Service co‐creation in community‐based aged healthcare

Co-Design as Enabling Factor for Patient-Centred Healthcare: A Bibliometric Literature Review

Service design and in particular co-design are approaches able to align with the need of healthcare contexts of value-based and patient-centered processing through a participatory design of services. The purpose of this study is to identify the characteristics of co-design and its applicability to the reengineering of healthcare services, as well as to detect the peculiarities of the application of this approach in different geographical contexts. The methodology applied for the review, Systematic Literature Network Analysis (SLNA), combines qualitative and quantitative perspectives. In detail, the analysis applied the paper citation networks and the co-word network analysis to detect the main research trends over time and to identify the most relevant publications. The results of the analysis highlight the backbone of literature on the application of co-design in healthcare as well as the advantages and the critical factors of the approach. Three main literature streams emerged concerning the integration of the approach at meso and micro level, the implementation of co-design at mega and macro level, and the impacts on non-clinical related outcomes. Moreover, the findings underline differences in co-design in terms of impacts and success factors in developed countries and economies in transition or developing countries. The analysis shows the potentially added value of the application of a participatory approach to the design and redesign of healthcare services both at different levels of the healthcare organization and in the contexts of developed countries and economies in transition or developing countries. The evidence also highlights potentialities and critical success factors of the application of co-design in healthcare services redesign.

Consumers' and health providers' views and perceptions of partnering to improve health services design, delivery and evaluation: a co-produced qualitative evidence synthesis

BACKGROUND

Partnering with consumers in the planning, delivery and evaluation of health services is an essential component of person-centred care. There are many ways to partner with consumers to improve health services, including formal group partnerships (such as committees, boards or steering groups). However, consumers' and health providers' views and experiences of formal group partnerships remain unclear. In this qualitative evidence synthesis (QES), we focus specifically on formal group partnerships where health providers and consumers share decision-making about planning, delivering and/or evaluating health services. Formal group partnerships were selected because they are widely used throughout the world to improve person-centred care. For the purposes of this QES, the term 'consumer' refers to a person who is a patient, carer or community member who brings their perspective to health service partnerships. 'Health provider' refers to a person with a health policy, management, administrative or clinical role who participates in formal partnerships in an advisory or representative capacity. This QES was co-produced with a Stakeholder Panel of consumers and health providers. The QES was undertaken concurrently with a Cochrane intervention review entitled Effects of consumers and health providers working in partnership on health services planning, delivery and evaluation.

OBJECTIVES

1. To synthesise the views and experiences of consumers and health providers of formal partnership approaches that aimed to improve planning, delivery or evaluation of health services. 2. To identify best practice principles for formal partnership approaches in health services by understanding consumers' and health providers' views and experiences.

SEARCH METHODS

We searched MEDLINE, Embase, PsycINFO and CINAHL for studies published between January 2000 and October 2018. We also searched grey literature sources including websites of relevant research and policy organisations involved in promoting person-centred care.

SELECTION CRITERIA

We included qualitative studies that explored consumers' and health providers' perceptions and experiences of partnering in formal group formats to improve the planning, delivery or evaluation of health services.

DATA COLLECTION AND ANALYSIS

Following completion of abstract and full-text screening, we used purposive sampling to select a sample of eligible studies that covered a range of pre-defined criteria, including rich data, range of countries and country income level, settings, participants, and types of partnership activities. A Framework Synthesis approach was used to synthesise the findings of the sample. We appraised the quality of each study using the CASP (Critical Appraisal Skill Program) tool. We assessed our confidence in the findings using the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach. The Stakeholder Panel was involved in each stage of the review from development of the protocol to development of the best practice principles.

MAIN RESULTS

We found 182 studies that were eligible for inclusion. From this group, we selected 33 studies to include in the final synthesis. These studies came from a wide range of countries including 28 from high-income countries and five from low- or middle-income countries (LMICs). Each of the studies included the experiences and views of consumers and/or health providers of partnering in formal group formats. The results were divided into the following categories. Contextual factors influencing partnerships: government policy, policy implementation processes and funding, as well as the organisational context of the health service, could facilitate or impede partnering (moderate level of confidence). Consumer recruitment: consumer recruitment occurred in different ways and consumers managed the recruitment process in a minority of studies only (high level of confidence). Recruiting a range of consumers who were reflective of the clinic's demographic population was considered desirable, particularly by health providers (high level of confidence). Some health providers perceived that individual consumers' experiences were not generalisable to the broader population whereas consumers perceived it could be problematic to aim to represent a broad range of community views (high level of confidence). Partnership dynamics and processes: positive interpersonal dynamics between health providers and consumers facilitated partnerships (high level of confidence). However, formal meeting formats and lack of clarity about the consumer role could constrain consumers' involvement (high level of confidence). Health providers' professional status, technical knowledge and use of jargon were intimidating for some consumers (high level of confidence) and consumers could feel their experiential knowledge was not valued (moderate level of confidence). Consumers could also become frustrated when health providers dominated the meeting agenda (moderate level of confidence) and when they experienced token involvement, such as a lack of decision-making power (high level of confidence) Perceived impacts on partnership participants: partnering could affect health provider and consumer participants in both positive and negative ways (high level of confidence). Perceived impacts on health service planning, delivery and evaluation: partnering was perceived to improve the person-centredness of health service culture (high level of confidence), improve the built environment of the health service (high level of confidence), improve health service design and delivery e.g. facilitate 'out of hours' services or treatment closer to home (high level of confidence), enhance community ownership of health services, particularly in LMICs (moderate level of confidence), and improve consumer involvement in strategic decision-making, under certain conditions (moderate level of confidence). There was limited evidence suggesting partnering may improve health service evaluation (very low level of confidence). Best practice principles for formal partnering to promote person-centred care were developed from these findings. The principles were developed collaboratively with the Stakeholder Panel and included leadership and health service culture; diversity; equity; mutual respect; shared vision and regular communication; shared agendas and decision-making; influence and sustainability.

AUTHORS' CONCLUSIONS

Successful formal group partnerships with consumers require health providers to continually reflect and address power imbalances that may constrain consumers' participation. Such imbalances may be particularly acute in recruitment procedures, meeting structure and content and decision-making processes. Formal group partnerships were perceived to improve the physical environment of health services, the person-centredness of health service culture and health service design and delivery. Implementing the best practice principles may help to address power imbalances, strengthen formal partnering, improve the experiences of consumers and health providers and positively affect partnership outcomes.

Patient-centred e-health supports value cocreation and quality of medical care in Taiwan

BACKGROUND

Patient-centred e-health (PCEH) focusses on the interaction between patients and physicians. However, only a limited number of studies have focussed on the design of physician-patient value cocreation mechanisms in the PCEH context. Thus, we extend Grönroos' concept of value cocreation to understand how PCEH might improve the quality of care.

OBJECTIVES

This study proposes a theoretical framework to embody PCEH-supported value cocreation and presents some empirical validation. We expect that PCEH-supported value cocreation should comprise capabilities for patient empowerment, intention for information sharing, complementation for checking and verifying information, and interaction for shared understanding.

METHODS

This study surveyed a small group of patients that have used PCEH, 'My Health Bank' in Taiwan. The questionnaires were delivered to patients in hospitals (n = 167 questionnaires, 98% response rate).

RESULTS

Results indicate that certain PCEH-supported value cocreation mechanisms-capabilities for patient empowerment and interaction for shared understanding-affect the perceived quality of medical care.

LIMITATIONS

The survey only considered patient perceptions of value cocreation.

CONCLUSION

This study shows the patient perception of value cocreation in patient-centred e-Health. Further research needs to validate the framework for health professionals and in other e-Health record information sharing settings.

Empowering Patients to Co-Create a Sustainable Healthcare Value

Extensive literature suggests that a solution to the current problems of healthcare sustainability is the active involvement of patients in health management through the empowerment of their abilities. Latest marketing frameworks suggest that patients are important resources for co-creating health value together with operators. This research aims to analyze the effects of patient empowerment on patients’ value co-creation behaviors. An empirical survey was conducted on 250 patients with chronic diseases in Italy. The results, analyzed using the structural equation modeling, showed that their empowerment enhanced value co-creation behaviors. Patients apply their health competencies and resources in their co-creation of health service with operators. It is, therefore, important to empower patients in their transformation from passive to active stakeholders, working with providers for the most optimal health outcomes. This research provides practitioners with suggestions for patient involvement which utilizes their knowledge, capabilities and responsibility to improving healthcare services.

Co-creating services—conceptual clarification, forms and outcomes

Purpose

The purpose of this paper is to assess, clarify and consolidate the terminology around the co-creation of services, establish its forms and identify its outcomes, to resolve the conceptual pluralism in service co-creation literature.

Design/methodology/approach

A focused literature review screened the articles published in five major service research journals to determine relevant contributions on the concept of co-creation of services. Then, a thematic analysis identifies the forms, themes and outcomes of co-creating services in the set of 80 qualifying articles.

Findings

The study reduces conceptual pluralism by establishing different forms of co-creating services and developing an explicit definition of co-creation in services. The authors develop an integrative framework that recognizes involvement, engagement and participation as prerequisites for co-creation. Relating to the different phases of the service process, the specific co-creation forms of co-ideation, co-valuation, co-design, co-testing and co-launching are classified as regenerative co-creation, while the specific co-creation forms of co-production and co-consumption are recognized as operative co-creation. Both beneficial and counterproductive outcomes of co-creation are identified and arranged into a typology.

Research limitations/implications

The integrative framework illustrates that service providers and customers are involved, engaged and participate in co-creating services, which manifests in specific forms of co-creation; they attain beneficial and counterproductive outcomes (personal, social, hedonic, cognitive, economic and pragmatic); and are influenced by a contextual multi-actor network.

Practical implications

Co-creation in services is actionable; the typology of outcomes suggests service managers ways to motivate customers and employees to participate in co-creating services.

Originality/value

This paper defines and establishes the conceptual forms of co-creating services and the identified outcomes, and develops an integrative framework of co-creation in services.

The excellence of patient-centered healthcare

Purpose

Nowadays, international healthcare agendas are focused on patient centeredness. Policies are aimed at improving patient’s satisfaction by enhancing patient empowerment and value co-creation. However, a comprehensive model addressing the relationships between these constructs has not so far been developed. The purpose of this paper is to develop and test a model which explains the effects of patient empowerment and value co-creation on patients’ satisfaction with the quality of the services they experience.

Design/methodology/approach

The links between patient satisfaction, empowerment and value co-creation are theoretically outlined via an in-depth literature review. The resulting model is tested through a survey administered to 186 chronically ill patients. The results are analyzed through covariance-based structural equation modeling.

Findings

The results show that patient empowerment positively influences value co-creation which, in turn, is positively related to patient satisfaction. In addition, the analysis reveals that patient empowerment has no direct effects on satisfaction.

Research limitations/implications

Although the cross-sectional design made it possible to clearly estimate the relationships among variables, it overlooked the longitudinal dimensions of co-creation processes.

Practical implications

The study provides practitioners with suggestions to design patient-centered healthcare services by leveraging on patient knowledge, participation, responsibility in care and involvement in the value-creation process.

Originality/value

Over the last decade, healthcare management literature has shifted its focus from healthcare organizations to patients. The number of contributions about patient satisfaction, empowerment and value co-creation exponentially increased. However, these dimensions are often studied separately. This work advances available knowledge by clarifying and testing the relationships between these three constructs.

The experience of lived space in persons with dementia: a systematic meta-synthesis

BACKGROUND

Identifying how persons with dementia experience lived space is important for enabling supportive living environments and creating communities that compensate for the fading capabilities of these persons. Several single studies have explored this topic; however, few studies have attempted to explicitly review and synthesize this research literature. The aim of this systematic meta-synthesis was therefore to interpret and synthesize knowledge regarding persons with dementia's experience of space.

METHODS

A systematic, computerized search of AgeLine, CINAHL Complete, Embase, Medline and PsycINFO was conducted using a search strategy that combined MeSH terms and text words for different types of dementia with different descriptions of experience. Studies with 1) a sample of persons with dementia, 2) qualitative interviews as a research method and 3) a description of experiences of lived space were included. The search resulted in 1386 articles, of which 136 were identified as eligible and were read and assessed using the CASP criteria. The analysis was inspired by qualitative content analyses.

RESULTS

This interpretative qualitative meta-synthesis included 45 articles encompassing interviews with 672 persons with dementia. The analysis showed that living in one's own home and living in long-term care established different settings and posed diverse challenges for the experience of lived space in persons with dementia. The material revealed four main categories that described the experience of lived space: (1) belonging; (2) meaningfulness; (3) safety and security; and (4) autonomy. It showed how persons with dementia experienced a reduction in their lived space due to the progression of dementia. A comprehensive understanding of the categories led to the latent theme: "Living with dementia is like living in a space where the walls keep closing in".

CONCLUSION

This meta-synthesis reveals a process whereby lived space gradually becomes smaller for persons with dementia. This underscores the importance of being aware of the experiences of persons with dementia and the spatial dimensions of their life-world. To sustain person-centred care and support the preservation of continuity and identity, one must acknowledge not only the physical and social environment but also space as an existential experience for persons with dementia.

On the road to value co-creation in health care: the role of consumers in defining the destination, planning the journey and sharing the drive

The role of consumers is now extending beyond being passive health care recipients and even active participants in their own care to involvement in innovation and value co-creation in health care - from being "users and choosers" to becoming "makers and shapers" of services. For active dialogue to occur in co-creation, consumers must become equal partners with health care organisations and providers, with the focus on areas of interest to all parties. The use of value co-creation in health care involves embedding the approach across the whole health care system - from the microsystem level to the mesosystem and the entire macrosystem.

Value co-creation in healthcare through positive deviance

PURPOSE

To explore how converging fields of co-creation and positive deviance may increase value in healthcare.

METHODS

Informed by research in positive deviance, patient engagement, value co-creation, and quality improvement, we propose a positive deviance approach to co-creation of health.

RESULTS

Co-creation has shown to improve health outcomes with regard to multiple health conditions. Positive deviance has also shown to improve outcomes in multiple healthcare and patient community environments.

CONCLUSION

A positive deviance co-creation framework may aid in achieving improved outcomes for patients, care teams and their respective healthcare organizations.

Co-creating value through demand and supply integration in senior industry-observations on 33 senior enterprises in Taiwan

OBJECTIVE

With global population aging, great business opportunities are driven by the various needs that the elderly face in everyday living. Internet development makes information spread faster, also allows elderly and their caregivers to more easily access information and actively participate in value co-creation in the services. This study aims to investigate the designs of value co-creation by the supply and demand sides of the senior industry.

DESIGN

This study investigated senior industry in Taiwan and analyzed bussiness models of 33 selected successful senior enterprises in 2013. We adopted series field observation, reviews of documentations, analysis of meeting records and in-depth interviews with 65 CEOs and managers.

SETTING

Thirty-three quality enterprises in senior industry.

PARTICIPANTS

Sixty-five CEOs and managers in 33 senior enterprises.

INTERVENTIONS

None.

MAIN OUTCOME MEASURES

Value co-creation design, value co-creating process.

RESULTS

We constructed a conceptual model that comprehensively describes essential aspects of value co-creation and categorized the value co-creation designs into four types applying for different business models: (i) interaction in experience spaces co-creation design, (ii) on-site interacting co-creation design, (iii) social networking platform co-creation design and (iv) empowering customers co-creation design. Through value co-creation platform design, the senior enterprises have converted the originally passive roles of the elderly and caregivers into active participants in the value co-creation process.

CONCLUSIONS

The new paradigm of value co-creation designs not only promote innovative development during the interactive process, lead enterprises reveal and meet customers' needs but also increase markets and profits.

Quality and legal aspects in public care procurement

Purpose

– The purpose of this paper is to assess the applicability of care quality concepts as contract award criteria for public procurement of health and social care, using the case of Sweden.

Design/methodology/approach

– Based on a literature review, European and Swedish legal texts, government regulations as well as 26 Swedish court review cases concerning care procurement have been analysed.

Findings

– Methods used for assessing care quality are seldom useful for predicting the quality to be delivered by a potential contractor. Legal principles of transparency and equal treatment of tenderers make it necessary to apply strict requirements for verification.

Research limitations/implications

– Results refer primarily to a Swedish context but could be applicable throughout the EU. Further studies of relations between award criteria and public/private collaborative practices for improving care quality during contractual periods are desirable.

Practical implications

– Local and regional procurement officials should benefit from a better understanding of how quality criteria should be designed and applied to the award procedures for care contracts. Care providers in the private sector would also be able to develop their quality strategies and present their abilities more efficiently when tendering for public contracts.

Social implications

– Issues of quality of health and social care are of obvious importance for social sustainability. Public awareness of care quality problems is evident and often a cause of media concern.

Originality/value

– This investigation pinpoints the difference between traditional care quality thinking and the legal principles underlying contract award in public procurement of care services.

Examining the effects of patient characteristics and prior value needs on the patient-doctor encounter process in healthcare service delivery

Purpose

Considering the increasing conceptualization of value creation, this paper aims to empirically examine the influence of pre-encounter value needs of patients on the clinical encounter process and how this impacts on their perceived experiential value, and contributes to the patient’s role in value creation in healthcare service delivery.

Design/methodology/approach

A model is proposed to suggest the antecedent and consequences of key elements of the patient–doctor encounter process. Following survey design approach, data collected from 332 outpatients from two clinics in Accra, Ghana, are examined through structural equation modeling using AMOS 23.0.

Findings

The findings reveal that patient pre-encounter value needs significantly influence key elements of the patient–doctor encounter process (care delivery approach, level of trust and shared-decision making approach). This in turn affects patient’s perceived experiential value and satisfaction evaluation. The results also suggest that patient characteristics (e.g. educational background and frequency of visit) had no significant effect on the encounter process leading to perceived experiential value; however, patient’s age had significant influence on the encounter process.

Research limitations/implications

This study empirically establishes a need to understand patient’s pre-encounter value needs, which fundamentally influence the patient-doctor encounter process and their perceived experiential value. However, the research only focused on the patient, which could limit the findings considering the multi-actors involved in the service delivery.

Practical implications

Creating value with patients suggests a need for providers to understand patient value needs or goals and adopt an approach to engage in a holistic manner that would result in positive experiences. This would empower and increase confidence of patients in consultations.

Originality/value

Using a quantitative research approach, this research engages in a highly focused investigation of the influence of patient’s pre-encounter value needs on key elements of the patient–doctor encounter process, which has received limited attention in the extant literature. The study also furthers our understanding of the effects of fundamental patient characteristics on encounter process and how this influence actor perceived experiential value.

EXQ: measurement of healthcare experience quality in Malaysian settings

Purpose

The customer experience quality (EXQ) cannot be measured by using traditional tools to investigate service quality. There is a need to use new tools to directly measure EXQ from a customer perspective. The current study aims to contribute in this domain of knowledge and validate EXQ scale by linking it to marketing outcomes of satisfaction, loyalty and word of mouth in Malaysian private healthcare settings.

Design/methodology/approach

The authors collected data from 330 randomly selected Malaysians, visiting private hospitals in the city of Kuala Lumpur. The data analysis is performed by confirmatory factor analysis using structural equation modelling – SEM – procedures.

Findings

The results reveal that two dimensions of EXQ scale moments of truth and peace of mind are highly valued by customers. Furthermore, the EXQ perceptions significantly contribute to satisfaction and loyalty. In a mediating relationship, the customer satisfaction is found to be a positive and significant variable.

Practical implications

Healthcare marketing policymakers should emphasize on recruitment of frontline staff – individuals with strong interpersonal skills and expertise who are able to create a memorable customer service experience.

Originality/value

The study is an original contribution to the existing body of knowledge – generally in services marketing literature and specifically in the field of healthcare marketing with a focus on customer experience in a developing country context of Malaysia.

Toward the Development of a More Integrated Aged Care Assessment Process for Rural Older Australians: Practitioners' Perspectives

There is an identified need for more effective assessment processes in rural Australia, with prior research revealing little knowledge sharing and even duplication across existing services. This article aims to explore the challenges to more closely integrated assessment processes, drawing on interview data with practitioners from three agencies located in the same rural region. Findings highlight the challenges of rural assessment, both demand-driven (more older people with complex needs, geographic isolation) and supply issues (time and distance, funding formulae, workforce shortages). The need for closer collaboration is recognized but significant systemic issues require addressing if it is to be achieved.

Patient value co-creation in online health communities

Purpose

– Patient value co-creation represents a key research priority and an essential determinant of health care service outcomes. Yet few studies empirically examine the factors that motivate patients to participate actively in value co-creation. The purpose of this paper is to seek to identify the motivators of such activities in online health communities (OHC) and examine their specific and unique effects.

Design/methodology/approach

– A netnographic study helps identify the motivators that drive patients’ value co-creation activities in OHCs. The combination of these results with social identity theories suggest the hypotheses; mediation analyses test the hypothesized model with data collected from eight OHCs that address both life-threatening and non-life-threatening illnesses.

Findings

– The netnographic results show that social identity drives patients’ value co-creation activities. Interactions among OHC members and the cognitive resources of the OHC both contribute to the development of its social identity. Furthermore, benevolence trust, shared vision, and shared language determine how likely an OHC member is to identify with a particular OHC, which further influences his or her value co-creation activities in that OHC.

Originality/value

– Although value co-creation is critical to the health care sector, few studies examine antecedents of patient value co-creation empirically. This study represents an initial attempt to do so by combining innovative netnographic analyses with mediation analyses.

Service-based vs. goods-based positioning of the product concept

Purpose

– To counteract increasing competition and satisfy evolving customers’ needs, many firms are changing the positioning of their product concepts, from being product-based into service-based. Despite the increasing relevance of this shift, it is still unclear if this choice has a differential impact on customer perceived value. The purpose of this paper is to analyze customer perceived value for a firm’s product concept being positioned either as service-based or goods-based.

Design/methodology/approach

– An experiment was conducted using stimuli for two different product categories (hearing aids and bicycles) and measuring customers perceived value through the PERVAL scale’s four dimensions (quality value, emotional value, price value and social value).

Findings

– The results show that presenting the product concepts as service-based instead of good-based can enhance customer perceived value (in particular: quality, emotional and social value), but only if customers are not familiar with the product.

Research limitations/implications

– The study is based on one experiment and considers only two product categories. Further studies are needed to corroborate findings.

Practical implications

– The findings suggest that, under specific circumstances, the firm may improve customers’ attitude toward the product by emphasizing a service-based instead of a good-based positioning of the product concept.

Originality/value

– To our knowledge, this is the first research to evaluate the effects on customer perceived value of repositioning a product which has been traditionally goods-based (such a hearing aid and a bicycle) into service-based.

Translational models of workplace violence in health care

Decision makers have little time to study literature on the prevention and management of workplace violence (WPV). In a health care workplace setting, identifying the person, stimulus, and environmental interactions that can lead to violence is a complicated process. Those in positions of leadership make decisions that affect many individuals, agencies, and communities. Often, they come from different professional backgrounds yet need ways of rapidly understanding concepts of violence that transcend their profession, training, or experience. Translational models (TMs) in WPV visually summarize and interprofessionally facilitate this understanding of concepts, enhancing the chances of more effective collaborative solutions to WPV. The purpose of this article is to demonstrate how TM can be used in interprofessional settings to find effective solutions to reduce WPV.

Factors that influence intent to adopt a hearing aid among older people in Italy

Hearing loss is one of the most prevalent health impairments associated with ageing in developed countries, and it can result in social, emotional and communication dysfunction. Hearing loss in Italy is increasing, yet, despite the availability of free hearing aids and access to qualified community-based health professionals specialising in audiology services, their uptake remains low (about 15%-20%). This paper presents an investigation of the possible reasons why older people in Italy resist adopting a hearing aid. We used the literature to identify factors influencing people with hearing loss's decision-making, and drew on the theory of reasoned action to create an explanatory model. To test our hypotheses, we applied a cross-sectional design. We developed a questionnaire including 13 items related to adopting a hearing aid. Health professionals identified 400 persons aged 60-90 who were candidates for a free hearing aid. Those willing to participate were sent a copy of the questionnaire and telephoned between August and September 2009; a total of 243 responded (response rate of 60.8%). Linear regression analysis highlighted that a person's intention to adopt a hearing aid was positively related to their attitude towards its adoption, but negatively linked to their perceived subjective norms. It was found that trust in the health professional does not moderate the relationship between a person's attitude and their intention to adopt a hearing aid, but trust mitigates the relationship between a person's perceived subjective norms and their intentions. These findings underline the importance of the potential role that the healthcare professional could play in reducing the uncertainty created by external social pressures. For this purpose, stronger collaboration between the various health professionals involved in hearing aid provision, from diagnosis to fitting, is recommended.

A five-senses perspective to quality in hospitals

Purpose

– The purpose of this paper is to report on research on the sensory perceptions that patients and bystanders experience during hospitalisation. Sight, hearing, smell, taste and touch influence both clinical outcomes and satisfaction. The paper offers suggestions to hospital management on ways to improve receivers’ sensory perceptions.

Design/methodology/approach

– Considering services as social interactions, a subjectivist view of reality is adopted and, accordingly, a qualitative research approach implemented. Data are collected through participant observation. Desk activity includes reasoned literature review, categorisation and model adaptation.

Findings

– A simplified system model for service provision in the hospital ward is proposed. A management tool is provided in the form of a check list that the ward management can employ to assess its service-provision system from a five-senses perspective.

Research limitations/implications

– The paper is affected by judgements subject to cultural biases. The validity of the management tool is still to be tested.

Practical implications

– Once up and running, the model and the check list will be able to guide health managers towards improvements of satisfaction, clinical outcomes and working environment.

Originality/value

– The paper represents an original effort to adapt tools already used in the commercial field to influence health service receivers’ perceptions positively. While the positive results of improvements to a single sensory perception have been well documented, an integrated approach has not been put forward previously in the health industry.

Including customers in health service design

This article will explore the concept and meaning of codesign as it applies to the delivery of health services. The results of a pilot study in health codesign will be used as a research based case discussion, thus providing a platform to suggest future research that could lead to building more robust knowledge of how the consumers of health services may be more effectively involved in the process of developing and delivering the type of services that are in line with expectations of the various stakeholder groups.