This qualitative study analyzes an Italian hospital’s endeavor to introduce a coproduction practice and the critical factors that affect its efficacy and efficiency. The empirical evidence shows that the meaningful engagement of the patient can be achieved only by factoring in the socioorganizational conditions of all stakeholders; that no divide exists between organizational production and client coproduction, rather, it is a relationship of interdependence that in turn raises critical issues; and that formalized and effective "practices-in-use" cannot work unless there is strong managerial commitment and enforcement of the new coproduction initiative.