医疗保健的合作生产正受到越来越多的关注,然而,人们仍然不甚了解合作生产的过程。本文探讨了医院使病人与医护人员参加合作生产活动的原因及实践中医院对合作生产的体验。我们对五家荷兰医院进行了定性研究,包括半结构化访谈(27人)、观察(70小时)及文档分析,病人和医护人员都参与其中以改善服务。研究结果表明,各家医院使病人和医护人员参加活动的动机不同,且都调整了现有方法来让病人参与。令人关注的是,病人提出需要改进的地方通常是已知的,但合作生产过程的确以另外的方式促进质量改进。合作生产过程激发医院思考如何实现质量改进。这一过程推动了质量改进,因为看到病人并听到病人的体验使医护人员产生了一种紧迫感,促使他们对病人提出的问题采取行动。此外,这些体验使高级管理机构的改进变得合理化。 Cooperative production of health care is receiving more and more attention. However, people still do not have a good understanding of the process of cooperative production. This article explores the reasons why hospitals make patients and health care workers participate in co-operative activities and experiences of co-operative hospitals in practice. We conducted qualitative research on five Dutch hospitals, including semi-structured interviews (27), observation (70 hours) and document analysis, with patient and healthcare staff involved to improve services. The findings suggest that hospitals have motivated patients and health care providers to participate in events differently and that existing methods have been adapted to involve patients. It is interesting to note that where patients are asked to make improvements are generally known, co-production does promote quality in other ways. Cooperative production process to stimulate the hospital to think about how to achieve quality improvement. This process has led to improvements in quality, as seeing patients and hearing about the patient’s experience creates a sense of urgency for healthcare workers to motivate them to act on the patient’s questions. In addition, these experiences rationalize the improvements of the senior management.