33
concepts, tools and techniques have been specifically developed for the field of service
operations (see, for example, Lovelock and Young, 1979, Lengnick-Hall, 1996, Meyer
Goldstein et al., 2002, Zomerdijk and De Vries, 2007). Service operations management
research has covered a wide variety of services in the profit sector, such as financial,
restaurant and airline services. Furthermore, there is a growing realization that service
operations management may be relevant to changes in public and non-profit sectors in
general (Verma et al., 2005, Verma et al., 2006) and the health care sector in particular
(e.g. Boaden et al., 2000, Hyer et al., 2003, Young et al., 2004, Bohmer, 2005). Examples
in health care settings can be found primarily in hospital care (Vissers and Beech, 2005),
in particular in the development of clinical pathways (e.g. Layton et al., 1998, Bragato
and Jacobs, 2003) and focused clinical factories (e.g. Herzlinger, 1998, Leung, 2000).
However, these examples are useful mainly for narrowly defined, homogeneous, client
groups, suffering from only one or very few ailments, thereby having a predictable
course of action in their care trajectory. Conversely, elderly clients usually have widely
varying needs and wants, requiring a package of goods and services from several fields
and specializations to support their lives.
Although literature that specifically addresses the joint provision of demand-based
care and service packages on the operational level is scarce, the application of service
operations management has shown its ability to address client-centeredness for the
non-profit sector in general. In order to meet new requirements on their demand sides,
non-profit organizations focus on increasing flexibility and producing high-quality
goods and services through the implementation of service operations management
techniques and practices. A notable example of this is the research of Schellekens
(2004) who applied concepts originating from OM in the non-profit context of higher
professional education.
The above shows the possibilities of service operations management to make the
provision of non-profit goods or services more client-centered. This makes it useful to
explore further service operations management focusing on the field of HWC service
provision to elderly people living independently. The focus of concepts that stem
from OM on the delivery of customer value might give new insights in and effective
responses to the issues faced by HWC service organizations. Furthermore, the fact
that services are different from goods and the understanding that in service provision
both product and process need to be taken into account are important starting points
for shaping demand-based care. These insights will be further explored in the next
section, where we discuss specific OM principles in order to address the operational
implications of demand-based care.
D
emand-based pr
ovision
of housing
, w
elfar
e
and car
e
Chapt
er 2
34
2.4 The client at the centre of interest on the operational
level
A number of researchers suggest that modularity is the key to providing tailor-made
products while at the same time working in a cost effective manner (Duray et al., 2000).
Modular production principles traditionally stem from a manufacturing setting and,
as such, have not been specifically developed for services. However, the attention given
to modularity in services increases (e.g. Meyer and DeTore, 2001, Bohmer, 2005), with
the aim of providing service packages that are tuned specifically to the requirements of
the individual client. In this section, we will elaborate on the OM concept of modular
production principles. Furthermore, we will argue that in services, modularity will
have to be supported by conditions that take into account the specifics of services.
2.4.1 Modular production principles
In one of the first contributions to the literature on modular production, Starr (1965)
formulates the basic idea behind modularity as “… design, develop, and produce
[…] parts which can be combined in the maximum number of ways”. The seamless
combination of parts that is referred to is allowed by the specific architecture of
modular products. A product architecture is the scheme by which the functionalities
of a product are assigned to product parts, or components (Ulrich, 1995). A modular
product architecture includes a one-to-one mapping of functional elements to physical
components (Fixson, 2005). This means that each component, independently and
separately from the other components, brings about one function of the product. The
components of a modular product are standardized, so they are always produced in the
same manner. To connect the separate, standardized components, and create a flexible
product construction, a modular product architecture uses standardized connections,
or interfaces (Sanchez
and Mahoney, 1996).
In essence, literature suggests that modular production can facilitate the enlargement
of the number of product features available, while at the same time preventing a rise in
costs (Duray et al., 2000). Since components can be easily mixed and matched through
uniform interfaces, numerous combinations can be assembled that offer increased
choice options to the organization’s clients (Salvador et al., 2002). Furthermore, the
individual components included in a product can be changed or replaced independently,
because each component has a separate function. Therefore, product distinctions can
be easily achieved through transformation or modification of components (Duray
et al., 2000). In addition, modular production principles allow variations of goods
and services to be delivered by different organizations (Ulrich, 1995, Baldwin and
Clark, 1997), which again enlarges choice options for clients. All these features make
Modular
Care Provision