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Purpose

This contribution describes the integration of netnography in critical contexts where traditional service design faces limitations, presenting the case of a neonatal intensive care unit clinical setting under COVID-19 pandemic restrictions.

Design/methodology/approach

Under tough constraints, netnographic immersion, digital surveys and remote participatory methods replaced successfully the intended ethnographic observation research. The study follows four phases: research approach, data collection, data analysis and sharing of findings.

Findings

The findings highlight the potential of netnography for service design in highly constrained environments. Digital immersion facilitated contextual understanding and iterative co-creation. This hybrid approach helps to engage stakeholders and overcome access limitations in critical ecosystems such as healthcare.

Research limitations/implications

The COVID-19 emergency prolonged the data collection process longer than expected. While work continued in 2022 and 2023, the main phase of the project was carried out under significant time pressure.

Practical implications

This study provides guidelines for applying netnography in critical service design contexts. In healthcare, the model developed can be adopted in projects devoted to improve patient-centered service design, optimize healthcare workflows and enhance collaboration between frontline professionals and decision-makers.

Social implications

The case demonstrates that digital tools can help to bridge geographical, cultural or institutional barriers. They can also facilitate participatory design processes in critical contexts.

Originality/value

Previous studies have explored ethnographic approaches in service design and netnography in digital research. This study bridges the two and offers a scalable and adaptable approach for complex, critical service environments. The study delves into the use of digital tools to develop participatory research processes.

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