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Evolving Roles and Structures of Triadic Engagement in Healthcare

Research output: Contribution to journalJournal article

Published

Standard

Evolving Roles and Structures of Triadic Engagement in Healthcare. / Keeling, Debbie Isobel; Laing, Angus Wallace; de Ruyter, Ko .

In: Journal of Service Management, Vol. 29, No. 3, 06.2018, p. 352-377.

Research output: Contribution to journalJournal article

Harvard

Keeling, DI, Laing, AW & de Ruyter, K 2018, 'Evolving Roles and Structures of Triadic Engagement in Healthcare', Journal of Service Management, vol. 29, no. 3, pp. 352-377. https://doi.org/10.1108/JOSM-09-2016-0249

APA

Keeling, D. I., Laing, A. W., & de Ruyter, K. (2018). Evolving Roles and Structures of Triadic Engagement in Healthcare. Journal of Service Management, 29(3), 352-377. https://doi.org/10.1108/JOSM-09-2016-0249

Vancouver

Keeling DI, Laing AW, de Ruyter K. Evolving Roles and Structures of Triadic Engagement in Healthcare. Journal of Service Management. 2018 Jun;29(3):352-377. https://doi.org/10.1108/JOSM-09-2016-0249

Author

Keeling, Debbie Isobel ; Laing, Angus Wallace ; de Ruyter, Ko . / Evolving Roles and Structures of Triadic Engagement in Healthcare. In: Journal of Service Management. 2018 ; Vol. 29, No. 3. pp. 352-377.

Bibtex

@article{9472047d0c43480591c23e83c2dbd1a6,
title = "Evolving Roles and Structures of Triadic Engagement in Healthcare",
abstract = "PurposeThe purpose of this paper is to focus on the changing nature of healthcare service encounters by studying the phenomenon of triadic engagement incorporating interactions between patients, local and virtual networks and healthcare professionals.Design/methodology/approachAn 18-month longitudinal ethnographic study documents interactions in naturally occurring healthcare consultations. Professionals (n=13) and patients (n=24) within primary and secondary care units were recruited. Analysis of observations, field notes and interviews provides an integrated picture of triadic engagement.FindingsTriadic engagement is conceptualised against a two-level framework. First, the structure of triadic consultations is identified in terms of the human voice, virtual voice and networked voice. These are related to: companions{\textquoteright} contributions to discussions and the virtual network impact. Second, evolving roles are mapped to three phases of transformation: enhancement; empowerment; emancipation. Triadic engagement varied across conditions.Research limitations/implicationsThese changing roles and structures evidence an increasing emphasis on the responsible consumer and patients/companions to utilise information/support in making health-related decisions. The nature and role of third voices requires clear delineation.Practical implicationsStructures of consultations should be rethought around the diversity of patient/companion behaviours and expectations as patients undertake self-service activities. Implications for policy and practice are: the parallel set of local/virtual informational and service activities; a network orientation to healthcare; tailoring of support resources/guides for professionals and third parties to inform support practices.Originality/valueContributions are made to understanding triadic engagement and forwarding the agenda on patient-centred care. Longitudinal illumination of consultations is offered through an exceptional level of access to observe consultations.",
keywords = "Healthcare, Empowerment, Emancipation, Consultations, Triadic engagement",
author = "Keeling, {Debbie Isobel} and Laing, {Angus Wallace} and {de Ruyter}, Ko",
note = "This article is (c) Emerald Group Publishing and permission has been granted for this version to appear here. Emerald does not grant permission for this article to be further copied/distributed or hosted elsewhere without the express permission from Emerald Group Publishing Limited.",
year = "2018",
month = jun
doi = "10.1108/JOSM-09-2016-0249",
language = "English",
volume = "29",
pages = "352--377",
journal = "Journal of Service Management",
issn = "1757-5818",
publisher = "Emerald",
number = "3",

}

RIS

TY - JOUR

T1 - Evolving Roles and Structures of Triadic Engagement in Healthcare

AU - Keeling, Debbie Isobel

AU - Laing, Angus Wallace

AU - de Ruyter, Ko

N1 - This article is (c) Emerald Group Publishing and permission has been granted for this version to appear here. Emerald does not grant permission for this article to be further copied/distributed or hosted elsewhere without the express permission from Emerald Group Publishing Limited.

PY - 2018/6

Y1 - 2018/6

N2 - PurposeThe purpose of this paper is to focus on the changing nature of healthcare service encounters by studying the phenomenon of triadic engagement incorporating interactions between patients, local and virtual networks and healthcare professionals.Design/methodology/approachAn 18-month longitudinal ethnographic study documents interactions in naturally occurring healthcare consultations. Professionals (n=13) and patients (n=24) within primary and secondary care units were recruited. Analysis of observations, field notes and interviews provides an integrated picture of triadic engagement.FindingsTriadic engagement is conceptualised against a two-level framework. First, the structure of triadic consultations is identified in terms of the human voice, virtual voice and networked voice. These are related to: companions’ contributions to discussions and the virtual network impact. Second, evolving roles are mapped to three phases of transformation: enhancement; empowerment; emancipation. Triadic engagement varied across conditions.Research limitations/implicationsThese changing roles and structures evidence an increasing emphasis on the responsible consumer and patients/companions to utilise information/support in making health-related decisions. The nature and role of third voices requires clear delineation.Practical implicationsStructures of consultations should be rethought around the diversity of patient/companion behaviours and expectations as patients undertake self-service activities. Implications for policy and practice are: the parallel set of local/virtual informational and service activities; a network orientation to healthcare; tailoring of support resources/guides for professionals and third parties to inform support practices.Originality/valueContributions are made to understanding triadic engagement and forwarding the agenda on patient-centred care. Longitudinal illumination of consultations is offered through an exceptional level of access to observe consultations.

AB - PurposeThe purpose of this paper is to focus on the changing nature of healthcare service encounters by studying the phenomenon of triadic engagement incorporating interactions between patients, local and virtual networks and healthcare professionals.Design/methodology/approachAn 18-month longitudinal ethnographic study documents interactions in naturally occurring healthcare consultations. Professionals (n=13) and patients (n=24) within primary and secondary care units were recruited. Analysis of observations, field notes and interviews provides an integrated picture of triadic engagement.FindingsTriadic engagement is conceptualised against a two-level framework. First, the structure of triadic consultations is identified in terms of the human voice, virtual voice and networked voice. These are related to: companions’ contributions to discussions and the virtual network impact. Second, evolving roles are mapped to three phases of transformation: enhancement; empowerment; emancipation. Triadic engagement varied across conditions.Research limitations/implicationsThese changing roles and structures evidence an increasing emphasis on the responsible consumer and patients/companions to utilise information/support in making health-related decisions. The nature and role of third voices requires clear delineation.Practical implicationsStructures of consultations should be rethought around the diversity of patient/companion behaviours and expectations as patients undertake self-service activities. Implications for policy and practice are: the parallel set of local/virtual informational and service activities; a network orientation to healthcare; tailoring of support resources/guides for professionals and third parties to inform support practices.Originality/valueContributions are made to understanding triadic engagement and forwarding the agenda on patient-centred care. Longitudinal illumination of consultations is offered through an exceptional level of access to observe consultations.

KW - Healthcare

KW - Empowerment

KW - Emancipation

KW - Consultations

KW - Triadic engagement

U2 - 10.1108/JOSM-09-2016-0249

DO - 10.1108/JOSM-09-2016-0249

M3 - Journal article

VL - 29

SP - 352

EP - 377

JO - Journal of Service Management

JF - Journal of Service Management

SN - 1757-5818

IS - 3

ER -