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This article aims to examine how users' involvement in value co-creation influences the development and orchestration of well-being ecosystems to help tackle complex societal challenges. This research contributes to the public management literature and answers recent calls to investigate novel public service governances by discussing users' involvement and value co-creation for novel well-being solutions.

The authors empirically explore this phenomenon through a case study of a complex ecosystem addressing increased well-being, focussing on the formative evaluation stage of a longitudinal evaluation of Sweden's first support centre for people affected by cancer. Following an abductive reasoning and action research approach, the authors critically discuss the potential of user involvement for the development of well-being ecosystems and outline preconditions for the success of such approaches.

The empirical results indicate that resource reconfiguration of multi-actor collaborations provides a platform for value co-creation, innovative health services and availability of resources. Common themes include the need for multi-actor collaborations to reconfigure heterogeneous resources; actors' adaptive change capabilities; the role of governance mechanisms to align the diverse well-being ecosystem components, and the engagement of essential actors.

Although using a longitudinal case study approach has revealed stimulating insights, additional data collection, multiple cases and quantitative studies are prompted. Also, the authors focus on one country but the characteristics of users' involvement for value co-creation in innovative well-being ecosystems might vary between countries.

The findings of this study demonstrate the value of cancer-affected individuals, with “lived experiences”, acting as sources for social innovation, and drivers of well-being ecosystem development. The findings also suggest that participating actors in the ecosystem should utilise wider knowledge and experience to tackle complex societal challenges associated with well-being.

Policymakers should encourage the formation of well-being ecosystems with diverse actors and resources that can help patients navigate health challenges. The findings especially show the potential of starting from the user's needs and life situation when the ambition is to integrate and innovate in fragmented systems.

The proposed model proposes that having a user-led focus on innovating new solutions can play an important role in the development of well-being ecosystems.

The purpose of this paper is to empirically explore and demonstrate the ability of healthcare professionals to attain professional fulfilment when providing healthcare inspired by “value shops”.

A qualitative case study incorporating interviews and observations was conducted.

The empirical data suggest that the professional fulfilment of both physicians and nurses is facilitated when care is organized through “value shops”. Both groups of professionals state that they are able to return to their “professional core”.

The beneficial outcomes of organizing healthcare inspired by the “value shop” have previously been explored in terms of efficiency and quality. However, the professional fulfilment of healthcare professionals when providing such care has not been explicitly addressed. Professional fulfilment is vital in order to safeguard high-quality care, as well as healthcare professionals' involvement and engagement in implementing quality improvements. This paper highlights the fact that care provision inspired by the “value shop” may facilitate professional fulfilment, which further strengthens the potential positive outcomes of the “value shop” when utilized in a healthcare setting.

The concept of value is becoming increasingly fashionable in healthcare and various improvement approaches (IAs) have been introduced with the aim of increasing value. The purpose of this paper is to construct a taxonomy that supports the management of parallel IAs in healthcare.

Based on previous research, this paper proposes a taxonomy that includes the dimensions of view on value and organizational focus; three contemporary IAs – lean, value-based healthcare, and patient-centered care – are related to the taxonomy. An illustrative qualitative case study in the context of psychiatric (psychosis) care is then presented that contains data from 23 interviews and focuses on the value concept, IAs, and the proposed taxonomy.

Respondents recognized the dimensions of the proposed taxonomy and indicated its usefulness as support for choosing and combining different IAs into a coherent management model, and for facilitating dialog about IAs. The findings also suggested that the view of value as “health outcomes” is widespread, but healthcare professionals are less likely than managers to also view value as a process.

The conceptual contribution of this paper is to delineate some important characteristics of IAs in relation to the emerging “value era”. It also highlights the coexistence of different IAs in healthcare management practice. A taxonomy is proposed that can help managers choose, adapt, and combine IAs in local management models.

The purpose of this paper is to study critical practices when adopting improvement knowledge as a management innovation in a professional organization.

This paper is based on an action research approach, in which practitioners and researchers are seen as a part of a participative community generating actionable knowledge. Research involved gathering data over a five-year period through more than 250 interviews and 25 focus groups.

This paper identifies five critical practices for adopting a management innovation in a professional context: first, focussing on labeling and theorizing to create an organization’s own vocabulary; second, focussing on the role of internal change agents; third, allowing for an evolutionary adoption process; fourth, building new professional competence through the change agents; and fifth, adopting a research-driven approach to the adoption of a management innovation.

For healthcare practitioners, this paper points to practices to consider when adopting improvement knowledge – for example, identifying the patient as the guiding principle and encouraging involvement and local change initiatives. For practitioners in other professionally driven organizations, this paper identifies critical practices for adopting a management innovation – for example, focussing on theorizing and labeling in order to create an organization’s own vocabulary related to the professional context.

On a generic level, this paper contributes to the understanding of critical aspects when adopting management innovations in a professional organization. In a healthcare context, this paper points to the value of improvement knowledge for improving quality of care. Improvement knowledge is relatively new in healthcare, and this study provides an example of a hospital in which this management innovation helped transform the organization.

The purpose of this study is to investigate what happens within an organization when a process view of the business is adopted. With the example of an empirical case, we aim to illustrate: how members of the organization make sense of process management; what contributions members of the organization consider to be the result of adopting a process view; and the relationship between the functional and the process structure. The empirical base in this study is one of Sweden’s largest purchasing organizations within the public sector. The results are drawn from interviews with the process owners and a survey to all members involved in process teams. The case findings reveal an ambiguous image of process management. At the same time as process management solved specific organizational problems, it generated new dilemmas. It is argued that it is more rewarding to consider the adoption of the process view a “social negotiation” rather than the result of planned implementation. The study also highlights that the meaning of process management is not anything given but something being created, and its negotiation and translation into organizational practice is open‐ended. Furthermore, the study givs an illustration of the conflict between the adopted process view and the existing functional organization.

This chapter presents a framework for an action research based intervention to develop and transform sustainable healthcare in a regional context. The framework is illustrated by the case of the Regional Cancer Centre (RCC) West in western Sweden.

The framework draws upon and develops Pettigrew’s context–content–process model of strategic change and applies it to the unfolding narrative of the change effort. The empirical focus is the activities of a learning platform consisting of the RCC leadership, senior cancer physicians designated as process owners and an action research team. Data were collected from documents, observations of the learning platform, notes from meetings and interviews. Outcome data were obtained via the self-reporting of the physicians.

The learning platform established the capability for wide ranging development and quality improvement on the 23 cancer pathways as well as some support activities around principles of patient-centred care. A clear result is greater inter-organisational collaboration between care professionals as well as the introduction of new medicines, clinical methods, joint learning activities and new forms of measurement and monitoring of care practices. All of the improved measures are sustained.

Whilst there is no shortage of rhetoric on patient-centred care, the reality is that in complex healthcare systems solutions such as process-oriented approaches often fail. This case presents a model and an approach that eschews clear visions for change and instead places an emphasis on dialogue, participation, professional autonomy and collaborative communities as means for achieving the patient-centred ideal. The case also shows the value of seeing sustainable health systems as being grounded on practitioner–scholar collaboration that combines practical knowing with scientific knowledge.

This article explores the symbolic aspects of change agency on a learning platform designed to facilitate system-wide transformation in cancer care. A sensemaking–sensegiving perspective is adopted to analyze the construction of meaning in interaction between the leader of a regional cancer center, senior physicians, and an action research team in relation to patient-centered care. The analysis suggests that the physicians, as change agents, made sense of the vision from three quite distinct discourses in relation to the development effort. We argue that although meanings reconstructed in development initiatives may well be far from shared, this by no means implies that they are dysfunctional.

Purpose – This chapter examines the developmental journey toward a sustainable health care system in the West of Skaraborg County in Sweden from 2008 to the present by proposing and illustrating the concept of a clinical microsystem to capture the work of a mobile team to care for elderly people with multiple diseases in its embedded context.

Design – An action research approach was adopted that entailed four researchers, one of whom was also a health care practitioner, engaging in iterative dialogues with the mobile team. This aimed at catalyzing joint learning in repeated action-reflection cycles at least three times a year over a period of 3 years. Data from patient databases were also drawn upon as additional resources for reflection.

Findings – The outcome of the initial periods of the team's work in the microsystem dramatically improved the care of these patients, significantly increasing quality of life and stabilizing their medical situation. It has also led to decreased resource utilization, not just by the team, but elsewhere in the wider health system.

Originality/value – We draw on and develop the concept of clinical microsystems to argue that such systems have a team at their core, but their work practices and patient outcomes require us to look beyond the team itself and take into account its interactions with patients and actors in the wider health care system. We also draw on the framework of Christensen, Grossman, and Hwang (2009) to propose that each microsystem has three distinct value configurations, namely shops, a chain, and a network. In terms of design, we suggest that the clinical microsystem can be seen as a parallel learning structure to that of the established health care bureaucracy.

The purpose of this paper is to investigate if different applications of process orientation exist and how these are characterised. Furthermore, the objective is to investigate how the applications of process orientation relate to the line organization.

Empirical research was conducted within the Region of Västra Götaland, Sweden. A questionnaire with the purpose of capturing the respondents' attitude towards their process initiatives was sent to people with explicit knowledge of process orientation. A total of 180 individuals were questioned (response rate 68 per cent).

The study indicates that process orientation can be classified into three various applications – process view, process mapping, and process management. The study shows further that in most cases process approach is used as an improvement technique in traditional line organizations although all respondents answered that they desire more process orientation.

By viewing process orientation as a spectrum of applications, the study contributes to a more nuanced debate on process orientation.

The purpose of this paper is to investigate what happens when a new management idea with manufacturing origin is implemented in a healthcare organization. In this paper, it is focussed on process management: what happens when the processes are highlighted, process owners are appointed and more power is allocated to the process dimension of the organization.

The paper uses the case of a hospital group in Sweden to investigate difficulties in implementing process management. The studied hospital group has been involved in systematic fundamental change to the system for nearly a decade. The research project was conducted using a collaborative management research approach in which academic researchers worked together with the development director.

The paper shows that the organization itself in many ways becomes an obstacle to the achievement of a process‐oriented management style. In the empirical story, voices from the healthcare staff reveal conflicts over organizing principles and structures such as budgeting and reimbursement systems – systems obviously built on a more functional view from an organizational perspective. It is not completely evident that the two alternative perspectives are able to co‐exist easily – managing them seems to be an advanced balancing act.

The paper provides an illustration of knowledge transfer from manufacturing to service industries. It focuses on the meeting between a Swedish healthcare organization and the idea of process management.