Purpose This study explores how healthcare staff enact organizational citizenship behavior (OCB) in everyday practice, how patients and staff interpret these behaviors and how staff implement them under contextual constraints. Design/methodology/approach A single qualitative case study was conducted in four departments (geriatrics, oncology, spinal surgery, orthopedics) of a German hospital group. Data comprise 48 semi-structured interviews with patients, healthcare professionals and managers, field observations, and document analysis. Findings The study finds that OCB consists of symbolically rich behaviors that create moments of connection and joy between patients and staff. Four OCB categories are identified: enhancing physical comfort, providing food and personal items, facilitating activities and engaging in conversation. Four strategies used by staff to engage in OCB under constraints are derived: making time for gestures, responding to opportunities in interaction, improvising when resources are scarce and navigating rules. Practical implications To foster OCB in every day practice, healthcare organizations can create a supportive culture, enable time for patient interaction, provide practical resources and guide staff in balancing discretion with professional boundaries. Originality/value This study extends prior literature on OCB by identifying different types of OCB in healthcare, highlighting its symbolic meaning, and shifting the analytical lens from healthcare professionals' motivations to engage in OCB toward the strategies they use to navigate contextual constraints.
Maarten Volkers (Thu,) studied this question.