The project investigates the introduction of patient involvement in Swedish health care, i.e. ways of working where the patients are active in their own care process or in developing the prerequisites for that process. Focus is on how health care staff (nurses and physicians) relate to the new idea, how they interpret it based on their daily work practice and how they integrate it in their local organizational context. Special emphasis is placed on how the new methods challenge established conceptions, identities and logics, and thereby directly influences the working conditions for the employees. In such situations, several important questions about control, knowledge, influence and power are raised, questions of relevance not only for those working in the healthcare sector, but for service work in general. The study has a qualitative approach where staff and management in two-three care units working with patient involvement within the county of Värmland, Sweden, are interviewed. The organizational practices revealed in the interviews are analysed using relevant theories about organizational translation, resistance and the handling of conflicting work demands. The interviews are supplemented by official published material about the involvement methods, as well as information from patient interest groups and observation of working places.By highlighting the actual work of implementing patient involvement the project contributes to an enriched and nuanced understanding of what patient involvement is really about, something that hitherto has mainly been studied from an (often uncritical) patient perspective. On an general level, the project also contributes to an increased understanding of how the conditions for personnel-intensive, professional service work are shaped and reshaped through the relationship with the customer/user.