Hannah Snyder

The Antecedents, Forms and Consequences of Patient Involvement : A Narrative Review of the literature

OBJECTIVES Despite the centrality of patient involvement in the policy and rhetoric of health care, the theoretical and empirical basis for patient involvement is lacking at the micro-level of practice. The purpose of this narrative review is to provide an overview and synthesize the current empirical research related to patient involvement at the micro-level of health care. DESIGN Narrative review. DATA SOURCES A database search was conducted (in PubMed, CINAHL, Academic Search Premier, EconLit and PsycINFO) for articles published between 1990 and April 2015 in the field of patient involvement in health care. Out of 4238 references, 214 articles were eligible for this review. REVIEW METHODS We analyzed our sample using thematic analysis. RESULTS The reviewed articles revealed nine themes for patient involvement, concerning enablers; empowerment, patient education, communication for involvement, staff training, service systems, types; decision making, delivery, development, and consequences of patient involvement. The themes were synthesized into a tentative model that described patient-involvement research. CONCLUSIONS Our narrative review includes a wide variety of empirical studies on patient involvement in decision-making, delivery and development, and provides an integrative perspective suggesting that patient involvement should be viewed not only as isolated activities, but also as a result of educating and preparing patients, staff and systems.

The changing role of the health care customer: review, synthesis and research agenda

Purpose 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. Design/methodology/approach 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. Findings 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. Originality/value 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 role of customers in the development of public organizations

In this chapter we focus on the role of customers in the development of public organizations. We aim to illustrate how customer involvement can be used not only to learn about customer needs, but also to create a tension for change. Following Van de Ven (1986), we view tension for change as dissatisfaction with current conditions that trigger change. Success for public organizations is dependent on their ability to satisfy the needs of their stakeholders (Bryson, 2004). As a consequence, key stakeholders are increasingly being considered an important resource in public sector reforms and change initiatives (Bingham et al., 2005; Tritter and McCallum, 2006). The customer – who receives private value at an agency’s business end – is conceived of as a stakeholder of vital importance for renewal and change (Osborne et al., 2014). The image of the citizen or customer as someone who is passive and submissive is gradually being replaced by someone who is active and engaged (Nordgren, 2008).