Corporate Reputation Review

https://doi.org/10.1057/s41299-019-00090-0

ORIGINAL ARTICLE

Employee Engagement and Internal Branding: Two Sides of the Same

Coin?
Kati Suomi1 · Saila Saraniemi2 · Mervi Vähätalo1 · Tomi J. Kallio1 · Terhi Tevameri3

© Reputation Institute and Springer Nature Limited 2019

Abstract
This study examines the link between employee engagement and internal branding. It seeks to understand which antecedent
factors healthcare professionals consider important for employee engagement and what kinds of implications this engagement-
related information may have for internal branding. The study reviews the literature on employee engagement and internal
branding and presents a conceptualisation of the linkage between the two concepts. The empirical portion content analyses
more than 1200 answers to open questions to examine employee engagement in the case organisation, a large private health-
care organisation in Finland. The findings suggest the following eight antecedent factors to be particularly important for
healthcare professionals’ employee engagement: organisational culture, reward, working environment, training, HR practices,
reputation and values, communication, and physical environment. Based on the empirical and theoretical analyses, it can
be said that the antecedent factors of employee engagement and elements of internal branding can be considered two sides
of the same coin.

Keywords Employee engagement · Internal branding · Healthcare · Knowledge-intensive organisations · Services

Introduction with as well as enthusiasm for work’, and Maslach et al.

(2001) came close to Harter et al. (2002) in suggesting that
In the post-industrial age, recruiting and retaining compe- engagement constitutes employees’ involvement, energy
tent personnel can be considered one of the most important and efficacy. By internal branding we refer to ‘a doctrine to
responsibilities of employers (e.g. Hillebrandt and Ivens ensure employees’ delivery of the brand promise by shap-
2013; Edlinger 2015; Tanwar and Prasad 2016). Given the ing employees’ brand attitudes and behaviours’ (Punjaisri
shortage of competent healthcare professionals in many et al. 2008, p. 407). Indeed, one of the critical success fac-
Western countries, once professionals are recruited, engag- tors for service organisations today is service employees’
ing them with an organisation can be considered crucial. job performance enabled by engagement (Lee et al. 2014).
It is well acknowledged that attracting the best talents is Lee et al. (2014) suggested that employee engagement is a
important, but motivating them to stay is even more so (Tan- viable condition linking internal branding to the nurturing
war and Prasad 2016; see also Whelan et al. 2010). Thus, in of job satisfaction. Internal branding also positively affects
the current study, we focus on both employee engagement employee engagement. Despite these findings, there is sur-
and internal branding. Harter et al. (2002, p. 269) described prisingly little research regarding the relationship between
engagement as an ‘individual’s involvement and satisfaction these two concepts, potentially due to their roots in differ-
ent disciplines. Thus, in this study, we examine their fuzzy
relationship in more depth.
* Kati Suomi Ewing et al. (2002) argued that organisations operating
kati.suomi@utu.fi in knowledge-intensive service industries are increasingly
1 facing a situation in which it is easier to find skilled workers
Pori Unit, Turku School of Economics at the University
of Turku, PL 170, 28101 Pori, Finland than eager customers. In the service context, employees per-
2 sonify a corporate brand (e.g. Iglesias et al. 2013) and can be
Oulu Business School, University of Oulu, Oulu, Finland
considered ‘the embodiment of the service brand’ (Punjaisri
3
The Centre for Economic Development, Transport et al. 2009a, b). Employees’ skills and knowledge are not the
and the Environment, Helsinki, Finland

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 K. Suomi et al.

only important thing for the corporate brand; compatibility The next section reviews the literature on employee
between the employee and the organisation (Elving et al. engagement and internal branding and provides literature-
2013) is also crucial for employees to ‘live the brand’ and based integration of these concepts to address the study’s
become ‘brand ambassadors’ (Ind 2004). Particularly in the conceptual and theoretical background. Thereafter, the
service sector, employees play the critical role of building data collection and methods of analysis based on the cre-
the corporate brand not only at their workplace, but also ated framework are described. Next, the empirical findings
through interactions with families, friends and networks (e.g. section shows how healthcare professionals experience the
Morokane 2016). antecedents of employee engagement and how elements of
The literature shows a strong relationship between internal branding are intertwined in the same experiences.
employee engagement and organisational performance The Discussion section focuses on the theoretical and mana-
(Lowe 2012). Similarly, internal branding impacts com- gerial contributions of the findings, following suggestions
panies’ performance (e.g. Tuominen et al. 2016; see also for future research.
Iyer et al. 2018). However, little research has examined the
focus of the present study: the relationship between the two
internal processes of employee engagement and internal Theoretical Background
branding. Some findings have implied such a relationship,
suggesting that elements of internal branding, such as nego- Employee Engagement
tiating and co-constructing values between management and
employees, enhance employee engagement (Aggerholm In recent years, employee engagement has received grow-
et al. 2011) and that employee engagement mediates internal ing interest, particularly in the organisational and human
branding and employee-related outcomes (Lee et al. 2014). resource management literature (e.g. Robertson and Cooper
In addition, Davies et al. (2018) suggest that employees’ 2010; Rana et al. 2014), but also in the literature on psy-
engagement increases in line with their positive percep- chology and healthcare (see Dagher et al. 2015). The con-
tions of their employer’s image; the effects of these percep- cept originated in burnout research, which tends to examine
tions on their engagement are mediated by the employees’ employees’ well-being, not just their ‘unwell-being’ (see
satisfaction. Schaufeli et al. 2002). According to Robinson et al. (2004),
Although the importance of internal branding is well engagement is a two-way relationship between employer
acknowledged in service industries in general (e.g. Pun- and employee. Using social exchange theory, Saks (2006,
jaisri et al. 2009a) and in the context of knowledge-intensive p. 603) interpreted Kahn’s (1990) seminal article in the area,
organisations in particular (e.g. Sujchaphong et al. 2015), which posited that employee engagement means a condition
few studies have examined internal branding in the context in which employees feel obligated to integrate themselves
of healthcare (Gapp and Merrilees 2006; Heilmann 2010; more deeply into their role performance as repayment for the
Hytti et al. 2015), Nevertheless, this topic is highly relevant resources they have received from the organisation. Through
in Western countries, including Finland. Health services are this engagement, employees ‘employ and express themselves
increasingly required to facilitate greater opportunities to physically, cognitively, and emotionally during role perfor-
choose services and service providers according to custom- mance’ (Kahn 1990, p. 694). Following this concept multi-
ers’ needs and preferences. This is likely to enhance compe- dimensionality, Schaufeli et al. (2002, p. 74) provided one of
tition for both employees and customers, pointing to a need the most widely cited definitions of engagement: ‘a positive,
to pay better attention to employee engagement. fulfilling, work-related state of mind that is characterised by
Lee et al. (2014, p. 1376) suggested that ‘internal brand- vigor, dedication and absorption’. As Robertson and Cooper
ing should be precedent of employee engagement’. Develop- (2010) stated, engaged employees have positive attitudes,
ing on this idea from a theoretical perspective, the present but also an active use of emotions and cognitions, with focus
study aims to combine the concepts of employee engage- on their formal role performance (unlike in some similar
ment and internal branding in the context of healthcare. constructs, such as job involvement or commitment; Saks
From a managerial perspective, the underlying assumption 2006; Lee et al. 2014).
is that recognising important factors in employee engage- Many studies, such as that by Saks (2006), suggest that
ment enables the management of healthcare organisations employee engagement covers both job engagement and
to enhance internal branding practices to involve employees organisational engagement, meaning that an employee has
more effectively in brand value co-creation (c.f. Saleem and both a work role and a role as an organisational member.
Iglesias 2016). The study addresses the following research However, despite many attempts, the concept is vague and
question: How are employee engagement and internal lacks clarification (Robertson and Cooper 2010; Dagher
branding conceptually linked? et al. 2015).
Employee Engagement and Internal Branding: Two Sides of the Same Coin?

In short, literature has discussed the psychological condi- job design and characteristics, supervisor and co-worker
tions (Kahn 1990), dimensions (Schaufeli et al. 2002), work- relationships, workplace environment and human resource
life factors (Maslach et al. 2001), antecedents (Rana et al. development practices. Further, Rana (2015) identified
2014; Rana 2015), components (Rothbard 2001), elements employee power, information, reward and knowledge as
(Beattie and Waterhouse 2015), determinants (Anitha 2014), antecedents of employee engagement. Next, we review the
outcomes (May et al. 2004; Wollard and Schuck 2011; Beat- literature on internal branding to address the relationship
tie and Waterhouse 2015; Lee et al. 2014) and consequences between these two concepts.
of employer engagement (Saks 2006).
For the purposes of this study, we are particularly inter- Internal Branding
ested in the antecedents of employee engagement for under-
standing what makes an employee achieve a ‘positive, Prior studies have noted the importance of employees in
fulfilling work-related state of mind’ (see Schaufeli et al. building strong service brands (e.g. Löhndorf and Diaman-
2002). According to earlier literature, employee engagement topoulos 2014). Building a consistent corporate brand in
has positive consequences for employee and organisation the service context might be challenging, as services (e.g.
alike. For example, in the healthcare context, Lowe (2012) healthcare) are intangible and complex in nature (Zeithaml
found that high employee engagement is related to retention, et al. 2012), in addition to being constructed of people-based
patient-centred care, a patient safety culture and a positive processes, through which employees may either enhance
employee evaluation of the quality of care or services. or damage a corporate brand (e.g. Roper and Fill 2012).
Several conceptual and empirical papers have identified Accordingly, firms’ employees may be regarded as internal
various antecedents (or elements) of employee engagement. customers who deliver brand promise and co-create brand
Beattie and Waterhouse (2015) suggested the following ele- value through their interactions with customers and other
ments of employee engagement: feeling valued and having stakeholders (e.g. Merz et al. 2009; see also Davies and
a voice, job satisfaction and meaningful work, supportive Chun 2002). Therefore, internal branding can be deemed
culture, senior management style and vision, line manage- important because it ensures that employees deliver the
ment support, communication, teamwork and supportive brand promise to customers (de Chernatony and Harris
colleagues, supporting health and wellbeing, performance 2000; Bergstrom et al. 2002; Foster et al. 2010; Hytti et al.
management and reward, equality and learning. Anitha 2015; Kuoppakangas et al. 2019).
(2014) found that working environment, leadership, team The extant literature describes the rationale and reasons
and co-worker relationship, training and career develop- for internal branding in terms of underlining the importance
ment, compensation programme, organisational policies of ‘selling the brand inside’. This means that companies need
and procedures, and workplace well-being were determi- to pay attention to internal branding to their employees, par-
nants of employee engagement, which we see as paralleling ticularly when the company is facing a major challenge or
the antecedents of employee antecedents. change and when employees are searching for direction. Fur-
Saks (2006) also mentioned five antecedents of employee thermore, companies should align their internal and external
engagement. First, job characteristics include challenges, branding, bring the brand alive for employees and create a
variety of tasks, opportunities to make important contri- connection for them on an emotional level with the brand
butions, time pressure and quantitative job demands (see (e.g. Mitchell 2002; Hytti et al. 2015; Kuoppakangas et al.
also Kahn 1990; Maslach et al. 2001). Secondly, employ- 2019). With regard to the consequences of internal branding,
ees’ perceptions of organisational support, and thirdly, per- it has been argued that internal branding affects the extent to
ceived supervisor support, rewards and recognition can be which employees identify with, commit to, and show loyalty
considered antecedents of employee engagement. Fourthly, towards the brand, as well as the extent to which employees
procedural justice, or an employee’s perception of fairness behave in ways that are consistent with the delivery of the
in allocating resources, can be considered an antecedent of company’s brand promise (Punjaisri et al. 2009a; Punjaisri
employee engagement. Finally, Saks (2006) suggested distri- and Wilson 2011). Moreover, internal branding indirectly
bution justice, or perceived fairness of outcomes or decisions affects brand performance (Tuominen et al. 2016; Iyer et al.
made, as an antecedent of employee engagement. Further, 2018) and market performance (Tuominen et al. 2016).
Welch (2011) highlighted communication as an important However, for the purposes of this study, we are particularly
antecedent of employee engagement and maintained that interested in the elements of internal branding that, accord-
it would be useful for employers to consider personnel’s ing to the literature (e.g. Aggerholm et al. 2011; Lee et al.
communication needs in accordance with differences in 2014), seem to be conceptually close to the antecedents of
employee engagement (see also Saks 2006). employee engagement.
In their conceptual paper, Rana et al. (2014) consolidated Wallström et al. (2008) describe the internal brand
several antecedents of employee engagement, including building process as comprising three stages, related to
 K. Suomi et al.

brand audit, brand identity and brand position statement. As illustrated in Table 1, employee engagement and inter-
Punjaisri and Wilson (2011) highlighted internal commu- nal branding are closely related and contain several overlap-
nication and training as key elements of internal branding. ping elements that relate to organisational culture, rewards,
Internal communication consists of both formal and infor- working environment, training, HR practices, reputation and
mal communications between employees and management values, and communication. It seems that the basic differ-
(Dean et al. 2016), and it is vital for building a culture of ence between the concepts is internal branding’s stronger
transparency and engaging employees in the organisation emphasis on a brand-centred perspective. Furthermore,
and its vision (Mishra et al. 2014). Concretely, it includes looking at these elements from an internal branding perspec-
newsletters, daily briefings and group meetings, for example tive implies a more strategic approach for management that
(Punjaisri and Wilson 2011). Further, training may include concerns the organisation and its brand as a whole, stem-
programmes, courses and orientation (Punjaisri and Wilson ming with and spreading from the top-management level.
2011). In addition to internal communication and training, By contrast, the employee engagement perspective seems
Lee et al. (2014) added a third element of internal brand- to focus far more on individual factors or tools of HRM
ing, namely rewards. Like training, rewards represent human while also being more nuanced and employee-centred in
resource practices. Rewards may include reward systems and its approach. Furthermore, with regard to internal brand-
recognition schemes (Punjaisri and Wilson 2007). ing, there is an underlying assumption, typical of market-
Further, Saleem and Iglesias (2016, p. 50) defined inter- ing, that embraces customer and stakeholder orientation, and
nal branding as the process through which organisations considers internal activities directly or indirectly affecting
integrate five elements—brand ideologies, leadership, customer relationships (e.g. Grönroos 2006). Ultimately,
human resource management (HRM), internal brand com- it is suggested that elements of internal branding enhance
munications and internal brand communities—as a strategy employee engagement (Aggerholm et al. 2011), and that
to enable employees to co-create brand value with stake- both concepts are reflected in the motivation to continue in
holders. As such, the definition approaches internal branding the work (see Tanwar and Prasad 2016).
from a wide perspective, assuming that this strategy occurs
in a supportive organisational culture (ibid, p. 50). Brand
ideologies reflect a brand’s vision, mission, aims, norms Data Collection and Analysis
and values. Brand leadership refers to leaders who deliver a
clear brand ideology and enable a shared understanding of The data used in this study were collected from a large
the brand promise. Brand-centred HRM relates to recruiting private healthcare organisation. The organisation operates
and selecting employees whose values are compatible with in Finland and has numerous clinics around the country
the brand’s values. Internal brand communication is linked employing several thousand personnel. The personnel con-
to such issues as effective internal communication and sist of employees and practitioners, who work entrepreneuri-
treating employees like customers. Finally, internal brand ally. The first group—employees—comprises such health-
communities refer to both physical and online communities care professionals as nurses, physiotherapists and physicians.
that enable employees to identify with the brand in question The second group consists primarily of specialised physi-
(Saleem and Iglesias 2016). cians and, to a smaller extent, other healthcare professionals,
To summarise the above discussion, it appears that, in such as therapists, who both work for the company a few
prior literature, internal branding targets both cognitive and hours a month or more. Further, it was typical for practition-
behavioural levels of change among employees (c.f. Lee ers in this study to work simultaneously in one or several
et al. 2014) and has been approached primarily as a brand- other healthcare organisations in either the public or the pri-
centred organisational strategy and culture. vate sector. The study data were gathered during the spring
of 2016 as part of a larger research project. The electronic
Integrating Employee Engagement and Internal survey targeted physicians, nurses and related healthcare
Branding professionals who were working for the company at the time
of the survey.
The review of employee engagement and internal branding The physicians’ group covered the following person-
illustrates several concrete connections between the two con- nel groups: general practitioners, specialist and specialis-
cepts. In Table 1, we summarise the overlapping elements of ing doctors and dentists. The group of nurses consisted of
employee engagement and internal branding. This clarifies nurses, physiotherapists, radiographers, laboratory nurses
that elements of internal branding, both actions and con- and occupational health nurses. The respondents worked
ditions, precede employee engagement. Recognising both as either employees or practitioners in the studied health-
aspects in the management of a service organisation enables care organisation. Thus, the study covered the total sample
a holistic understanding of employee retention. of the above-mentioned groups. Three survey reminders
Employee Engagement and Internal Branding: Two Sides of the Same Coin?

Table 1  Comparison of the antecedents of employee engagement and the elements of internal branding
Antecedents of employee engagement Elements of internal branding

Organisational culture
Supportive culture (Beattie and Waterhouse 2015) Supportive corporate culture
Feeling valued and having a voice (Beattie and Waterhouse 2015) (Saleem and Iglesias 2016)
Perceived fairness (Maslach et al. 2001) Leadership (Vallaster and de Chernatony 2006)
Equality (Beattie and Waterhouse 2015)
Employee satisfaction (Davies et al. 2018)
Reward
Rewards and recognition (Maslach et al. 2001) Reward (Lee et al. 2014)
Reward (Rana 2015)
Reward (Beattie and Waterhouse 2015)
Compensation programme (Anitha 2014)
Working environment
Working environment (Anitha 2014) Internal brand community (Saleem and Iglesias 2016)
Team and co-worker relationships
(Anitha 2014)
Workplace environment (Rana et al. 2014)
Supervisor and co-worker relationships (Rana et al. 2014)
Community and social support (Maslach et al. 2001)
Teamwork and supportive colleagues (Beattie and Waterhouse 2015)
Positive work environment (Lee et al. 2014)
Training
Training and career development (Anitha 2014) Training (Punjaisri and Wilson 2011)
Learning (Beattie and Waterhouse 2015) Training (Lee et al. 2014)
Training (Roper and Fill 2012)
HR practices
Human resource development practices (Rana et al. 2014) Brand-centred human resource management
Supporting health and wellbeing (Beattie and Waterhouse 2015) (Saleem and Iglesias 2016)
Human resource management
(Aurand et al. 2005)
Reputation and values
Values (Maslach et al. 2001) Brand ideologies (Saleem and Iglesias 2016)
Positive image of employer among employees (Davies et al. 2018) Brand leadership (Saleem and Iglesias 2016)
Shared meanings and corporate values (Roper and Fill 2012)
Communication
Information (Rana 2015) Internal brand communication
Knowledge (Rana 2015) (Saleem and Iglesias 2016)
Communication (Beattie and Waterhouse 2015) Internal communication (Lee et al. 2014)
Internal communication (Punjaisri and Wilson 2011)
Internal communication (Roper and Fill 2012)

were sent to catch those recipients who worked for the • Which factors (in general) decrease or could decrease
company only rarely. The questionnaire was sent through your engagement with an employer (if you are a practi-
email to all representatives of the above-listed personnel tioner, with your working place)? (N = 611)
groups: 3782 people altogether. In total, 772 individuals
responded. The overall response rate for the survey was The answers reflect both the present state in the studied
20.4%, which can be considered adequate in comparison organisation and the antecedent factors that increase/could
to recent studies (e.g. Boon et al. 2011). The current study increase or decrease/could decrease engagement more gener-
concentrates on respondents’ verbal answers to the follow- ally. Through these responses, we were able to gain knowl-
ing two open-ended questions, which produced more than edge about the antecedents respondents believed to affect
1200 individual answers: their employee engagement.
The data gathered through the two open-ended questions
• Which factors (in general) increase or could increase your were analysed qualitatively, using thematic analysis (Braun
engagement with an employer (if you are a practitioner, and Clarke 2006) and applying abductive logic. Although
with your working place)? (N = 631) a tentative theoretical framework based on the literature
 K. Suomi et al.

review was implemented in the early phases of the research emphasised in relation to issues concerning leadership
process, it was developed alongside an analysis of the empir- and management (see also Hatch and Schultz 1997; Fom-
ical data (Dubois and Gadde 2002). In the analysis, attention brun et al. 2015). The respondents, for instance, deemed it
was paid to what was said, rather than how it was said. The important for one to be able to autonomously define her/his
first phase of the data analysis began with a careful read- tasks. Accordingly, managers’ interference in irrelevant or
ing of all verbal answers to the two open questions. The minor details of work tasks (so-called micro-management)
data were then coded inductively to examine which ante- was believed to decrease engagement. For healthcare pro-
cedents the respondents considered important for employee fessionals in this study, being involved in decision-making
engagement. This phase identified numerous detailed items in the workplace was important. Many mentioned having a
(Table 2), which were at a low level of abstraction. voice, emphasising that they would appreciate if managers
The coding of the data guided the researcher to notice that truly listened to personnel. Respondents felt that, since they
the answers to the two questions appeared to be reversed. knew the content of the work, they should be listened to
Namely, issues believed to increase (or that could increase) when developing guidelines and protocols. For example, one
employee engagement, when working well, were largely the of the respondents stated that, in case of employee engage-
same as those believed to decrease (or that could decrease) ment, ‘guidelines from the top [of the company] which are
engagement if not functioning well. Consequently, in a third not explained, and employees have not been heard of when
phase, the data collected by the two questions were treated as planning them’ (employee) had a negative effect.
one and, thus, combined. In the fourth phase, the data were A supportive culture, in terms of showing concern for
further condensed. This procedure yielded 26 categories of employee well-being, encouraging them and showing
employee engagement antecedents, which are presented in positive regard for employees, was considered crucial for
Table 2. employee engagement. As one employee emphasised feeling
In the fifth and the last phase of the analysis, in the spirit valued: ‘It is important to feel that one’s work is important’.
of abductive reasoning (Dubois and Gadde 2002; Kovácks Furthermore, in a big company, the employees felt it neces-
and Spens 2005), the 26 categories were reviewed in light sary to feel appreciated, and not just one of thousand. As
of the theoretical categorisation presented in Table 1. The one employee described, companies were ‘treating person-
themes were incorporated into Table 1’s seven wider theo- nel (professionals) as conveyor belt workers… Not trusting
retical themes to further abstract the empirical findings. In them [decreases employee engagement]’ (employee).
order to increase reliability of analysis, the authors discussed Further, the respondents emphasised fairness and equal-
the findings (see Patton 2002). The authors noted that, of 26 ity among both employees and supervisors. They indicated
empirical categories, one category—namely, physical envi- the importance of management being interested in employ-
ronment—did not fit any of the theoretical categories, as ees’ well-being and being aware of how individuals are
the theoretical category of “working environment” (Anitha doing in ways other than those based on numbers. In fact,
2014) did not include elements of the physical environment. the respondents mentioned the management’s concentration
Thus, this category is presented separately among the eight on monitoring the number of patients and resulting profits
categories discussed more closely in the following section. as problematic. Conflicts were considered likely to occur if
companies did not live the brands they promoted. As one
employee pointed out: ‘As we are advertising ‘“A healthy
Empirical Findings employee does his/her work better”, could X [case com-
pany] itself set an example of this?’ (employee).
This section describes how healthcare professionals describe Further, respondents mentioned that relocating person-
the antecedents of employee engagement. Table 2 presents nel from one unit to another and continuous staff reduc-
these antecedents in detail, along with their connection to tion negotiations created uncertainty and caused the best
the theoretical framework of this study. The connection employees to switch to other companies. Moreover, employ-
between the antecedents of employee engagement and ele- ers should have a good understanding of the requirements of
ments of internal branding will be discussed further in the the work. For example, they should arrange enough time to
Discussion section. conduct the paperwork. Some of the respondents mentioned
continuous changes and changes in rules concerning work
Organisational Culture practices as negatively impacting engagement.

The data showed that organisational culture was perceived Reward

as important for employee engagement. While organisa-
tional culture was reflected either explicitly or implicitly Not surprisingly, salary level was considered remarkably
from numerous different perspectives, it was particularly important for engagement by numerous employees. Salary
Table 2  Comparison of the antecedents of employee engagement and the elements of internal branding augmented with empirical data from healthcare professionals
Antecedents of employee engagement Empirical findings of antecedents of employee engagement Elements of internal branding

Organisational culture
Supportive culture (Beattie and Waterhouse 2015) Management culture, leadership skills, change management, lis- Supportive corporate culture (Saleem and Iglesias 2016)
Feeling valued and having a voice (Beattie and Waterhouse 2015) tening, feedback, regard, thanking, fairness, ways of monitoring
Perceived fairness (Maslach et al. 2001) one’s performance, “invisible work”
Equality (Beattie and Waterhouse 2015) Duration of one’s contract, certainty of continuity, secure jobs,
sufficiency of patients of practitioners, certainty of one’s
income, staff turnover
Respect, appreciation
Fairness, equality
Flexibility
Reward
Rewards and recognition (Maslach et al. 2001) Salary, income Reward (Lee et al. 2014)
Reward (Rana 2015) Reward
Reward (Beattie and Waterhouse 2015)
Rent percent (for practitioners)
Compensation programme (Anitha 2014)
Occupational healthcare, the way in which eating at workplace is
arranged, luncheon vouchers, coffee, parking
Working environment
Working environment (Anitha 2014) Cooperation, work community, support from work community, Internal brand community (Saleem and Iglesias 2016)
Employee Engagement and Internal Branding: Two Sides of the Same Coin?

Team and co-worker relationships sense of community, multi-professional cooperation, support

(Anitha 2014) from other staff, sharing know-how, number and quality of
Workplace environment (Rana et al. 2014) assisting staff, “internal customership”
Supervisor and co-worker relationships (Rana et al. 2014) Workplace climate
Community and social support (Maslach et al. 2001)
Teamwork and supportive colleagues (Beattie and Waterhouse
2015)
Positive work environment (Lee et al. 2014)
Training
Training and career development (Anitha 2014) Orientation, training, mentoring, possibilities to develop, develop- Training (Punjaisri and Wilson 2011)
Learning (Beattie and Waterhouse 2015) ing of skills, career advancement, career paths Training (Lee et al. 2014)
Table 2  (continued)
Antecedents of employee engagement Empirical findings of antecedents of employee engagement Elements of internal branding

HR practices
Human resource development practices (Rana et al. 2014) Human resources Brand-centred human resource management (Saleem
Supporting health and wellbeing (Beattie and Waterhouse 2015) Balance of work and leisure time and Iglesias 2016)
Work well-being
Possibilities to influence one’s working times and holidays to meet
the needs of one’s family life, flexible working hours, own health
Location, distance from one’s family
Content of one’s work, possibilities to influence one’s tasks,
autonomy, ability to engage in high-quality patients’ care, one’s
work, meaningfulness of one’s work, challenges
Invoicing, secretary services, support services, booking of
appointments
IT and electronical services
Instructions/guidelines, processes
Reputation and values
Values (Maslach et al. 2001) Organisational reputation, corporate brand Brand ideologies (Saleem and Iglesias 2016)
Ethics in operations, ethical payment of taxes, honesty, meeting Brand leadership (Saleem and Iglesias 2016)
of organisation’s and one’s own values, goals, ability to work in
accordance with one’s professional ethics
Quality of patient care, expertise
Communication
Information (Rana 2015) Communication, openness, interaction, sharing of knowledge Internal brand communication
Knowledge (Rana 2015) (Saleem and Iglesias 2016)
Communication (Beattie and Waterhouse 2015) Internal communication (Lee et al. 2014)
Internal communication (Punjaisri and Wilson 2011)
Physical environment
Equipment, instruments, working spaces, breakrooms, inside air/
air conditioning, ergonomics, the quality of laboratory services,
location, traffic connections
K. Suomi et al.
Employee Engagement and Internal Branding: Two Sides of the Same Coin?

was discussed particularly in relation to rewards and rec- important, as the whole care chain aimed to achieve what
ognition for high work requirements, as the extract below was best for patients and customer firms of occupational
demonstrates: healthcare. Further, working in a community was deemed
as one reason for practitioners to work simultaneously in
Better salary [would increase engagement] because
the public sector: In the public sector, one gets more support
the job description is more demanding here than in
from colleagues, as there are almost always other physicians
the public sector, and even with increments included,
available in both the same and other medical specialties. The
I get the same as I would get in the public sector.
importance of a positive work environment and supportive
Why would I continue working here and doing more
colleagues was illustrated in the following extract:
demanding tasks, when I could do easier work in the
public sector and get the same salary or sometimes Respect for all areas of [healthcare] work and seam-
even more?…Particularly when the employer pres- less collaboration in multi-professional work envi-
sures all the time towards even more efficient work ronment [effect positively in employee engagement].
and tasks that do not relate to my work. (employee) (employee)
In addition to salary level, respondents mentioned that they Respondents mentioned a feeling of inequality as decreas-
would appreciate rewards based on experience, education ing engagement in terms of both supervisor and co-worker
and other achievements. Indeed, with respect to compensa- relationships. They saw inequalities between both manage-
tion programmes, respondents felt that employees should be ment and staff and physicians and nurses. In addition, some
rewarded for good work input and special skills. practitioners mentioned the importance of an equal division
Practitioners mentioned the rent percent of the infrastruc- of customers among specialists in the same branch of medi-
ture and the quality of the services it covers as crucial for cine. In contrast, ‘too many practitioners, and no one has
their engagement. Rent percent is the percentage practition- sufficient number of patients’ (practitioner) was regarded as
ers pay a company to have their doctor’s appointments on the having negative impact on engagement.
company’s premises and to use the company’s facilities in However, the employees faced the opposite challenge.
terms of equipment, treatment rooms and support services. They emphasised the importance of assigning sufficient staff
The organisation’s current percent was considered rather to shifts to avoid an overload of work. Furthermore, employ-
high. According to respondents, increasing rent would have ees hoped that management and employers would be equally
a negative impact on engagement. Rent percent was dis- flexible. They also mentioned haste as negatively impacting
cussed by numerous respondents who were physicians and engagement, particularly as healthcare work requires special
practitioners at the company. The practitioner’s obligation to accuracy.
follow the level of customer fees determined by the employer
company was also mentioned as negatively impacting prac- Training
titioners’ engagement. Just as employees discussed desires
related to their salaries, practitioners discussed their incomes Training and career development were considered impor-
in terms of a confidence in attracting a sufficient number of tant for increasing engagement. The respondents mentioned
clients to ensure a stable income. the importance of continuous development and learning to
retain professional skills and develop new skills. Possibilities
Working Environment for career development were also emphasised. The respond-
ents also highlighted the importance of new employees’ ori-
Working environment and cooperation were considered entation and training. As one practitioner pointed out:
important for employee engagement. In a multi-professional
environment, good team and co-worker relationships were I would appreciate possibilities for young general prac-
emphasised. Warm and friendly atmosphere and support titioners to consult more experienced colleagues. For
from colleagues were considered important for working example, in Y [competitor’s name], there are named
environment and, thus, for engagement. Patient care was tutor-physicians, who one can call to. (practitioner)
seen as involving cooperation, such that a multi-professional
team should support one another and collaborate seamlessly Human Resource Practices
to support a patient’s well-being. Thus, a sense of community
and social support was deemed important. Particularly, prac- As a broad category of human resource practices, issues
titioners emphasised the number and quality of support staff. regarding work-life balance, working tasks and support func-
In this context, a good spirit of internal customership, a clear tions were defined. Indeed, balancing work and other areas
division of labour and mutual appreciation were considered of life was believed to enhance employee engagement. Work-
important. A competent community was also considered life balance and well-being were reflected in employers’
 K. Suomi et al.

practices to enhance employees’ abilities to influence their Thus, the implementation of external brand communication
working times and hours to fit their schedules: ‘An employee raised concerns regarding the ethics of brand ideology.
who feels good shares positivity around him/her and thus Some of the respondents mentioned the organisation’s
it is nice to work with this kind of person’ (practitioner). reputation as important for their engagement. Respondents
Indeed, supporting health was reflected in one’s ability to discussed their relationship with the organisation’s reputa-
engage in his/her work. tion and brand from different perspectives:
With respect to employee engagement, the content of
A bad brand, too obvious pursuit for economic ben-
one’s work—namely, the ‘ability to focus as much as pos-
efit [decreases employee engagement]. Although we
sible to basic task [of a physician]’ (practitioner) and having
all aim at it, a company must stand on ethically solid
an interesting and meaningful work—was considered very
ground and we, as employees, should be encouraged
important by the healthcare professionals surveyed in this
towards that. (practitioner)
study. Respondents highlighted possibilities to work inde-
pendently, have autonomy and schedule one’s own calendar. A willingness to care about the organisation’s reputa-
They also mentioned the ability to engage in high-quality tion and service promises weakens, if we as employees
patient care, so that ‘service would be as effective and high- are not taken care of. (employee)
class as possible’ (practitioner), as enhancing engagement.
Support functions were discussed in terms of invoicing Communication
and secretary services. The respondents mentioned flu-
ency of practicalities in terms of appointment bookings Numerous respondents felt that, in the studied organisation,
and workable IT software. The respondents described elec- internal communication was inadequate and sometimes even
tronic patient records or other practical matters not work- contradictory. According to respondents, this negatively
ing as frustrating and, thus, hindering patient care. Further, impacted engagement. Respondents felt that ‘enhancing the
practitioners mentioned the promptness and accuracy of the information flow, in particular in relation to one’s own work-
rendering of accounts. The importance of support functions place’ (practitioner) would support employee engagement.
in increasing engagement is illustrated below: An additional problem was that respondents lacked time to
read and internalise the information. As a consequence, it
Developing of fluency of all such support functions
was considered ‘embarrassing that customers sometimes
which enable a physician’s concentration on diag-
know more about what is happening in this house than your-
nostics of a patient’s symptoms, and care and sets the
self’ (practitioner).
physician free from tasks related to statistics, and con-
Sometimes, the internal communication was considered
tinuously increasing ‘electronic paper works’… Many
contradictory, as the following extract illustrated: ‘There is
things could be allocated to support personnel. In my
communication, like: “do your job in entrepreneurial way”,
opinion, I don’t get enough value for the rent that I pay.
but at the same time our calendars are controlled in ‘fear’
(practitioner)
that someone has too long lunch breaks’ (practitioner). This,
according to respondents, negatively impacted engagement.
Finally, the respondents did not find all external brand
Reputation and Values
communication appealing and comprehensible. As one prac-
titioner stated: ‘[the company has] absurd health-illness
The respondents highly appreciated the possibility to work in
claims in advertising’.
accordance with their professional values and ethics and that
practices were generally ethically acceptable. Indeed, health-
Physical Environment
care professionals considered themselves primarily profes-
sionals and not ‘salesmen’. The respondents mentioned that
The respondents discussed physical environment actively,
they did not like an excessive marketing orientation, in terms
particularly in terms of the quality and modernity of the
of an open and hard pursuit of profits. As examples of this,
medical equipment. Physical environment was related to
the respondents mentioned high office fees and expensive
keeping up with competition between other players in pri-
laboratories, which could increase patient costs to an almost
vate healthcare sector and ensuring high-quality healthcare.
‘unbearable level’.
Respondents in the group of practitioners directly related
Some of the respondents mentioned the problem of bal-
their requirements concerning the quality of equipment and
ancing customer satisfaction and high-quality patient care.
instruments to their rent percent, speaking in terms of ‘value
The goal of 100% customer satisfaction was considered
for money’. Their answers mentioned high-quality equip-
unreasonable and even unethical in healthcare, although
ment (e.g. for ultrasound and blood sampling). Function-
this sentence was used as slogan on the company’s website.
ality and speed of laboratory and x-ray devices were also
Employee Engagement and Internal Branding: Two Sides of the Same Coin?

highlighted, as were possibilities to order a diverse variety were found: organisational culture, reward, working environ-
of medical examinations. Respondents mentioned adequate ment, training, HR practices, reputation and values and com-
instruments in treatment rooms and clear responsibilities for munication. These same categories were discovered from
maintenance as important issues to increase engagement. the internal branding literature, though described as ele-
Furthermore, cleanness and spacious treatment rooms were ments. Furthermore, the connections were verified through
mentioned by both employees and practitioners. The possi- empirical data. In addition, based on the empirical analy-
bility to organise the working space and select instruments sis, physical environment is suggested as an antecedent of
was mentioned as enhancing engagement, and impractical employee engagement. The way in which healthcare profes-
facilities and poor equipment were mentioned as decreasing sionals described the antecedents of employee engagement
engagement, as illustrated below: also reflected the elements of internal branding, which in
this paper was defined as a strategic approach (e.g. Saleem
In my profession, one of the most important things
and Iglesias 2016) Although earlier literature has implicitly
is the quality of equipment and staying in ‘compe-
touched on these connections (Aggerholm et al. 2011; Lee
tition’ [with regard to competitors]. In this medical
et al. 2014; Davies et al. 2018), explicit reference to them
specialty, development ahead is crucial, and, at this
is novel, showing that interdisciplinary research in this field
time, for example, the equipment for mammography is
enhances both literatures, employee engagement and inter-
hopelessly out of date. I can’t really recommend it for
nal branding, and provides a more holistic view to the joint
customers. Today, customers inquire about the age of
phenomenon under examination.
equipment, for example, when they book an appoint-
In general, the eight antecedent factors identified in this
ment and, of course, they will choose a company with
study support the view of Lee et al. (2014), who argued
newer and more modern equipment. (employee)
that internal branding aims to change employees at the cog-
Some of the respondents also mentioned the location of the nitive and behavioural levels. However, their perspective
workplace and traffic connections as important for employee views employees as somewhat passive targets of internal
engagement. branding activities. By contrast, in line with Saleem and
Iglesias (2016), we suggest that implementing a combination
of internal branding elements is a strategic action that may
Discussion enable employees to co-create the company’s brand value,
which is linked, for example, to the increasing meaningful-
Theoretical Implications ness of their work. Furthermore, our study discourages the
view of identified factors solely as separate antecedents of
This study examined the link between employee engagement employee engagement or tools of HRM (c.f. Maslach et al.
and internal branding to address the following research ques- 2001; Saks 2006) because they are linked to strategic actions
tion: How are employee engagement and internal branding in the intersection of HR and brand management. Accord-
conceptually linked? In addition, the study sought to under- ingly, our study implies that pursuing a holistic (i.e. brand-
stand which antecedent factors healthcare professionals con- centred) approach to HR and leadership nurtures employee
sidered important for employee engagement. Consequently, engagement. Paying attention to both sides of the coin
the study adds to the scarce literature on the intersection of enables a more detailed understanding of the antecedents
employee engagement and internal branding, particularly in of employee engagement and provides a way to enhance
the context of healthcare services (e.g. Gapp and Merrilees employee engagement. Our study extends the findings of, for
2006; Heilmann 2010; Hytti et al. 2015; Lowe 2012). Three example, Saleem and Iglesias (2016) and Lee et al. (2014)
theoretical contributions of the study are discussed below. by suggesting that these two sides of the same coin comple-
As the first theoretical contribution, this study points out ment each other: employee engagement entails a nuanced
the connections between the concepts of employee engage- and employee-centred approach, whereas internal branding
ment and internal branding and suggests that the anteced- ultimately embraces customer and stakeholder orientation
ents of employee engagement are also elements of internal while considering internal activities, directly or indirectly,
branding. This connection is confirmed by both the literature that also affect external relationships. Furthermore, we sug-
review and our analysis of the empirical data. In line with gest that internal branding has nuances according to which
Lee et al. (2014), who argued that internal branding should the brand either becomes more or less salient, through
precede employee engagement, our findings indicate that organisational management.
internal branding enhances employee engagement, and a In line with some earlier studies (Schaufeli 2013), this
lack of it may lead to contradictions and may negatively study shows that employee engagement is a context-bound
affect engagement. On the basis of the literature, seven cat- phenomenon: In professional services, certain anteced-
egories representing antecedents of employee engagement ent factors of employee engagement, such as physical
 K. Suomi et al.

environment, may be context-specific, and engagement that this group is a challenging target for internal branding
may be based on employees’ roles. As its second theoretical and, thus, employee engagement. Our study challenges the
contribution, this study adds to the employee engagement existing literature concerning employees’ internalisation
literature by suggesting that the eight identified antecedents of a brand (e.g. Ind 2004), asking whether it is possible for
of employee engagement are particularly important for pro- a practitioner to ‘live the brand’ and become a true ‘brand
fessionals in healthcare organisations. Some of these factors ambassador’, even with effective internal branding, if he/
reflect special features of the healthcare context. In the fol- she works for two or more organisations at the same time.
lowing, as an example, reputation and values and physical In so doing, this study extends the very rare literature on
environment are briefly discussed. the multi-employer perspective, particularly with regard to
With regard to reputation and values, professionals stated internal branding (or internalisation of a brand), but also
that their engagement would decrease notably if they were with regard to employee engagement. In addition, patients
expected, for example, to prescribe antibiotics without tend to create relationships with healthcare professionals
medical justification, based solely on a customer’s wishes. in person, not with the company. Our results indicate that
Thus, our study confirms the findings of earlier literature the best-known practitioners may even be regarded as per-
(e.g. Reay and Hinings 2009; Kippist and Fitzgerald 2009; sonal brands themselves, supporting findings from other
Noordegraaf 2011; Croft et al. 2014) that medical profes- fields (e.g. Blackston 2000). Interestingly, the results of
sionals typically have a strong indoctrination-based sense this study indicate that physicians, particularly those who
of what is ethical and justifiable. Accordingly, it is crucial are working as independent practitioners, may engage
for companies operating in the private sector to enable pro- more with the professional brand (i.e. the brand of their
fessionals to apply a logic they respect and to allow them profession) than with the corporate brand of their health-
to follow their core values. Preventing them from applying care organisation. This implies that in fields with strong
their professional logic is likely to cause conflict. professionalism, professional identity plays an important
Furthermore, our results indicate that the physical envi- role with regard to employee engagement and internal
ronment is an antecedent of employee engagement. This branding activities.
antecedent may be context-specific and particularly impor- Furthermore, with regard to employee engagement,
tant in healthcare. Although the reviewed literature did not when comparing employees and practitioners, this study
emphasise it, the physical environment was particularly suggests that employees are more critical of their employer
emphasised by practitioners, as reflected in terms of their but that practitioners may actually be less engaged. The
discussions of obtaining value for the rent paid, keeping study provides an opportunity to discuss whether vari-
up with the competition and ensuring high-quality patient ous groups of personnel differ in terms of the factors
care. The relationship between physical environment and that increase or decrease their engagement. Differences
employee engagement has been discussed in the prior aca- are understandable when considering employees’ and
demic literature, for example, in architectural science, con- practitioners’ organisational roles and tasks. Although
centrating on green offices (McCunn and Gifford 2012). Fur- the above-mentioned antecedents are important for both
ther, in the retailing context, there are studies concentrating employees and practitioners, there are some dissimilari-
on store design (e.g. Johnson et al. 2014), and the literature ties, as we have seen.
on service management pays attention to “servicescape” With regard to the connections between internal branding
(e.g. Harris and Ezeh 2008), but these studies concentrate on and employee engagement, our results suggest that brand
physical environment’s effects on customers, not employees. management with too much of a focus on external stakehold-
Thus, our study adds understanding on the importance of ers may be harmful to employee engagement, and that it is
physical environment in employee engagement, highlighting important for internal stakeholders to find brand commu-
its particular importance in healthcare sector. nication appealing and comprehensible (see also Burmann
As the third theoretical contribution, this study adds to and Zeplin 2005). This finding is in line with Machtiger
the rare intersection of literatures on employee engage- (2004, p. 21), who described this challenge thus: ‘While
ment and internal branding, particularly in the context of external marketing becomes more intricate, segmented and
healthcare services. Because both the employees and prac- targeted, internal communications too often remain a blunt
titioners (entrepreneurs) worked for the same company, the instrument’. Furthermore, our results imply that highlighting
studied case is interesting with regard to internal branding. potential employees but dismissing current employees may
As a special contextual feature, practitioners, specifically damage employee engagement. This finding crystallises the
those who are physicians, usually represent more than one importance of a strategic approach to internal branding (see
employer and healthcare brand simultaneously, because Saleem and Iglesias 2016) to support internal stakeholders
they often work both in public healthcare and for com- in their engagement and to encourage them to participate
peting private sector organisations. The results indicate and to co-create and deliver the brand value of the company.
Employee Engagement and Internal Branding: Two Sides of the Same Coin?

Managerial Implications Our findings indicate that representatives of healthcare

professionals should be involved in designing marketing
On the basis of this study, we suggest that managers should campaigns during the early stages of planning, as in devel-
consider both employee engagement, that is, the HR man- opment projects in general. Marketing campaigns typically
agement perspective, and internal branding, that is, the stra- remain uninternalised for employees if their representatives
tegic brand management perspective, for both to work in the have not been involved in planning and if the employees
organisation. have not been educated about the campaigns’ aims. When
Our results indicate that internal branding should be decisions are made regarding, for example, advertising, it is
carefully considered in healthcare organisations because important to ensure that they are communicated in a timely
the healthcare field seems to face challenges in terms of the manner to every employee. Furthermore, managers should
division between employees and practitioners, on the one pay attention to the alignment of internal and external com-
hand, and between physicians and other groups of healthcare munication (see also Reed 1998).
professionals, on the other. The current data indicate that, in the case of a private
With respect to employee engagement, employees and healthcare organisation, physicians—particularly those who
practitioners may have different needs. For example, our data are practitioners working entrepreneurially and paying rent
revealed that whereas employees complained about urgency to the company—may believe themselves to be considered
and too many patients, practitioners were concerned about internal customers by nurses and other staff. On the other
sufficient number of patients and adequate earning levels. hand, this seems to cause assistant personnel to feel unequal
It would be beneficial for managers in the healthcare sec- in relation to the physicians. In such situations, role-based
tor to pay extra attention to the planning of internal brand- engagement management might help to handle confronta-
ing for personnel who work for more than one healthcare tions. Motivating career paths were considered important by
employer at the same time and who thus represent more the healthcare professionals in this study. However, caution
than one employer brand simultaneously. In particular, it is in job advertisements is necessary to avoid promising too
important to educate these people about the distinguishing much; otherwise, new recruits may have overly optimistic
features of the healthcare brand in question. With regard expectations of their career paths, which could lead to disap-
to internal communication, in a multi-professional environ- pointment and frustration later.
ment, the targeting of internal communication plans should With regard to HR practices, if an organisation wishes
be considered carefully (see also Welch 2011). Healthcare to pay attention to individualised employee engagement,
professionals may become frustrated if they receive numer- low-level managers should be aware of the ways in which
ous messages that are not relevant to their own unit or pro- they can influence employees’ personal-level engagement.
fession. Furthermore, healthcare professionals should seek Development discussions, for example, could provide a plat-
clear and open communication. Welch (2011) has suggested form to discuss issues that enhance or prohibit engagement
that it would be useful to plan internal communications at a personal level; such discussions require education and
according to the varying levels of employee engagement. alertness among managers, however. In addition, allowing
However, our results indicate that an even bigger challenge employees and practitioners to plan their working spaces and
than targeting is ensuring that the necessary information is tools could enhance employee engagement.
communicated to everyone. The healthcare professionals
in this study expressed their disappointment at the lack of Limitations and Future Studies
internal communication and mentioned the importance of
feeling informed about what was happening in the work- The context of this study was one private healthcare organi-
place. For example, a lack of information about activities sation in one European country. Thus, it would be useful
related to decreasing personnel may launch rumours, which to examine the relationship between employee engagement
could negatively affect employee engagement. Furthermore, and internal branding in other companies and countries, as
the employees in our study indicated that it is important different companies and national healthcare systems may
to feel that one’s work is meaningful and to feel valued in offer additional knowledge on the topic. Further, studying
workplace in order to be engaged. Bearing in mind Kahn’s the topic in the context of public healthcare might provide
(1990) idea that engaged employees feel obligated to inte- an additional understanding of this complex phenomenon.
grate themselves deeply into their role performance, we Extending the study to perceptions of potential employees
argue that internal branding could be employed to commu- should also yield beneficial information for both academ-
nicate with professionals about the value and relevance of ics and practitioners on developing practices of employer
their work for both the organisation and customers, thereby branding (see e.g. Foster et al. 2010) and aligning them with
influencing employees’ engagement and performance (see those of internal branding. Including more specifically the
also Robertson and Cooper 2010). physical environment’s role in further studies on employee
 K. Suomi et al.

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corporate branding and customer orientation. Journal of Business toral researcher at the Pori Unit of Turku School of Economics at the
Research 63 (11): 1164–1171. University of Turku, Finland. Previously she has worked as a clinical
Wollard, K.K., and B. Shuck. 2011. Antecedents to employee engage- nurse specialist in University hospital of Turku and done research and
ment: A structured review of the literature. Advances in develop- development projects related to health service processes and health pro-
ing human resources 13 (4): 429–446. motion. Her academic research interests include, for example, organisa-
Zeithaml, V.A., M.J. Bitner, and D.D. Gremler. 2012. Services market- tion of health and social services, service architecture and institutional
ing: Integrating customer focus across the firm, 6th ed. New York: logics. She has published in journals such as International Journal of
McGraw-Hill Irwin. Operations and Production Management.

Publisher’s Note Springer Nature remains neutral with regard to Tomi J. Kallio is Professor of Management and Organization at the Pori
jurisdictional claims in published maps and institutional affiliations. Unit of Turku School of Economics at the University of Turku, Finland.
He holds PhDs both in Administrative Science (University of Tampere,
Finland) and in Business Economics (University of Turku, Finland).
His research and teaching interests include organisational theory, per-
Kati Suomi, D.Sc. (Econ. & Bus. Adm.) works as a lecturer in Market- formance management, knowledge-intensive organisations and research
ing at the Pori Unit of Turku School of Economics at the University methodology. He has published in journals such as Human Relations,
of Turku, Finland. Her research interests include reputation manage- International Journal of Operations and Production Management,
ment, branding, word-of-mouth and value co-creation in the service Studies in Higher Education, Policy Studies, Facilities, Journal of
contexts, particularly higher education, healthcare and cultural events. Business Ethics and Culture and Organization.
Her research has been published in the Journal of Business Research
and Tourism Management, among others. Terhi Tevameri (D.Sc. Econ. & Bus. Adm., RN) works currently as a
branch manager in social and healthcare services at the Centre for
Saila Saraniemi, D.Sc. (Econ. & Bus. Adm.) is a senior lecturer in Mar- Economic Development, Transport and the Environment. Previously
keting at the Oulu Business School, University of Oulu, Finland. Her and during conducting this study, she worked at the Pori Unit of Turku
research interests include service, corporate and b2b branding, digital School of Economics at the University of Turku, Finland. Her research
value creation, and business networks. She has published in the Journal interests include, for instance, organisation theory and health care
of Brand Management, Journal of Product and Brand Management, organisations.