This research analyzes the internal service supply chain of a perioperative surgical services department of a nonacademic community hospital using the theory of swift and even flow as a theoretical lens. Performance data were gathered using an in-depth case study and it was determined that the swift and even flow constructs did affect flow speed and variance, but did not account for all the effects observed. To understand the need for departments to coordinate their efforts with each other and how this affected flow, further analysis was conducted using insights from Pagell's (2004) theory of internal integration and Gittell's (2002) research about coordinating mechanisms. The findings suggest the need to incorporate a variable measuring supply chain coordination into the theory of swift and even flow.

In services, which require significant customer participation to create value, customers who lack the knowledge, skills and motivation necessary to participate effectively can negatively impact service quality and cost outcomes. This paper develops a conceptual model to investigate the effectiveness of utilizing customer training and education (CTE) to improve customer readiness to provide effective behaviors in a professional service. The model was tested using survey data from patients diagnosed with diabetes who received CTE as part of their healthcare service. We found that customers who are taught why they have to perform the tasks, have higher levels of motivation to perform these tasks effectively. Further, as proposed by the customer readiness model, when their task performance is higher, they have improved health and lower healthcare costs.

AN IN‐DEPTH, INTERDISCIPLINARY CASE study was conducted to map and describe the information, material, and functional processes common to high‐volume surgical specialty procedures at a southeastern US hospital.RESEARCHERS IDENTIFIED PROCESS defects and their effects using both observation and staff member interviews.OUTDATED INFORMATION and structural barriers to communications were responsible for many procedural delays, procedural interruptions, and staff member work‐arounds.OPPORTUNITIES FOR IMPROVEMENT are identified, including redesigns and enhancement of information technology systems. AORN J 87 (January 2008) 187‐208. © AORN, Inc, 2008.

PurposeCustomer participation (CP) has received considerable interest in the service literature as a way to improve the customer experience and reduce service providers' costs. While its benefits are not in question, there is a paucity of research on potential pitfalls. This paper provides a conceptual foundation to address this gap and develops a comprehensive model of the risks of customer participation in service delivery, integrating research from the marketing, operations and supply chain management, strategy, and information technology fields.Design/methodology/approachThe model is derived deductively by integrating insights from research in marketing, operations and supply chain management, strategy, and information technology.FindingsThis paper identifies three categories of potential risks of CP (i.e. market, operational, and service network) and discusses ways that firms can mitigate these risks. Building on the model, it develops a CP risk assessment tool that managers can use when evaluating increases in CP.Research limitations/implicationsThe conceptual model proposed in this paper can serve as a robust basis for future research in customer participation, particularly in such areas as sharing economy services, service delivery networks, and experiential services. The risk assessment tool offers clear guidelines for managers who are considering an increase in customer participation in their service.Originality/valueThis is the first attempt to conceptually define customer participation risk and develop a comprehensive model of its drivers and strategies to mitigate it. This paper develops a straightforward method for managers to evaluate CP risk.

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