Crafting and stimulating service innovation is considered a main research priority and remains a challenge for service providers. One suggested component of stimulating service innovation is customer creativity. Customers who adapt, modify and transform services or products to better suit themselves are increasingly being recognized as a source of competitive value and innovation. It has been proposed that understanding and supporting the customer's value creating practices is the key to creating and sustaining value over time in health care. Health services directly address a customer's well-being and have a significant impact on his or her quality of life. In these types of services, the service outcome is highly dependent on the activities of the individual customer. Health care services often require customers to participate extensively, over long periods of time, with limited support and control. Health services also stretch far beyond the particular service setting into the customer's daily life. While research, policy, and legislation have all emphasized the active role of health care customers, such customers have traditionally had few opportunities to design their health care services. Nevertheless, health care customers solve health-related problems and engage in self-care and medical decision-making on a day-to-day basis, although this creativity is often unknown to the service provider. To understand how health care customers can enable service innovation, this thesis seeks to conceptualize and investigate the concept of customer creativity in health care. The thesis focuses on customer creativity, not only as an outcome, but also as a dynamic and contextualized process that can be enhanced. The thesis combines insights from health care research with service and innovation research to provide build a framework for health care customer creativity. Building on five papers, the research develops an understanding for health care customer creativity. The individual papers are based on systematic literature reviews as well as empirical data in the form of customers' ideas for service innovation collected through diaries. The results of the thesis suggest that despite the negative nature of the service, health care customers are creative. Given the opportunity, health care customers can provide creative ideas and solutions on a multitude of aspects, both within and outside the health care setting. This provides the potential to view the health care experience through the customers' eyes and take part in their creativity in spheres where the service providers have not traditionally had any access. This thesis contributes to the literature by providing a framework for health care customer creativity that recognizes the concept as a complex interplay of factors operating at the individual, contextual, and situational levels. The proposed framework specifies the health care specific factors upon which customer creativity depends, with the intention of positing potential research directions and developing an enriched theory of health care customer creativity.
For a long time, patients were seen as weak and passive recipients of care, whose only role was to provide information and comply with doctors' orders. This is beginning to change, and patients are more seen as autonomous, active, and involved collaborators in care, co-creating value with service providers and others. In parallel, the healthcare sector is changing due to an aging population, advances in technology, medical knowhow, and the prevalence of chronic diseases, which all call for a more involved patient. During the last decade, patient involvement in healthcare has been recognized as important to provide more efficient, integrated, patient-focused healthcare. Despite this recent gain in attention, there is a gap between rhetoric's and practice, since the meaning and benefits of patient involvement are unclear both in theory and practice. This thesis takes an alternate perspective on patient involvement, departing from service theory on value creation and customer involvement. It aims to understand and explore patient involvement and how patients can be involved in both the use, and development, of healthcare services. This thesis is based on three different studies using both qualitative and quantitative research methods. The first study is a systematic literature review of healthcare research, addressing the topic of patient involvement and related concepts. Based on a total of 125 reviewed empirical articles, this study serves as an introduction and orientation to the diverse field. It aims to contribute to the knowledge base in the growing research field of patient involvement. The second study addresses and explores lead-user theory as a method to identify highly innovative patients who can be suitable for involvement in healthcare development. The third study explores how patients, depending on disease, care process and context, can take different roles in healthcare development. The results indicate that patient involvement is not an isolated activity but influences the whole healthcare system. This extends the view of patient involvement from just decision-making and isolated encounters to patients potentially being substantially involved in all aspects of healthcare. This is also important in involvement in use. The patient's individual experiences, context, and type of illness play an important role in development initiatives. Patients should be selected carefully, for involvement in healthcare development, depending on the goal of the initiative. The type of illness and the patient's context are key factors to the kind of contributions patients can make. Depending on the type of illness, and if it shows up mostly at home or at the care provider's, patients develop different contributions. This thesis contributes to understanding patient involvement by taking a service perspective on co-creation and customer involvement. This approach to patient involvement extends the traditional view by proposing that patients should be involved in all stages of healthcare. Understanding how individuals create value and manage their health is important for individuals, healthcare providers, and government. Much of a patient's value creation takes place outside the patientprovider sphere, and is therefore unknown to the healthcare provider. By actively involving patients in both use and development, healthcare providers can apply a whole-person perceptive. ; Förutsättningarna för vården har förändrats under de senaste decennierna. Anledningar till dessa förändringar utgörs av bland annat en åldrande befolkning, teknisk och medicinsk utveckling och en ökad förekomst av kroniska sjukdomar. Traditionellt har patienter setts som passiva mottagare av vård, vars roll endast varit att svara på frågor samt följa läkarens ordination av behandling. På senare tid har detta dock börjat förändras. Patienter börjar att i högre grad ses som självständiga, engagerade och deltagande i vården. Enligt detta nya betraktningssätt kan patienter bidra aktivt till värdeskapande, tillsammans med vårdpersonal och andra resurser. Under det senaste decenniet har patientinvolvering setts som en allt viktigare del för att kunna leverera en mer effektiv, integrerad och patientfokuserad vård. Trots detta ökande intresse, finns det en skillnad mellan retorik och praktik. Patientinvolvering och fördelarna med patientinvolvering är oklara både i teori och praktik – bland forskare, sjukvårdspersonal och patienter. Denna licentiatsavhandling utgår från ett tjänsteperspektiv på patientinvolvering och syftar till att förstå och undersöka hur patienter kan vara involverade i användandet och utvecklingen av vården. Avhandlingen bygger på tre olika studier med både kvalitativa och kvantitativa forskningsmetoder. Resultaten av studierna tyder på att patientinvolvering inte är en isolerad process utan istället kan ses som något som påverkar alla delar av sjukvården. Detta utökar synen på vad patientinvolvering kan vara. Istället för att se patientinvolvering som kopplat till att patienten ger information och är involverad i beslutsfattande, kan patienten vara involverad i alla aspekter av sjukvården, både i själva utförandet och utvecklingen. Men det är också viktigt att patientens individuella erfarenheter och preferenser, sammanhang och sjukdomsbild spelar en stor roll för hur mycket och vilken typ av involvering som är lämplig. Vid patientinvolvering i utvecklingen av vården, bör patienter väljas noggrant beroende på mål med utvecklingen och vilken typ av involvering det rör sig om. Även sammanhang och typ av sjukdom är viktiga faktorer för vilken typ av bidrag som kan förväntas av patienter. Beroende på typ av sjukdom och kontext, kan patienter förväntas bidra på olika sätt. Denna avhandling bidrar till en ökad förståelse för patienters involvering i vården genom att ta utgångspunkt ur ett tjänsteperspektiv men fokus på värdeskapande och patienters engagemang. Detta förhållningsätt till patientinvolvering utökar den traditionella synen på involvering genom att föreslå att patienter ska vara involverade i alla steg och aktiviteter i vården. Mycket av patientens värdeskapande sker utanför vården, i den privata sfären, och är därför dolt för vårdgivaren. Att förstå hur patienter skapar värde och sköter sin hälsa är grundläggande för att kunna förbättra vården och stödja patientens egna ansträngningar. Genom att aktivt involvera patienter både i den egna vården men även i utvecklingen av vården i stort är det möjligt att gemensamt skapa en bättre vård.
Service innovations challenge existing offerings and business models, shape existing markets, and create new ones. Over the last decade, service research has shown increasing interest in the concept of innovation and should by now have reached maturity and created a strong theoretical basis. However, there is no coherent theoretical framework that captures all the facets of service innovation, and to move service innovation research forward, we must revisit the key assumptions of what an innovation is. To enable this, the present article addresses three fundamental questions about service innovation: (1) What is it and what is it not? (2) What do we know and what do we not know? and (3) What do we need to know to advance service research? By doing so, this article offers an updated and comprehensive definition of service innovation and provides a research agenda to suggest a path forward.
Poor cognitive control has been associated with maladaptive thinking, like rumination and worry, that increase risk for internalizing psychopathology. However, little research has investigated how cognitive control is associated with commonalities between rumination and worry (i.e., repetitive negative thinking; RNT). The current study aimed to investigate how cognitive control predicts engagement in a common component of RNT over time via an indirect mechanism of dependent stress generation in a one-semester longitudinal study of emerging adult college students ( N = 224). Executive functioning task performance and self-reported attentional control (not working memory capacity task performance) prospectively predicted RNT, mediated by dependent stress, but did not predict change in stress or RNT from baseline. These findings suggest that aspects of cognitive control relevant for successful goal pursuit may be involved with maintaining levels of stressful life events and subsequent RNT.
AbstractPublicly funded national science agencies create value as innovation catalysts and through their scientific and research missions, they tackle wicked problems. Understanding how dynamic capabilities and business model innovation enable research‐intensive organisations to seize the market in the mission is key to translating bold new science that has impact. We qualitatively explore how Australia's national science agency—the Commonwealth Scientific Industrial Research Organisation (CSIRO)—has pursued open innovation to support business model–dynamic capabilities in an evolving publicly funded landscape. We reflect on the value of open innovation initiatives that have allowed the CSIRO to ambidextrously pursue world‐class science while achieving impact.Points for practitionersDynamic capabilities and business model innovation are strategic tools for publicly funded national science agencies seeking to seize the market in the mission.We examine a case of business model–dynamic capabilities in CSIRO.Open innovation has been important for CSIRO as part of an ambidextrous approach.
In India, men who have sex with men (MSM) and truck drivers are high-risk groups that often do not access HIV testing due to stigma and high mobility. This study evaluated a field testing package (FTP) that identified HIV positive participants through video pre-test counseling, OraQuick oral fluid HIV testing, and telephonic post-test counseling and then connected them to government facilities. 598 MSM and truck drivers participated in the FTP and completed surveys covering sociodemographics, HIV testing history, risk behaviors, and opinions on the FTP. Those who had previously been tested preferred traditional methods to video counseling. MSM and truck drivers equally preferred video counseling, although MSM who had been previously tested preferred traditional methods. Nearly all participants preferred oral testing. Rates of counseling completion and linkage to government centers were low, with one third of newly identified positives completing follow-up. With increased public-private coordination, this FTP could identify many hard-to-reach preliminary positive individuals and connect them to government testing and care.
