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Strong professionals who influence the development of healthcare services have dominated healthcare organizations for many years. However, this dominance has been challenged recently through patient involvement. One method of achieving patient involvement is experience-based co-design (EBCD), in which patients and healthcare professionals work together to improve care. Patient involvement has considerable potential, but also presents certain challenges. This article addresses these challenges using experiences from patients and healthcare professionals who participated in two action research projects that aimed to improve patient experienced quality using EBCD in pediatric care. The paper shows that patient involvement in quality improvements can challenge the traditional roles of professionals and patients by new roles as co-designers. The role as co-designer embraces new perspectives for healthcare professionals that force them to step out of their comfort zone. Accordingly, healthcare professionals are able to view patients as equal partners in improvement work. Reflecting dialogues during the projects offered eye-opening stories for patients and healthcare professionals that enabled them to construct a common picture of care. The contribution of this study is strengthening earlier research that argues that an action research approach can strengthen important values for successful EBCD projects: equal partnerships, new roles, and dialogue. The findings show that the combination of EBCD and action research is a promising approach to address the challenges of patient involvement in healthcare improvement.

Purpose– The purpose of this paper is to study critical practices when adopting improvement knowledge as a management innovation in a professional organization.Design/methodology/approach– This paper is based on an action research approach, in which practitioners and researchers are seen as a part of a participative community generating actionable knowledge. Research involved gathering data over a five-year period through more than 250 interviews and 25 focus groups.Findings– This paper identifies five critical practices for adopting a management innovation in a professional context: first, focussing on labeling and theorizing to create an organization's own vocabulary; second, focussing on the role of internal change agents; third, allowing for an evolutionary adoption process; fourth, building new professional competence through the change agents; and fifth, adopting a research-driven approach to the adoption of a management innovation.Practical implications– For healthcare practitioners, this paper points to practices to consider when adopting improvement knowledge – for example, identifying the patient as the guiding principle and encouraging involvement and local change initiatives. For practitioners in other professionally driven organizations, this paper identifies critical practices for adopting a management innovation – for example, focussing on theorizing and labeling in order to create an organization's own vocabulary related to the professional context.Originality/value– On a generic level, this paper contributes to the understanding of critical aspects when adopting management innovations in a professional organization. In a healthcare context, this paper points to the value of improvement knowledge for improving quality of care. Improvement knowledge is relatively new in healthcare, and this study provides an example of a hospital in which this management innovation helped transform the organization.