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in several industries, such as automotives. We believe that modularization is equally
applicable in care and service provision to independently living elderly. However,
because the context of care and related services differs from an industrial context,
an adaptation of the concept is necessary. Furthermore, case research is particularly
appropriate for areas where research and theory are in their formative stages (Bensabat
et al., 1987). Therefore, it is an appropriate method to develop first insights into a new
phenomenon of study for which no specific hypotheses can yet be proposed.
5.4.1 Case selection
Our case study research followed the principles described by Yin (1993, 2003), Eisenhardt
(1989) and Voss et al. (2002). Purposive sampling was used for case selection to ensure
unity and comparability on some case characteristics, while enabling maximum variation
on others. Voss et al. (2002) stress the importance of control variables in case study
research. To be able to make meaningful comparisons, we selected only those companies
that have elderly people as the major part of their client base. Having the same target
population implies that all these organizations have to deal with similar issues concerning
needs assessment in many aspects of life that will influence the process of package
specification and construction. Besides, all case organizations provide their clients with
access to the three service domains that are of major importance to elderly, i.e. housing,
welfare and care. Thus, package specification and construction in all cases includes the
challenge of combining dissimilar types of services. Finally, all organizations are certified
with the care-related ISO9000 (HKZ certificate), meaning that their products and
processes are registered and implemented in an established manner. Although care comes
into existence by interaction between (at least) two people and, thus, might differ each
and every time it is provided, the certification will minimize variation among different
employees working in the same organization. This diminishes individual deviations
within one case but facilitates comparison among the case organizations.
Although all case organizations selected currently provide care and related
services
to independently living elderly, variation can be found in their historical background,
which is either in home care or institutional care. Home care organizations are used
to working in many locations; they may have as many working places as clients since
they deliver care in the homes of their clients. Traditionally, these organizations have
a service range focusing mainly on the care aspect of their client’s needs. Home care
organizations generally provide only one or a few care services to their clients who are
dispersed in the organization’s working area. Institutional care providers supply a range
of care and related services encompassing all domains of living, including welfare and
housing. Therefore, institutional organizations are used to deliver packages of care and
services to their clients. However, delivery only takes place at one single location, i.e.
Modular Care Provision
99
the premises that their clients live in collectively. Since we aim to gain insight into the
provision of packages of care and services to independently living elderly, knowledge
and experience of both types of organizations is essential for our research.
Furthermore, all organizations offer services in housing, welfare and care to their elderly
clients. However, the way in which the organizations make the various service domains
accessible varies from having all domains in-house, to different types of cooperation
with other providers. Different types of strategies might imply that entrance to the
various service types differs among the cases with respect to, e.g., the number and
types of employees needed or the time required for package specification and assembly.
Such variation might influence the way in which packages come into existence. Table
5.1 shows the particularities of each case used in the present study.
5.4.2 Data collection and analysis
To guide data collection and analysis in the field of operations management, Voss et al.
(2002) state that one should have a prior view of the general categories to be studied.
To acquire a thorough overview and understanding of the specification process, data
gathering was guided by a data collection protocol (Yin, 1989). With reference to
Eisenhardt (1989), the protocol comprised a topic list (based on our literature study)
with all research variables to be addressed concerning the specification and construction
of care and service packages and the respective questions. Topics concerned modularity
in relation to the production cycle, service and care modularity, and specifics of the
elderly care environment. Multiple sources of evidence were used for data collection to
facilitate a process of triangulation (Eisenhardt, 1989). Semi-structured interviews were
Table 5.1 Sample
of case organizations
Case K
Case R
Case T
Case V
Main client population
Elderly clients
Service range
Home care,
home nursing, welfare and domestic services
Product and process
stability
Certified with care related ISO-9000 (HKZ-certificate)
History in
Home
care and
residential care
Residential
care
Home care
Home care and
residential care
Strategy to make
all
service domains
accessible
Cooperational
agreement among
organizations
in both types of
care, welfare and
housing
All services
in-house
Initiatives for
cooperation
with organizations
in welfare and
housing
All
services in-house
M
odular car
e and ser
vic
e pack
ages f
or independen
tly
living elder
ly
Chapt
er 5