Paper/Speech Details of Conference Program for the 30th NISPAcee Annual Conference Program Overview WG3: Public Administration Reform in CEE and CA Author(s) Steven Nommik Tallinn University of Technology Tallinn Estonia Title Expectations and realisations of user engagement in multi-actor innovative healthcare initiatives: perspectives from Estonia File Paper files are available only for conference participants, please login first. Presenter Steven Nommik Abstract For the last decade, public management literature has been strongly influenced by discourse surrounding user engagement (Bovaird, Loeffler 2016). The challenges from NPM-oriented reforms as well as increased pressure on the public sector in an era of austerity have led to a pressure towards change with user engagement representing one of the key opportunities (Peters 2015; Hartley et al., 2013). Current academic literature has provided considerable insight into the drivers, barriers as well as effects (De Vries et al., 2016). This has further been complemented by research oriented towards specific policy fields from local to central level. The recommendations from the academic discourse has been mostly oriented towards the increase of user engagement towards more active forms with both the improvements to the endresults from „collaborative advantage“ as well as legitimacy to the governance structures representing some of the key arguments (S?rensen, Torfing 2016; Torfing et al., 2019). The analytical framework will cover both the governance structure and the different stages of innovation. The academic literature has highlighted a variety of role distributions for the different types of stakeholders (hierarchical; delegated/externalized; networked) upon which this analysis will rely upon (Kenis, Provan 2006; Bardach 2017; Agranoff 2014). For the innovation itself, the paper will rely on a broad differentiation of phases (ideation; adoption decision; adoption/diffusion) to enable the inclusion of the different types of innovation (product innovation; process innovation; governance innovation) (Damanpour, Schneider 2006). User engagement will be approached from the resources contributed (tangible; collective intangible; person-based intangibles) that enables to determine the level within the initiative (Bovaird, Loeffler 2016). This explorative paper will focus on the role of users both from the expectations preceding the collaboration as well as the role implementation during the process from the different stakeholders’ perspectives within innovative healthcare initiatives in Estonia. The choice of the policy field was connected to the prominent role of innovation in healthcare (including product, process and governance innovations) as well as the rising interest into the field due to the changing conditions (De Vries et al., 2016). The paper aims to answer the following research questions: What are the expectations for user engagement for the collaborative initiatives? What is the level of user engagement for the collaborative initiatives? What is the effect of governance structures on user engagement? For the paper a multiple case study method has been chosen with the analysis conducted by means of qualitative content analysis (Schreier 2012). The case-study criteria will be based on the varying roles of the public sector organisations within the collaboration as well as the implementation of the innovation. The data collection will be conducted through semi-structured interviews with the approach for sampling being a combination of snowball sampling and convenience sampling. For the analysis, the interviews will be coded. This research will provide several benefits. The insights from the practitioners will provide valuable knowledge towards the current perceptions to user engagement on a practical level. This is further complemented by a unique perspective from the CEE context to contribute to a discourse currently dominated by an Anglo-American perspective (De Vries et al., 2014).
