities, and challenges that can help advance our understanding of effective health care and use organizational agility to create more sustainable health care systems. This chapter provides health care system administrators an alternative design option.

The Covid-19 pandemic has placed health-care systems and their facilities throughout the world under immense pressure. The pandemic has highlighted the crucial role of health-care facilities design in looking beyond the ongoing crisis and considering how hospitals can better prepare for unexpected future health situations. This study aims to investigate how hospitals reacted to the crisis in terms of their physical spaces, which architectural features permitted the necessary transformations, and how this data can inform hospital design research in the future.

The research adopted a qualitative and multi-method approach to case studies. Data was collected directly (field survey and interviews) and indirectly (literature, periodicals, specialised websites, webinars, conferences and forums), and a strengths, weaknesses, opportunities, threats analysis supported the data evaluation.

Hospitals’ responses to the crisis were guided by a host of variables depending on the specific intervention context and risk scenario. Some key issues emerged as particularly meaningful to drive future research in hospital design, namely, architectural typology, layout and spatial proximities, technological systems, the quality of care spaces, the role of public spaces, facility management tools to drive the transformation, territorial health care networks and new technologies.

The paper suggests that the current crisis can be transformed into an opportunity, in terms of research and innovation, to rethink and improve the quality and efficiency of health-care spaces, restoring their crucial role of promoting health by design.

Changes in the physical environments of health care settings have become increasingly common to meet the evolving needs of the health care marketplace, new technologies, and infrastructure demands. Physical environment change takes many forms including new build construction, renovation of existing space, and relocation of units with little to no construction customization. The interrelated nature of the complex socio-technical health care system suggests that even small environmental modifications can result in system-level changes. Environmental modifications can lead to unintended consequences and introduce the potential for latent safety threats. Engaging users throughout the change lifecycle allows for iterative design and testing of system modifications. This chapter introduces a flexible process model, PROcess for the Design of User-Centered Environments (PRODUCE), designed to guide system change. The model was developed and refined across a series of real-world renovations and relocations in a large multihospital health care system. Utilizing the principles of user-centered design, human factors, and in-situ simulation, the model engages users in the planning, testing, and implementation of physical environment change. Case studies presented here offer exemplars of how to modify the model to support individual project objectives and outcomes to assess at each stage of the project.

This study aims to trace the relationship between the evidence-based design (EBD) process and decision-making during the architectural design process, the barriers to informing health-care architects and possible methods to overcome these barriers.

This study aims to explore the barriers to the EBD process during the design process by reviewing the relevant literature and future steps to overcome these barriers and support design decisions.

The study shows that EBD is a relevant, useful tool for providing evidence that positively affects design decisions. This study divides EBD barriers into simple barriers and complex barriers, depending on the nature of the barrier. Additionally, methods to overcome these barriers are discussed to ensure the best use of EBD findings with a significant impact on health-care design decisions, as they are core elements in informing architects, especially when combined with the traditional design process. This study investigates how likely it is for the EBD to contribute optimally to design decisions depending on architects’ skills and cooperation with researchers.

This study can apprize health-care architects of the need to consider the role of EBD in improving the quality of design decisions, and the importance of combining EBD with the traditional design process to implement optimal design decisions.

As supply chain excellence matters, designing an appropriate health-care supply chain is a great consideration to the health-care providers worldwide. Therefore, the purpose of this paper is to benchmark several potential health-care supply chains to design an efficient and effective one in the presence of mixed data.

To achieve this objective, this research illustrates a hybrid algorithm based on data envelopment analysis (DEA) and goal programming (GP) for designing real-world health-care supply chains with mixed data. A DEA model along with a data aggregation is suggested to evaluate the performance of several potential configurations of the health-care supply chains. As part of the proposed approach, a GP model is conducted for dimensioning the supply chains under assessment by finding the level of the original variables (inputs and outputs) that characterize these supply chains.

This paper presents an algorithm for modeling health-care supply chains exclusively designed to handle crisp and interval data simultaneously.

The outcome of this study will assist the health-care decision-makers in comparing their supply chains against peers and dimensioning their resources to achieve a given level of productions.

A real application to design a real-life pharmaceutical supply chain for the public ministry of health in Morocco is given to support the usefulness of the proposed algorithm.

The novelty of this paper comes from the development of a hybrid approach based on DEA and GP to design an appropriate real-life health-care supply chain in the presence of mixed data. This approach definitely contributes to assist health-care decision-makers design an efficient and effective supply chain in today’s competitive word.

Purpose – This chapter examines the impact of technology on sustainable effectiveness by focusing on the dynamic synchronization between the technical and the social subsystems at the Villa Beretta Rehabilitation Hospital (VBRH) and illustrates that technology can trigger and enable sustainable health care organizations.

Design/methodology/approach – The case study of VBRH relies on several data sources. They include interviews with key informants (VBRH executives, health care professionals, and technology suppliers), follow-up e-mails and phone conversations, direct observations of actors’ behavior, and notes of processes in action and archival data, such as patient pathway protocols, technical information systems documentation, performance and managerial reports, and administrative guidelines.

Findings – VBRH was capable to dynamically synchronize the social subsystem with the continuous innovation of the technical subsystem. This capability enabled sustainable effectiveness in three main areas. First, the correct alignment between technology and professionals’ practices and behaviors improved triple-bottom-line performance by promoting a more conscious use of the environmental, social, and financial resources. Second, technology-based initiatives promoted research-oriented plans of action that nurtured a culture of change and continuous improvement. Third, technology facilitated the extension of the research and operation networks that generated new ideas and initiatives for achieving sustainable effectiveness. Additionally, evidence from VBRH demonstrated that organization design, change management, and learning mechanisms are essential when institutionalizing new technology that requires the disruption of current professional practices and individuals’ behavior.

Originality/value – Previous contributions about sustainable effectiveness in health care failed to unveil and frame the complexity of dynamic synchronization between the technical and the social subsystems that is at the core of the sustainability of health care delivery. This chapter provides new insights that pave the way for a deeper-level understanding of the role that technology plays in sustainable effectiveness dynamics and outcomes in health care delivery. The chapter illustrates how different groups of technology contribute to sustainable effectiveness and the mechanisms that make them work.

The purpose of this paper is to contribute knowledge concerning the dynamics and potential cultural tensions that occur when applying user involvement and design thinking (DT) for improving quality in a health-care setting.

This paper is based on a case study following a quality improvement (QI) project in a medium-sized Swedish county council in the field of somatic care. The project involved eight health-care professionals, one designer, four patients and two relatives. A multiple data collection method over a period of ten months was used. It included individual interviews, e-mail correspondence and observations of workshops that covered the QI project.

The result shows tensions between QI work and the daily clinical work of the participants. These tensions primarily concern the conflict between fast and slow processes, the problem of moving between different fields of knowledge, being a resource for the individual clinic and the system and the participants’ expectations and assumptions about roles and responsibilities in a QI project. Furthermore, these findings could be interpreted as signs of a development culture in the health-care context.

There are several practical implications. Among others, the insights can inspire how to approach and contextualize the current concepts, roles and methods of DT and user involvement so that they can be more easily understood and integrated into the existing culture and way of working in the health-care sector.

This study provides a unique insight into a case, trying to uncover what actually is going on and perhaps, why certain things are not happening at all, when user involvement and design practices are applied for improving health-care quality.