Co-development of client involvement in health and social care services: examining modes of interaction.

PURPOSE: The involvement of clients in service encounters and service development has become a central principle for contemporary health and social care organizations. However, in day-to-day work settings, the shift toward client involvement is still in progress. We examined how health and social care professionals, together with clients and managers, co-develop their conceptions of client involvement and search for practical ways in which to implement these in organizational service processes. DESIGN/METHODOLOGY/APPROACH: The empirical case of this study was a developmental intervention, the client involvement workshop, conducted in a Finnish municipal social and welfare center. The cultural-historical activity theory (CHAT) framework was used to analyze the development of client involvement ideas and the modes of interaction during the intervention. FINDINGS: Analysis of the collective discussion revealed that the conceptions of client involvement developed through two interconnected object-orientations: Enabling client involvement in service encounters and promoting client involvement in the service system. The predominant mode of interaction in the collective discussion was that of "coordination." The clients' perspective and contributions were central aspects in the turning points from coordination to cooperation; professionals crossed organizational boundaries, and together with clients, constructed a new client involvement-based object. This suggests that client participation plays an important role in the development of services. ORIGINALITY/VALUE: The CHAT-based examination of the modes of interaction clarifies the potential of co-developing client-involvement-based services and highlights the importance of clients' participation in co-development.

Peer-Based Mental First Aid Following Workplace Incidents: Implementation Evaluation.

: The study evaluated the implementation of peer-based Mental First Aid (MFA) in a city organization. Its aim was to examine (1) the participants' user experiences of MFA, (2) the developmental needs of the MFA implementation process, and (3) whether and how the implementation of MFA changed the City's safety management. The data were from interviews, feedback from MFA testing and training, safety management documents, and a survey. MFA became established in the organization and there was a clear need for it. It was considered easy to use and had a low user threshold. It added value to traditional occupational safety and health practices by improving the participants' own practical skills to systematically manage the human factors of safety. MFA implementation needs clear management structures and a systematic commitment and learning process.