Challenging 'colour time': A practice and narrative approach to organising waiting time in hospitals.

Waiting time in hospitals is often studied from one of two perspectives: a distributed resource in hospitals or a potential steering and measuring factor. In this article, waiting time in an emergency department is examined from a practice and a narrative perspective, placing time at the core of our analysis. Our article explores patient waiting time as a local practice that builds on the temporal structuring that affects how waiting time is regulated by both normal clock time and event time-as interpretative time. We also consider how individual narratives in situated spaces allow for negotiations, but we also present isolated time experiences. The empirical data derive from an organisational ethnographic study of a newly introduced triage system for incoming patients at an emergency department in Denmark. The analysis shows how waiting time is organised in the formal visitation system as 'colour time' based on the negotiations of the health-care professional as at the 'right time' and as the patient's individual illness experiences with 'wasting time'. The findings indicate the importance of the unequal relationship between clock time and event time and the different contextual situations affecting the possibilities of organising.

Conceptions of patients and their roles in healthcare: Insights from everyday practice and service improvement.

PURPOSE: The purpose of this paper is two-fold. First, it sets the context for the special issue by considering conceptions of patients and their roles in service delivery and improvement. Second, it introduces the contributions to the special issue, and identifies thematic resonance. DESIGN/METHODOLOGY/APPROACH: The paper utilises a literature synthesis and thematic analysis of the special issue submissions. These emanated from the Ninth International Organisational Behaviour in Healthcare Conference, hosted by Copenhagen Business School on behalf of the Learned Society for Studies in Organizing Healthcare. FINDINGS: The articles evidence a range of perspectives on patients' roles in healthcare. These range from their being subject to, a mobilising focus for, and active participants in service delivery and improvement. Building upon the potential patient roles identified, this editorial develops five "ideal type" patient positions in healthcare delivery and improvement. These recognise that patients' engagement with health care services is influenced both by personal characteristics and circumstances, which affect patients' openness to engaging with health services, as well as the opportunities afforded to patients to engage, by organisations and their employees. ORIGINALITY/VALUE: The paper explores the relationally embedded nature of patient involvement in healthcare, inherent in the interdependence between patient and providers' roles. The typology aims to prompt discussion regarding the conceptualisation patients' roles in healthcare organisations, and the individual, employee, organisational and contextual factors that may help and hinder their involvement in service delivery and improvement. The authors close by noting four areas meriting further research attention, and potentially useful theoretical lenses.

The role of patient narratives in healthcare innovation: supporting translation and meaning making.

PURPOSE: The purpose of this paper is to investigate the process and impact of patient involvement in locally defined improvement projects in two hospital clinics. The paper particularly aims to examine how patient narratives, in the form of diaries and radio montage, help to create new insights into patient experience for healthcare professionals, and support professionals' enrolment and mobilisation in innovation projects. DESIGN/METHODOLOGY/APPROACH: Two case studies were undertaken. These drew upon qualitative interviews with staff and participant observation during innovation workshops. Patient diaries and a recorded montage of patient voices were also collected. FINDINGS: The findings illuminate translation processes in healthcare innovation and the emergence of meaning making process for staff through the active use of patient narratives. The paper highlights the critical role of meaning making as an enabler of patient-centred change processes in healthcare via: local clinic mangers defining problems and ideas; collecting and sharing patient narratives in innovation workshops; and healthcare professionals' interpretation of patient narratives supporting new insights into patient experience. PRACTICAL IMPLICATIONS: This study demonstrates how healthcare professionals' meaning making can be supported by articulating, constructing, listening and interpreting patient narratives. The two cases demonstrate how patient narratives serve as reflective devices for healthcare professionals. ORIGINALITY/VALUE: This study presents a novel demonstration of the importance of patient narratives for translating healthcare innovation in a clinical practice setting.