37
and executor of the components need to be specified exactly in advance, and adjusted
in such a way that they can be easily combined for or by an individual client.
Furthermore, service parts may well originate from multiple providers and then be put
together into one HWC service package, thereby not only increasing choice options
but also facilitating the coupled supply of a care and service package. For elderly clients,
who often require care and services from several suppliers in various fields, this will
increase the likelihood that all their needs and wants are covered. Elaborating on the
earlier example, the client who has problems with bending and stretching might require
the functionality ‘domestic adaptations’ as well, which is provided by a different HWC
service provider. This functionality includes components such as a heightened toilet,
the removal of thresholds and supplying support rails in the shower. Furthermore,
this provider supplies other components in the functionalities ‘cleaning the house’
(such as spring-cleaning) and ‘mobility’ (such as a shared taxi service and taxi service
with care), which the client might select as well. These additional components can be
seamlessly combined in the individual care and service package because the modular
package architecture uses standardized and well-tuned connections. Together, the
combination of care and service components, which originally stem from different
providers, provides an optimal answer to this client’s requirements.
Approaching client needs and wants as an entity, as in the example, is expected to
enhance the overall outcome of the HWC service provision for the client and provide
services that are better attuned to the needs of an individual elderly client. Individual
services
can be coordinated in terms of, for example, time, place, content,
condition,
quality and price. This is likely to diminish overlap among individual HWC service
parts as well as prevent gaps in HWC service provision from occurring, thereby
enhancing continuity and complementarity of care and service provision. An additional
advantage lies in the provision of the HWC service parts as a package, instead of each
individually; this could greatly reduce the time and effort that elderly clients have to
invest in searching for and keeping contact with HWC service providers. For providers,
the package-wise provision of HWC services can also result in saving time during the
intake, since all HWC services required by an elderly client can be identified at the
same time. Furthermore, standardization of the interfaces between components would
be likely to facilitate tuning both within and among organizations.
The needs and wants of elderly clients will probably change over time, due to
deteriorating or improving health. Modularity allows for easy adaptation of the HWC
service package, because the individual components included in a package can be
changed or replaced independently. When one component is omitted or added, the
other components are not influenced by this and the package as a whole continues to
function. This allows the HWC service providers to keep the care and service package
D
emand-based pr
ovision
of housing
, w
elfar
e
and car
e
Chapt
er 2
up-to-date with relative ease so client demands will be met optimally over time.
So far, we have argued how modular production principles can help HWC service
providers to put individual elderly client demands at the centre of service provision. At
the same time, the ability to standardize components can also facilitate a cost-efficient
way of working. Furthermore, it is likely that the content of a component will appeal
to more than one client or client segment. Therefore, the conceptual design (Sousa
and Voss, 2001) of a certain care or service component can be reused, thereby yielding
economies of scale. Although the efficiency potential is not specifically attached to
demand-based care and service provision, it favors a goal of the Dutch care sector
in general. Governmental policy can be characterized by efforts to introduce more
business risks (Breedveld et al., 2006) in the care sector, thereby initiating the need for
a cost containment in care and service provision. HWC providers are even encouraged
to drive down their costs of operation (e.g. Van der Geest, 2005). In working towards
this goal, a modular set-up of components is likely to be helpful.
2.5.2 Supporting conditions for modularity in HWC provision
To make optimal use of modular production principles HWC service providers not only
need to pay attention to the composition and content of the care and service packages.
To support the application of modularity, the processes and professionals involved
in the specification of these packages need major consideration. In order to provide
demand-based care and services, the information given by the elderly client should be
the basis on which HWC service providers specify which care and service parts have
to be combined into a package. The professionals who construct the demand-based
care and service packages have to be able to retrieve client information, to translate this
information, in collaboration with the client, into concrete needs and wants, and to link
these to the care best suited and service parts available. To be able to take client needs
and wants as the starting point of care and service provision, HWC service providers
need to create a situation in which elderly clients can easily interact with professionals
and express their requirements prior to the start of care and service delivery. Front
office activities take place in direct contact with the client and offer the opportunity
for interaction between the elderly client and the professional. In a front office setting,
the elderly client therefore will have the opportunity to express his needs and wants
to the HWC professional, who in turn can compose the care and service package in
a customized or personalized manner in cooperation with the client. In front office
activities, the client can also be a co-producer, for example, by letting the client him
or herself fill out a questionnaire about required care and services. This will allow for
greater client involvement in the construction of the care and service package. During
delivery, HWC services work directly with or on elderly clients (Hasenfeld, 1983), and
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Modular
Care Provision