Cultural Change of Applying User Involvement for Improving Healthcare Quality: A Review of the Impact on Attitudes, Values and Assumptions among Healthcare Professionals and Users

Jonas Boström, Helene Hillborg, Johan Lilja


Purpose: The purpose of this study is to provide a review of the impact on culture (attitudes, values and assumptions) among both healthcare professionals, as well as users, when involving users for improving quality in healthcare.

Methodology/Approach: The paper is based on an extensive, narrative literature review considering studies that included professional’s and users experiences of user involvement in quality improvement. The included articles were analyzed using an interpretive, along with a deductive, approach according to a theoretical framework.

Findings: The results indicate that there is currently limited research focusing on the impact of user involvement in quality improvement processes regarding professionals’ and users’ attitudes, values and/or assumptions. The articles identified during the study provides situations and statements, during the process of development, which can be interpreted as change in the culture. Although few articles specifically draw conclusions on user involvement as a “tool” for cultural change, the authors interpret several findings which strengthens that theory.

Research Limitation/implication: Research published in other databases could have been missed. The authors have tried to avoid this by using a snowball method reading references in identified articles.

Originality/Value of paper: The review provides a platform for both future research and the development of current practice within the area. There have been literature reviews showing obstacles and enablers when using patients, users and relatives in quality improvement work, but few which investigates cultural change.


patient involvement; quality improvement; professionals; culture; service design

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Copyright (c) 2017 Jonas Boström, Helene Hillborg, Johan Lilja

ISSN 1335-1745 (print)
ISSN 1338-984X (online)
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