Keeling, Debbie I, Laing, Angus and de Ruyter, Ko (2018) Evolving roles and structures of triadic engagement in healthcare. Journal of Service Management, 29 (3). pp. 352-377. ISSN 1757-5818

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Abstract

Purpose: This study focuses 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/approach: An 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.

Findings: Triadic engagement is conceptualised against a two-level framework. (1) 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. (2) Evolving roles are mapped to three phases of transformation: enhancement; empowerment; emancipation. Triadic engagement varied across conditions.

Research limitations/implications: These 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 implications: Structures 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/value: Contributions 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.

Item Type:	Article
Keywords:	Healthcare, triadic engagement, empowerment, emancipation, consultations
Schools and Departments:	School of Business, Management and Economics > Business and Management
Subjects:	Q Science > QZ Psychology R Medicine > R Medicine (General)
Depositing User:	Debbie Keeling
Date Deposited:	25 Oct 2017 09:00
Last Modified:	02 Jul 2018 15:06
URI:	http://srodev.sussex.ac.uk/id/eprint/70645

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