Changing the Rules of the Game in Healthcare Through Service Design

Vink, Josina; Joly, Maíra Prestes; Wetter-Edman, Katarina; Tronvoll, Bård; Edvardsson, Bo

doi:10.1007/978-3-030-00749-2_2

Cited by 12 publications

(11 citation statements)

References 72 publications

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“…Traditional institutional logic perspectives often engage a top-down analytic approach with less attention paid to the routine experiences of professionals and how innovations are negotiated, mediated and transformed through everyday frontline practices (Hampel et al , 2017; Lawrence et al, 2011; Suddaby and Viale, 2011; Zilber, 2013). Institutional work perspectives may provide insights into the work of frontline hospital staff engaged in pilot projects as they transform practice and the institutional arrangements they are embedded in (Checkland et al , 2018a; Vink et al , 2019). Study findings highlight early implementation challenges when introducing integrated care innovations in a hospital setting and provide insights into the intense institutional work required of frontline staff in efforts to transform models of care.…”

Section: Discussionmentioning

confidence: 99%

“…From an institutional work perspective, integrated care pilot projects may be seen as “proto-institutions”, that is, practices, rules or technologies that are neither well-established nor widely disseminated (Lawrence et al , 2002). Pilot projects may create a space in hospital settings where routine processes can be temporarily disrupted (Vink et al , 2019). In their review of the health services redesign literature, Vink et al (2019) relatedly observe that project work is important through helping to visualize key aspects of healthcare and the “rules of the game” that are often invisible and taken for granted in everyday practice.…”

Section: Discussionmentioning

confidence: 99%

“…Pilot projects may create a space in hospital settings where routine processes can be temporarily disrupted (Vink et al , 2019). In their review of the health services redesign literature, Vink et al (2019) relatedly observe that project work is important through helping to visualize key aspects of healthcare and the “rules of the game” that are often invisible and taken for granted in everyday practice. In fact, pilot projects and quality improvement interventions are often a preferred approach for introducing and trying out new service innovations in hospital settings (Bhatia et al , 2019; Bartram et al , 2020; Jespersen, 2013).…”

Section: Discussionmentioning

confidence: 99%

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Implementing integrated care pilot projects in hospital settings – an exploration of disruptive practices

Mansfield

Sandercock

Dowedoff

et al. 2020

JICA

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PurposeIn Canada, integrated care pilot projects are often implemented as a local reform strategy to improve the quality of patient care and system efficiencies. In the qualitative study reported here, the authors explored the experiences of healthcare professionals when first implementing integrated care pilot projects, bringing together physical and mental health services, in a community hospital setting.Design/methodology/approachEngaging a qualitative descriptive study design, semi-structured interviews were conducted with 24 healthcare professionals who discussed their experiences with implementing three integrated care pilot projects one year following project launch. The thematic analysis captured early implementation issues and was informed by an institutional logics framework.FindingsThree themes highlight disruptions to established logics reported by healthcare professionals during the early implementation phase: (1) integrated care practices increased workload and impacted clinical workflows; (2) integrating mental and physical health services altered patient and healthcare provider relationships; and (3) the introduction of integrated care practices disrupted healthcare team relations.Originality/valueStudy findings highlight the importance of considering existing logics in healthcare settings when planning integrated care initiatives. While integrated care pilot projects can contribute to organizational, team and individual practice changes, the priorities of healthcare stakeholders, relational work required and limited project resources can create significant implementation barriers.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Implementing integrated care pilot projects in hospital settings – an exploration of disruptive practices

Mansfield

Sandercock

Dowedoff

et al. 2020

JICA

View full text Add to dashboard Cite

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“…These practices – learned actions and interactions with specific affect patterns manifested in context – are identified as a core foundation of the macro-level changes enabled by the service design approach (Karpen et al ., 2017) and have been associated with the process of institutional work (Wetter-Edman et al ., 2018). The experiential, reflective and participatory nature of service design practices aid actors in creating the conditions for changes in institutional arrangements (Vink et al ., 2019).…”

Section: A Micro-level Perspective On Innovation In Service Ecosystemsmentioning

confidence: 99%

Reshaping mental models – enabling innovation through service design

Vink

Edvardsson

Wetter-Edman

et al. 2019

JOSM

Self Cite

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Purpose The purpose of this paper is to analyze how service design practices reshape mental models to enable innovation. Mental models are actors’ assumptions and beliefs that guide their behavior and interpretation of their environment. Design/methodology/approach This paper offers a conceptual framework for innovation in service ecosystems through service design that connects the macro view of innovation as changing institutional arrangements with the micro view of innovation as reshaping actors’ mental models. Furthermore, through an 18-month ethnographic study of service design practices in the context of healthcare, how service design practices reshape mental models to enable innovation is investigated. Findings This research highlights that service design reshapes mental models through the practices of sensing surprise, perceiving multiples and embodying alternatives. This paper delineates the enabling conditions for these practices to occur, such as coaching, diverse participation and supportive physical materials. Research limitations/implications This study brings forward the underappreciated role of actors’ mental models in innovation. It highlights that innovation in service ecosystems is not simply about actors making changes to their external context but also actors shifting their own assumptions and beliefs. Practical implications This paper offers insights for service managers and service designers interested in supporting innovation on how to catalyze shifts in actors’ mental models by creating the conditions for specific service design practices. Originality/value This paper is the first to shed light on the central role of actors’ mental models in innovation and identify the service design practices that reshape mental models.

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“…Healthcare is a continuously changing environment designed to tackle challenges associated with competitive advantage (Clack & Ellison, 2019), an aging population and internal and external pressures to change (Fry, 2019)-challenges which are pushing healthcare towards more innovative solutions. However, changes and innovations in healthcare are often complex and difficult to implement due to organisational resistance to change (Vink, Joly, Wetter-Edman, Tronvoll, & Edvardsson, 2019;Wang, Lee, & Maciejewski, 2015), along with a lack of focused and secure management (Fry, 2019;Nilsen, Dugstad, Eide, Gullslett, & Eide, 2016). In this context, innovative service design can be crucial for innovation, and it can help organisations obtain competitive advantages (Clack & Ellison, 2019), improve learning and undergo transformation (Kuure, Miettinen, & Alhonsuo, 2014).…”

Section: Introductionmentioning

confidence: 99%