EXPLORING VALUE CREATION PROCESSES IN HEALTHCARE. People, mechanisms, outcomes.

This thesis aims at exploring which processes can lead to the creation of value for both individuals and societies with a focus on public organisations (POs) activities, in particular POs of healthcare systems. These processes are linked to individuals and organisations’ behaviours, with their values and with specific and broad goals such as sustainability and quality of life (Berwick, Nolan, & Whittington, 2008; Porter, 2010). I will underline that to create value in broader terms it is fundamental to recognise and exploit stakeholders’ active contribution to POs activities and the potential of social interdependence and responsibility in fostering value creation processes in healthcare (De Rosis, Pennucci, & Nuti, 2019). Three papers are included to answer the question on how to reorient and reshape health care systems according to the Quadruple Value framework. In particular, going from theory to practice, the central challenge is about implementing a vision that makes POs to work not only on their side but including and fostering patients and communities’ perspective and active contribution. In particular, the first paper proposes a way to include chronic patients' feedback in evaluating how the system is managing their care pathways and the collaboration among different providers to ensure patient-centeredness and personal value creation. Secondly, I will present some case studies in the health prevention field to suggest which mechanisms are useful to innovate POs activities and possible ways of reshaping the health care system to create broader value for individuals and communities. Finally, an evaluation of effectiveness and efficiency of a co-production experience will give us the chance to deeper analyse actions innovatively designed in order to enhance the collaboration of POs and people, patients, communities. In all these experiences, I am suggesting that the healthcare systems should put in place interventions that build on what people and communities can do as the leading actors of decisions and actions regarding their health, creating a valuable system-individuals partnership to increase the value created through healthcare POs activities.