Improving long-term care provision: towards demand-based care by means of modularity

<p>Abstract</p> <p>Background</p> <p>As in most fields of health care, societal and political changes encourage suppliers of long-term care to put their clients at the center of care and service provision and become more responsive towards client needs and requirements. However, the diverse, multiple and dynamic nature of demand for long-term care complicates the movement towards demand-based care provision. This paper aims to advance long-term care practice and, to that end, examines the application of modularity. This concept is recognized in a wide range of product and service settings for its ability to design demand-based products and processes.</p> <p>Methods</p> <p>Starting from the basic dimensions of modularity, we use qualitative research to explore the use and application of modularity principles in the current working practices and processes of four organizations in the field of long-term care for the elderly. In-depth semi-structured interviews were conducted with 38 key informants and triangulated with document research and observation. Data was analyzed thematically by means of coding and subsequent exploration of patterns. Data analysis was facilitated by qualitative analysis software.</p> <p>Results</p> <p>Our data suggest that a modular setup of supply is employed in the arrangement of care and service supply and assists providers of long-term care in providing their clients with choice options and variation. In addition, modularization of the needs assessment and package specification process allows the case organizations to manage client involvement but still provide customized packages of care and services.</p> <p>Conclusion</p> <p>The adequate setup of an organization's supply and its specification phase activities are indispensible for long-term care providers who aim to do better in terms of quality and efficiency. Moreover, long-term care providers could benefit from joint provision of care and services by means of modular working teams. Based upon our findings, we are able to elaborate on how to further enable demand-based provision of long-term care by means of modularity.</p

Reducing avoidable visual impairment in elderly home healthcare patients by basic ophthalmologic screening

Contains fulltext : 203604.pdf (publisher's version ) (Open Access

Applying operations management in client-oriented and cost-efficient provision of care, welfare and housing services

PURPOSE: In all Western countries, ageing populations cause the demand for elderly care services to increase dramatically. In addition, elderly clients are getting more demanding about the services they require to fulfil their widely varying and multiple needs. Besides, cost reductions have been the focus of governmental policies and organisational practices for many years. Health care providers increasingly see operations management as a promising approach to align both client-orientation and cost-efficiency in their day-to-day practices. THEORY: The paper starts from operations management literature on front office—back office design and modular production. Organisations have several options for deciding which activities need to be performed by FO, BO, or the client himself, and in deciding which employees need to perform these activities. By applying modular production, organisations can differentiate care and related services to a high degree without major cost increases. METHOD: A literature review will be presented leading to a theoretical framework. This formed the basis for explorative case studies in the elderly care sector. RESULTS AND CONCLUSIONS: It will be argued how insights provided with the framework may enhance a client-orientation in integrated care delivery without major cost increases. Although case studies need to be interpreted with caution, interesting implications for organisational structures and inter-organisational cooperation can be seen. We will discuss how combined supply of care services can be made transparent to enhance choice options in service products, and what is required at the level of professionals for providing care and service packages based on client demand

Het alternatief voor de zorg.: Humaniteit boven bureaucratie

Critique of Dutch healthcare system and policy and proposal for an alternative

The human dimension of modular care provision: Opportunities for personalization and customization

Various behavioral issues are at stake in the health care sector, for example, the current strong plea for more demand-based care provision as opposed to traditional supply-driven approaches. Healthcare organizations are increasingly in need of systems and approaches that allow them to be more responsive to the needs and desires of their clients. To cope with heterogeneous and multiple demands, the application of modularity is increasingly proposed in care and services. In this paper the purpose is to study how interpersonal behavior responsive to client needs and values can be accommodated in modular care provision. Drawing on relevant literature from various service-related disciplines, we develop insight into how customization and personalization are simultaneously practiced by means of case research in the context of long-term care for elder people. Our empirics indicate that in care for elder people, personalization complements customization in adapting supply to demand. Customization is used to better match the needs of an individual customer in terms of the content of the service. Personalization is also used for this purpose, however, by adapting the way in which the service is provided. Moreover, the practice of personalization effectuates customization over time. The paper shows the importance of human behavior in the application of modularity in long term care for elder people. Approaching the issue of adaptation through the lens of modularity offers care providers insight into how customization and personalization are related. These insights can be used for the design of care delivery systems that enable comprehensive adaptation of supply to heterogeneous customer demands over time

Modular care and service packages for independently living elderly

Purpose – The purpose of this paper is to show how modularity manifests in a service context, more specifically in the provision of care and services to independently living elderly. Design/methodology/approach – Four case studies provide insight into the specification of relevant components and their subsequent assembly into a customized package of care and services. Findings – In all cases, component specification and package construction take place in two phases: partly before and partly during care delivery. Early client involvement allows for a combination of standard components that have a lower level of customization, whereas late client involvement allows for adaptation of these components resulting in a higher level of customization. The paper proposes that modularity theory should distinguish between the creation of modular offerings in care provision versus their creation in goods production, since the findings are the exact reverse of the state‐of‐the art knowledge in manufacturing modularity. Research limitations/implications – The empirical part of this paper is limited to providers of elderly care and services in The Netherlands and is exploratory in nature. However, the newness of care and service modularity justifies the exploratory research approach. Practical implications – This paper offers elderly care organizations in‐depth understanding of their complex and multi‐faceted specification process. The insights help both care and service providers to make well‐considered decisions as to what level of client involvement to allow and the type of modularity to apply. Originality/value – This paper contributes to the emerging literature on service modularity