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The purpose of this paper is to classify and describe the purpose of ward rounds, who attends each round and their role, and participants’ perception of each other’s role during the respective ward rounds.

A literature review of face-to-face ward rounds in medical wards was conducted. Peer reviewed journals and government publications published between 2000 and 2014 were searched. Articles were classified according to the type of round described in the study. Purposes were identified using keywords in the description of why the round was carried out. Descriptions of tasks and interactions with team members defined participant roles.

Eight round classifications were identified. The most common were the generalised ward; multidisciplinary; and consultant rounds. Multidisciplinary rounds were the most collaborative round. Medical officers were the most likely discipline to attend any round. There was limited reference to allied health clinicians and patient involvement on rounds. Perceptions attendees held of each other reiterated the need to continue to investigate teamwork.

A collaborative approach to care planning can occur by ensuring clinicians and patients are aware of different ward round processes and their role in them.

Analysis fulfils a gap in the literature by identifying and analysing the different ward rounds being undertaken in acute medical wards. It identifies the complexities in the long established routine hospital processes of the ward round.

Although health-care features prominently in transformative service research, there is little to guide service providers on how to improve well-being and social change transformations. This paper aims to explore actor-level interactions in transformative services, proposing that actors’ complementary health service literacy roles are fundamental to resource integration and joint value creation.

In-depth interviews with 46 primary health-care patients and 11 health-care service providers (HSPs) were conducted focusing on their subjective experiences of health literacy. An iterative hermeneutic approach was used to analyse the textual data linking it with existing theory.

Data analysis identified patients’ and HSPs’ health service literacy roles and corresponding role readiness dimensions. Four propositions are developed describing how these roles influence resource integration processes. Complementary service literacy roles enhance resource integration with outcomes of respect, trust, empowerment and loyalty. Competing service literacy roles lead to outcomes of discredit, frustration, resistance and exit through unsuccessful resource integration.

Health service literacy roles – linked to actor agency, institutional norms and service processes – provide a nuanced approach to understanding the tensions between patient empowerment trends and service professionals’ desire for recognition of their expertise over patient care. Specifically, the authors extend Frow et al.’s (2016) list of co-creation practices with practices that complement actors’ service literacy and role readiness. Based on a service perspective, the authors encourage transformative service researchers, service professionals and health service system designers, to recognize complementary health service literacy roles as an opportunity to support patients’ resources and facilitate value co-creation.

Studies demonstrate how patient roles in system redesign teams reflect a continuum of involvement and influence. This research shows the process by which patients move through this continuum and effectively engage within redesign projects.

The authors studied members of redesign teams, consisting of 5–10 members: clinicians, systems engineers, health system staff and patient(s), from three health systems working on separate projects in a patient safety learning lab. Weekly team meetings were observed, January 2016–April 2018, 17 semi-structured interviews were conducted and findings through a patient focus group were refined. Grounded theory was used to analyze field notes and transcripts.

Results show how the social identity process enables patients to move through stages in a patient engagement continuum (informant, partner and active change agent). Initially, patient and team member perceptions of the patient's role influence their respective behaviors (activating, directing, framing and sharing). Subsequently, patient and team member behaviors influence patient contributions on the team, which can redefine patient and team member perceptions of the patient's role.

As health systems grow increasingly complex and become more interested in responding to patient expectations, understanding how to effectively engage patients on redesign teams gains importance. This research investigates how and why patient engagement on redesign teams changes over time and what makes different types of patient roles valuable for team objectives. Findings have implications for how redesign teams can better prepare, anticipate and support the changing role of engaged patients.

The purpose of this paper is to focus on the changing nature of healthcare service encounters by studying the phenomenon of triadic engagement incorporating interactions between patients, local and virtual networks and healthcare professionals.

An 18-month longitudinal ethnographic study documents interactions in naturally occurring healthcare consultations. Professionals (n=13) and patients (n=24) within primary and secondary care units were recruited. Analysis of observations, field notes and interviews provides an integrated picture of triadic engagement.

Triadic engagement is conceptualised against a two-level framework. First, the structure of triadic consultations is identified in terms of the human voice, virtual voice and networked voice. These are related to: companions’ contributions to discussions and the virtual network impact. Second, evolving roles are mapped to three phases of transformation: enhancement; empowerment; emancipation. Triadic engagement varied across conditions.

These changing roles and structures evidence an increasing emphasis on the responsible consumer and patients/companions to utilise information/support in making health-related decisions. The nature and role of third voices requires clear delineation.

Structures of consultations should be rethought around the diversity of patient/companion behaviours and expectations as patients undertake self-service activities. Implications for policy and practice are: the parallel set of local/virtual informational and service activities; a network orientation to healthcare; tailoring of support resources/guides for professionals and third parties to inform support practices.

Contributions are made to understanding triadic engagement and forwarding the agenda on patient-centred care. Longitudinal illumination of consultations is offered through an exceptional level of access to observe consultations.

This study aims to compare Finnish medical students' perceptions of the suitability of three experiential methods in learning interpersonal communication competence (ICC). The three methods it seeks to explore are: theatre in education; simulated patient interview with amateur actors; and role‐play with peers. The methods were introduced in a pilot course of speech communication.

Students (n=132) were randomly assigned to three groups. The data were collected via questionnaire and focus group interviews, and analysed using qualitative content analysis and cross‐case analysis.

Most of the medical students thought these methods were suitable or very suitable for learning ICC. The methods had five similar elements: the doctor's role, the patient's role, reflective participation, emotional reactions and teachers' actions. Being in a doctor's role, realistic scripts and patient‐roles, observing the interaction and reflection in small groups were the most helpful elements in these methods.

The results of this study show that simulated patient interview with amateur actors, role‐play with peers, and TIE are very suitable methods for practising professionally relevant ICC in the context of doctor‐patient encounters from the medical students' perspective.

The purpose of this paper is to synthesize findings from health care research with those in service research to identify key conceptualizations of the changing role of the health care customer, to identify gaps in theory, and to propose a compelling research agenda.

This study combines a meta-narrative review of health care research, and a systematic review of service research, using thematic analysis to identify key practice approaches and the changing role of the health care customer.

The review reveals different conceptualizations of the customer role within the ten key practice approaches, and identifies an increased activation of the role of the health care customer over time. This change implies a re-orientation, that is, moving away from the health care professional setting the agenda, prescribing and delivering treatment where the customer merely complies with orders, to the customer actively contributing and co-creating value with service providers and other actors in the ecosystem to the extent the health care customer desires.

This study not only identifies key practice approaches by synthesizing findings from health care research with those in service research, it also identifies how the role of the health care customer is changing and highlights effects of the changing role across the practice approaches. A research agenda to guide future health care service research is also provided.

The purpose of this paper is two-fold. First, it sets the context for the special issue by considering conceptions of patients and their roles in service delivery and improvement. Second, it introduces the contributions to the special issue, and identifies thematic resonance.

The paper utilises a literature synthesis and thematic analysis of the special issue submissions. These emanated from the Ninth International Organisational Behaviour in Healthcare Conference, hosted by Copenhagen Business School on behalf of the Learned Society for Studies in Organizing Healthcare.

The articles evidence a range of perspectives on patients’ roles in healthcare. These range from their being subject to, a mobilising focus for, and active participants in service delivery and improvement. Building upon the potential patient roles identified, this editorial develops five “ideal type” patient positions in healthcare delivery and improvement. These recognise that patients’ engagement with health care services is influenced both by personal characteristics and circumstances, which affect patients’ openness to engaging with health services, as well as the opportunities afforded to patients to engage, by organisations and their employees.

The paper explores the relationally embedded nature of patient involvement in healthcare, inherent in the interdependence between patient and providers’ roles. The typology aims to prompt discussion regarding the conceptualisation patients’ roles in healthcare organisations, and the individual, employee, organisational and contextual factors that may help and hinder their involvement in service delivery and improvement. The authors close by noting four areas meriting further research attention, and potentially useful theoretical lenses.

When using a service, customers often develop their own solutions by integrating resources to solve problems and co-create value. Drawing on innovation and creativity literature, this paper aims to investigate the influence of place (the service setting and the customer setting) on customer creativity in a health-care context.

In a field study using customer diaries, 200 ideas from orthopedic surgery patients were collected and evaluated by an expert panel using the consensual assessment technique (CAT).

Results suggest that place influences customer creativity. In the customer setting, customers generate novel ideas that may improve their clinical health. In the service setting, customers generate ideas that may improve the user value of the service and enhance the customer experience. Customer creativity is influenced by the role the customer adopts in a specific place. In the customer setting customers were more likely to develop ideas involving active customer roles. Interestingly, while health-care customers provided ideas in both settings, contrary to expectation, ideas scored higher on user value in the service setting than in the customer setting.

This study shows that customer creativity differs in terms of originality, user value and clinical value depending on the place (service setting or customer setting), albeit in one country in a standardized care process.

The present research puts customer creativity in relation to health-care practices building on an active patient role, suggesting that patients can contribute to the further development of health-care services.

As the first field study to test the influence of place on customer creativity, this research makes a novel contribution to the growing body of work in customer creativity, showing that different places are more/less favorable for different dimensions of creativity. It also relates customer creativity to health-care practices and highlights that patients are an untapped source of creativity with first-hand knowledge and insights, importantly demonstrating how customers can contribute to the further development of health-care services.

Chapter X of The Social System is often cited as the “charter” for the specialty field of medical sociology. A notable feature of its analysis is the argument that the physician is an agent of social control in relation to the patient. This argument grounds the application to medical practice of Parsons’ general conception that social control is an aspect of all social relationships. Parsons started by addressing the situation of a patient who assumes the sick role and then becomes the patient of a physician. The sick role involves a suspension of at least some of the performance expectations associated with a person's everyday social life, such as expectations of working productively at one's job, attending the meeting of a civic association, or caring for one's family members. But in assuming the sick role, an individual encounters new expectations that he or she should try to get well. For minor illnesses this may involve only resting, drinking fluids, and avoiding stress. For more serious illnesses, given our culture's valuation of scientific medicine, it typically involves placing oneself in the care of a physician. It then becomes the physician's duty to offer treatment and guidance to restore one's health and enable one to return to meet expectations of everyday roles. Thus the physician becomes an agent of social control.

The purpose of this paper is to explore how multi-professional approved clinicians (MPACs), responsible for the care of patients detained under the Mental Health Act (2007), can enable clinical leadership in mental health settings.

A questionnaire was completed by clinical psychology and mental health nursing practitioners in a mental health trust in the UK working towards or having gained approved clinician (AC) status, identifying barriers to implementation of the roles and enablers. Qualitative interview data were also gathered with psychiatrists, clinical psychologist and Mental Health Nurse ACs (three in each group).

There are a number of barriers and enablers of distributed leadership promoted by the MPAC role. Themes identified focused on enabling person-centred care, clinical leadership and culture change more broadly within mental health care. The AC role is supporting clinical leadership by a range of professionals, promoting patient choice by enabling access to clinicians with the appropriate skills to meet needs. Clinical leadership roles are promoting links between organisational priorities, teams and patient care, fostering distributed leadership in practice.

This project reflects the views of a limited number of practitioners within one organisation which limits generalisabilty.

Organisations need clear strategies linked to workforce development and implementation of the roles to capitalise on their potential to support clinical leadership and person-centred care.

This study provides initial qualitative data on potential benefits and challenges of implementing the role.