Service strategy transition : product and service offerings in medical devices

This study explores how, by undertaking customer-oriented service analysis, a company follows a non-linear approach to product-service provision which is contrary to the approach advocated in the servitisation literature. The case study verifies applicability of existing service models using the example of a global manufacturer of medical products. Open-ended interviews serve as the main source of data to reveal the change opportunities for product-service provision. Study findings suggest that customer orientation is the key element causing the change in pattern; while the analysis of consumer operations provides understanding of the planned change initiatives

Sustaining Continuous Improvement in Public Sector Services Through Double Loop Learning

Abstract Purpose: Public Service Organisations (PSOs) are facing continuing funding challenges and increased pressure to maintain and improve service delivery with fewer resources. One response, with the promise of improving efficiency rather than cutting services, has been to implement Continuous Improvement (CI) but success has been sporadic and unpredictable. The well documented and pervasive CI methodologies in PSOs, including Lean and Six Sigma, have general agreement across practitioners and scholars alike, thus the reasons behind their potted success must lie elsewhere, in the culture or the environment perhaps? This work explores the wider contextual issues of CI implementation with the aim of providing guidelines to give a greater confidence of successful implementation. Study design/methodology/approach: A structured literature review provided the initial conceptual framework that was further developed through a series of in-depth, semi-structured interviews carried out with industry experts. The framework illustrates the phenomenon of organisational learning in relation to CI in UK PSOs. Findings: The research shows that emphasis should be placed on addressing logic and mindsets at an individual and organisational level in order to re-focus CI efforts and achieve sustainable process improvement. Particular attention should be placed on the role of leaders. Originality/value: This research takes a unique approach to CI in the UK PSO context, providing insights into the achievement of sustainable CI and a theoretical framework for addressing PSO logic. It establishes a theoretical foundation for the evaluation of organisational learning in relation to sustainable CI in UK PSOs. It also makes practical recommendations to support PSO to reveal, evaluate and address organisational principles through interactive workshops, which are currently being piloted in a UK health sector organisation. Research should continue to focus on the critical role of organisational learning and governing variables in relation to addressing PSO logic for sustained CI. Key words: Public Service Organisation (PSO), Continuous Improvement (CI), organisational learning, sustainment Paper Type: Research pape

An integrated safety measurement model : a new perspective for performance measurement

Performance measurement systems provide an opportunity not only to determine if organisations are effectively delivering their strategy and meeting their vision, but also to enable improvements. In 2009, the NHS implemented the NHS Performance Framework (Department of Health 2009), which has since been altered yearly in line with changing governments and policy alterations. Although originally designed to be applied to Primary Care Trusts (PCTs) from April 2010, the NHS reform, which seeks the replacement of PCTs with GP Consortia, has rendered the framework redundant in primary care (Department of Health 2010a). Since then, the NHS Outcomes Framework (Department of Health 2010b) has been published, and focuses on 5 outcome domains that are expected to show national level performance across the whole of the NHS. This high level system has failed to provide a performance picture of any individual service, of which there are many, in addition to proving reliant on outcome (lagging) indicators which have long been recognised as a poor singular method for measuring performance (Eccles and Pyburn 1992; Kaplan and Norton 1992). This study advocates service specific performance measurement and the engagement of stakeholders during the design process to develop leading and lagging indicators of value to the stakeholders. This is in particular with efforts to shift the onus onto patients to maintain health; as is true of the case management programme, which forms the case study for this research. The case management programme aims to reduce expensive hospital admissions for patients with complex long term conditions (LTCs) (Department of Health 2005). It expects to be able to achieve this by implementing a case management approach to oversee the most at risk patients, to develop an integrated care plan and to empower patients to become actively involved in their care at home. This paper will present the underlying literature that supports the development of a safety measurement model and describes the methodology used to gain validation by a key stakeholder group

Sustaining continuous improvement through double loop learning

Public Service Organisations (PSOs) are facing continuing funding challenges and increased pressure to maintain and improve service delivery with fewer resources. One response, with the promise of improving efficiency rather than cutting services, has been to implement Continuous Improvement (CI) but success has been sporadic and unpredictable. The well documented CI methodologies, notably Lean and Six Sigma, have general agreement across practitioners and scholars alike, thus the reasons behind their potted success must lie elsewhere, in the culture or the environment perhaps? This work explores the wider contextual issues of CI implementation with the aim of providing guidelines to give a greater confidence of successful implementation. A structured literature review provided the initial conceptual framework that was further developed through a series of in-depth, semi-structured interviews carried out with industry experts. This is supported by a case study with a UK health sector organisation. The research shows that emphasis should be placed on addressing logic and mindsets at an individual and organisational level in order to re-focus CI efforts and achieve sustainable process improvement culture. Particular attention should be placed on the role of leaders. This research takes a unique approach to CI in the UK PSO context, providing insights into the achievement of sustainable CI and a theoretical framework for evaluating PSO logic. It establishes a theoretical foundation for the evaluation of organisational learning in relation to sustainable CI in UK PSOs. It also makes practical recommendations to support PSO to reveal, evaluate and address organisational principles through interactive workshops and a preliminary pilot study. Research should continue to focus on the critical role of organisational learning and governing variables in relation to addressing PSO logic for sustained CI

Identifying limits of the product service system theory and the implications for innovation : international video entertainment company

Servitisation can be an attractive prospect to organisations looking to diversify, or add value to, existing products. Servitisation literature and theories of radical and sustained innovation were reviewed and six key areas of benefits of moving towards a service model were identified. Cross-case comparison was conducted over four international media entertainment companies, triangulated with an expert interview, to begin to identify limits of current trending theories in these domains and areas. One additional area of benefit was identified and areas for further research are scoped

Opportunities to improve health visiting services through lean thinking

This paper presents the findings of applying tools and techniques emerging from the manufacturing sector, commonly referred to as lean, to a service sector setting of a health visiting service. In particular, value stream mapping was employed to demonstrate the current level of waste in common tasks for the participating health visiting service. Through participatory design work a re-designed future process map was created. Concurrently, stakeholder mapping was conducted to demonstrate the multiple links to other services that needed to be considered in the future state service design. Despite quantifiable evidence collected during the study demonstrating measurable improvements that would free up resource within the organisation, which could be redirected towards providing better direct care to patients, changes were not implemented. From follow-up interviews and analysis, poor leadership and cultural issues were identified as the main barriers to implementation of improvements. Leadership support and cultural disposition are critical in the transformation process; adopting an improvement culture is critical in both manufacturing and service sectors for successful implementation of lean, but their manifestation is necessarily different in a service dominant business model as opposed to a product-dominant business model. These differences occur because the value proposition is predominantly experience based in a service-dominant model

Reconfiguring the product-service mix : servitisation strategies in medical devices

This study draws particular attention to the role of process analysis in business modelling to explore how, by undertaking customer- oriented service analysis, manufacturer of medical products follows a nonlinear path to servitisation contrary to the classic model to service provision. A structured literature review and following case study research were conducted to verify applicability of the existing product service models to a recognised leader in the production of orthopaedic implants. Semi-structured informal interviews with management and sales staff revealed the change point of product-service provision marked by evolution of both product and service components to establish more customer focused value proposition. The key element in the transition is the emerging consultancy service offering to support introduction of new products and capture critical process data for further solutions enhancement. Findings of the study indicate the need for existing servitisation concepts reconsideration

Customer centered value creation

This study explores approaches to management of value creation in complex systems and provides a basic method of determining to what extent a system is complex. In doing so it reviews approaches to value creation, the change from goods to services and implications for a business model and associated operational models. The study also examines the elements of value at the point of engagement. The concluding discussion highlights the importance of customer-centered rather than output-centered approaches to operational design and the implications which they have for both product and service offerings

UK health visiting : challenges faced during lean implementation

Purpose – The purpose of this paper is to present the challenges identified during a lean implementation in a health visiting service within a large primary care trust in NHS UK. Design/methodology/approach – Following a series of lean workshops a triangulated approach to data collection was adopted in order to determine the root cause of the challenges that were faced during this lean implementation. The three methods that were selected for qualitative analysis included semi-structured interviews, document analysis and researcher participant observation. Findings – Six key challenges were identified from the data analysis. These were: high process variability; a lack of understanding of lean; poor communication and leadership; target focused; problems defining waste; and difficulty in determining who is the customer and what do they value? Practical implications – Although this particular lean implantation had limited success, the research has highlighted a number of challenges which would have to be addressed prior to future lean exercises. This will assist other clinical and managerial staff to prepare for the challenges that may be faced during a lean implementation, and adapt their approach to future quality improvement. Originality/value – The barriers to lean implementation could be overcome with upfront planning, transformational leadership, excellent communication, identification and sharing of best practice and, above all, a shared vision. There is no quick and easy solution to productivity improvement, community services, as in this paper, cannot expect to select lean tools and techniques and emulate the success seen elsewhere. If they wish to deliver world-class healthcare in the face of constrained resources and greater demand, they need to adopt a long-term vision