One Master and Many End Users: Coordination Practices in Managing a Portfolio of Public Service Innovation Projects

AbstractManaging a portfolio of interdependent innovation projects requires various forms of coordination. Coordination is important to mitigate risk and control resource utilization, but also to ensure that the end users experience the outcome of various innovation projects as integrated solutions to their needs. Simultaneously achieving control and user focused harmonisation in a project portfolio is not an easy task and may be hindered by organizational structures and coordination practices that focus on the internal division of labour and budgets rather than on taking a user perspective. In our case study in a public service organization we analyse the impact of the presence of one powerful stakeholder and anonymous and invisible end users on practices of coordinating a portfolio of service innovation projects

The healthcare experience : the supportive role of technology and people in the elderly care sector

Healthcare is a key sector in society as it affects everyone’s life at some point in time. At the same time, the Western world is entering a profound ‘age wave’, leading to increased demand for healthcare service and alternative living arrangements for those in need of assistance in their daily lives. As a result of the challenges in this ageing society, healthcare – particularly service providers in elderly care – have to undertake transformational changes in their core concepts, structures, strategies, and policies in order to effectively serve this customer group. Recent market research suggests that innovation and technology will play a major role enabling healthcare organizations to successfully manage the care of ageing population. Health informatics, telemedicine technologies and remote monitoring systems may provide effective means to help the elderly manage illness. In unison, such technologies potentially ease the strain that the latter put on families in particular and the healthcare system in general. Thus, technology may provide a valuable addition to support the elderly in healthcare service. Healthcare is as a high emotion service, as it often involves intense feelings even before the service commences (Berry, Davis, Wilmet, 2015). Such feelings may emanate from a lack of familiarity with the delivered service or from a lack of control over the outcome of the service (Berry et al., 2015). Therefore, it is important to understand elderly patients’ needs and to move beyond token gestures (e.g., added amenities and updated room décor) to the patient experience. This study aims to extend our present knowledge on elderly patients’ healthcare experience and the role of technology and people in improving it. The healthcare sector is a fertile area for service research given its extensive growth (Berry & Bendapudi, 2007). However, to date service and experience focused research in this domain is rather limited. This study contributes to the present body of knowledge in the service literature with the aim to provide a better understanding of how technology can support and enhance the healthcare experience for the elderly. Three research questions guide our investigation: RQ1: How can technology enhance the healthcare service experience in the elderly home care context? RQ2: What is the role of other involved actors (i.e., formal service providers such as healthcare professionals, and informal service providers, such as patients’ family members) in enhancing the healthcare service experience in the elderly home care context? RQ3: What is the role of ‘technology’ versus ‘people’ in terms of the key contributors of the healthcare service experience? What are complementarities and conflicts? This study focuses on technology adoption by the elderly; it is possible that the elderly may exhibit less technology readiness, posing a barrier to a positive service experience. However, the use of technology may provide independence and personal autonomy to the elderly (Miskelly, 2001). The service experience of elderly who utilize healthcare assistance technology in the healthcare will be examined in an elderly ambulant care setting in Flanders, Belgium. Flemish ambulant care refers to home care and home nursing, which includes a range of services, such as personal care, housekeeping, and cleaning help. In recent years, the organizational context and complexity of care provided in home nursing has changed. Integrated services for home care are available and home nurses participate in shared care in collaboration with hospitals. This study focuses on the experience of elderly patients who receive integrated services from home care and the broader service context (e.g., from patient’s family members). Specifically, the use of technological applications in this setting will be explored. Our research is structured as follows. The study commences with a detailed review and synthesis of the current literature, providing a state-of-the-art overview on the healthcare service experience and related technologies. In a second step, the role of technology in elderly care is investigated by means of a multimethod investigation, comprising expert interviews and surveys, in the elderly homecare context in Belgium. Expected contribution This paper addresses a key research priority, improving well-being through transformative service. More specifically, the role of technology-enabled services in improving the well-being for vulnerable customers, such as the elderly, is explored (Ostrom, Parasuraman et al., 2015). In particular, this paper focuses on the call for a better understanding of how technology may support the service experience and the role of emotions of other actors involved in the experience (Jaakkola, Helkkula et al., 2015). We provide managers guidance in how to consider and use technology in an elderly care setting, while taking into account technology readiness levels of the elderly. References: Berry, L. L. & Bendapudi, N. 2007. Health care a fertile field for service research. Journal of Service Research, 10(2): 111-122. Berry, L. L., Davis, S. W. & Wilmet, J. 2015. When the customer is stressed. Harvard Business Review, 93(10): 86-94. Jaakkola, E., Helkkula, A. and Aarikka-Stenroos, L. (2015), "Service experience co-creation: conceptualization, implications, and future research directions", Journal of Service Management, 26(2): 182-205. Miskelly, F.G. (2001) “Assistive technology in elderly care”, Age and Ageing, 30: 455-458. Ostrom, A. L., Parasuraman, A., Bowen, D. E., Patrício, L. and Voss, C. A. (2015), "Service Research Priorities in a Rapidly Changing Context", Journal of Service Research, 18(2): 127-159