Vincent Peters, Mervi Vähätalo, Bert Meijboom, Alice Barendregt, Levinus Bok and Esther de Vries
This study examines how modular interfaces manifest in multi-provider contexts and how they can improve coordination and customization of services. The aim of the study is to…
Abstract
Purpose
This study examines how modular interfaces manifest in multi-provider contexts and how they can improve coordination and customization of services. The aim of the study is to describe interfaces in multi-provider contexts and elaborate on how they support the delivery of integrated patient care.
Design/methodology/approach
A qualitative, multiple case study was conducted in two multi-provider contexts in healthcare services: one representing paediatric Down syndrome care in the Netherlands and one representing home care for the elderly in Finland. Data collection involved semi-structured interviews in both contexts.
Findings
This study provides insight into several types of interfaces and their role in multi-provider contexts. Several inter- and intra-organizational situations were identified in which the delivery of integrated patient care was jeopardized. This study describes how interfaces can help to alleviate these situations.
Originality/value
This study deepens the understanding of interfaces in service modularity by describing interfaces in multi-provider contexts. The multi-provider contexts studied inspired to incorporate the inter-organizational aspect into the literature on interfaces in service modularity. This study further develops the typology for interfaces in modular services by adding a third dimension to the typology, that is, the orientation of interfaces.
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Melissa De Regge, Paul Gemmel and Bert Meijboom
Process management approaches all pursue standardization, of which evidence-based medicine (EBM) is the most common form in healthcare. While EBM addresses improvement in clinical…
Abstract
Purpose
Process management approaches all pursue standardization, of which evidence-based medicine (EBM) is the most common form in healthcare. While EBM addresses improvement in clinical performance, it is unclear whether EBM also enhances operational performance. Conversely, operational process standardization (OPS) does not necessarily yield better clinical performance. The authors have therefore looked at the relationship between clinical practise standardization (CPS) and OPS and the way in which they jointly affect operational performance. The paper aims to discuss this issue.
Design/methodology/approach
The authors conducted a comparative case study analysis of a cataract surgery treatment at five Belgium hospital sites. Data collection involved 218 h of observations of 274 cataract surgeries. Both qualitative and quantitative methods were used.
Findings
Findings suggest that CPS does not automatically lead to improved resource or throughput efficiency. This can be explained by the low level of OPS across the five units, notwithstanding CPS. The results indicate that a wide range of variables on different levels (patient, physician and organization) affect OPS.
Research limitations/implications
Considering one type of care treatment in which clinical outcome variations are small complicates translating the findings to unstructured and complex care treatments.
Originality/value
With the introduction of OPS as a complementary view of CPS, the study clearly shows the potential of OPS to support CPS in practice. Operations matters in healthcare standardization, but only when it is managed in a deliberate way on a hospital and policy level.
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Nadine Boesten, Melissa De Regge, Kristof Eeckloo, Mark Leys, Paul Gemmel and Bert R. Meijboom
Nurses are capable of acting as advocates for patients since they hold valuable knowledge on patient preferences and their psychosocial needs. Yet, in practice they tend to…
Abstract
Purpose
Nurses are capable of acting as advocates for patients since they hold valuable knowledge on patient preferences and their psychosocial needs. Yet, in practice they tend to contribute little to multidisciplinary team meetings (MDTMs). This study analyses the factors that influence whether or not nurses will speak up and increase patient-centred decision-making in MDTMs.
Design/methodology/approach
A multiple case study with cross-case comparison of twelve tumour groups across two Belgian hospitals was conducted. Data collection involved fifty structured non-participant observations and 41 semi-structured interviews with participants from the twelve tumour groups.
Originality/value
This study yields factors that increase the opportunities for nurses to speak up in MDTMs to enhance patient-centred decision-making. The findings help in the design of future interventions concerning multidisciplinary teamwork, that address nurses’ contributions to augment patient-centred care.
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Principles of supply chain management are discussed in relation to the modifications, extensions, and challenges currently prevalent in internationally operating companies. The…
Abstract
Principles of supply chain management are discussed in relation to the modifications, extensions, and challenges currently prevalent in internationally operating companies. The central issue is: How do international operations affect common SCM principles? First, insights from the literature are reviewed. Then, a case study is presented based on a company with activities that are spread all over the world and that belong to distinct stages in the supply chain. Subsequently, an evaluation is provided along the lines of the conceptual view on international supply chain management presented earlier. The paper concludes with implications for managers in international operations, as well as directions for further research.
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Hans Voordijk and Bert Meijboom
Firms in the aerospace industry face considerable pressure to improve co‐ordination in their supply chains. The major question of the present study is what supply chain…
Abstract
Purpose
Firms in the aerospace industry face considerable pressure to improve co‐ordination in their supply chains. The major question of the present study is what supply chain co‐ordination strategies are dominant in the Dutch aerospace industry given the market environment of this industry?
Design/methodology/approach
Because information is the key ingredient for coordinating the supply chain in a given problem situation, an information processing point of view is adopted. In the empirical research, supply chain co‐ordination strategies are investigated for six Dutch‐based aerospace firms with different products and technologies.
Findings
It is concluded that in terms of the framework of Galbraith, co‐ordination strategies increasing the capacity to process information dominate supply chain management in the Dutch aerospace industry. The information‐processing capacity is increased by investing in lateral relations, long‐term planning and information systems between companies involved in the same supply chain.
Originality/value
Information is provided on Dutch aerospace firms' supply chain strategies.
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Carolien de Blok, Katrien Luijkx, Bert Meijboom and Jos Schols
The purpose of this paper is to show how modularity manifests in a service context, more specifically in the provision of care and services to independently living elderly.
Abstract
Purpose
The purpose of this paper is to show how modularity manifests in a service context, more specifically in the provision of care and services to independently living elderly.
Design/methodology/approach
Four case studies provide insight into the specification of relevant components and their subsequent assembly into a customized package of care and services.
Findings
In all cases, component specification and package construction take place in two phases: partly before and partly during care delivery. Early client involvement allows for a combination of standard components that have a lower level of customization, whereas late client involvement allows for adaptation of these components resulting in a higher level of customization. The paper proposes that modularity theory should distinguish between the creation of modular offerings in care provision versus their creation in goods production, since the findings are the exact reverse of the state‐of‐the art knowledge in manufacturing modularity.
Research limitations/implications
The empirical part of this paper is limited to providers of elderly care and services in The Netherlands and is exploratory in nature. However, the newness of care and service modularity justifies the exploratory research approach.
Practical implications
This paper offers elderly care organizations in‐depth understanding of their complex and multi‐faceted specification process. The insights help both care and service providers to make well‐considered decisions as to what level of client involvement to allow and the type of modularity to apply.
Originality/value
This paper contributes to the emerging literature on service modularity.
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Bert Meijboom, Saskia Schmidt‐Bakx and Gert Westert
The purpose of the present paper is to discuss organisational problems that occur in situations that are complex because the treatment of patients requires input from multiple…
Abstract
Purpose
The purpose of the present paper is to discuss organisational problems that occur in situations that are complex because the treatment of patients requires input from multiple health care providers, and to argue conceptually how to resolve these problems by using SCM practices.
Design/methodology/approach
First SCM, being related to settings where several companies contribute to the production of one particular product, will be discussed in general. Since patient care is about service provision, the next to be examined will be service supply chains. Subsequently, major challenges in patient‐oriented care provision follow in settings where several health care providers are involved, based on which opportunities for applying SCM in patient care will be presented.
Findings
Based on literature addressing country comparisons of patient experiences, four major problem categories are distinguished: communication, patient safety, waiting times, and integration. Although problems also occur within organisational boundaries, the steps from one provider to the next generally represent the weakest spots in a system of health care providers. By applying insights from SCM, these problems can be tackled.
Practical implications
Problems with communication and integration might well benefit from the nomination of care coordinators. Information gathering and processing, i.e. both the availability of medical records of individual patients and information on provider performance, has to be improved. Breaking down functional barriers between care “silos”, within health care providers as well as inter‐organisationally, is a necessary condition for enhanced patient‐centred integration. Policy should also stimulate the provision of more coordinated services, for example, through integral cost prices for separate diseases (“case‐mixed accounting”).
Originality/value
This paper contributes to the emerging literature on using industrial processes or applying business concepts in health care. More specifically, insights from SCM are presented that contribute to patient‐oriented integration in situations where patients' needs cannot be fulfilled by one single (type of) institute. A supply chain perspective on patient care, combined with cross‐functional and cross‐organisational teams, continuous integration practices, lead time control, and appropriate information technology, shows to be promising.
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Bert Meijboom and Migon Houtepen
The specific challenges with which companies pursuing international manufacturing strategies are faced, if their output also contains a service dimension, are addressed. A…
Abstract
The specific challenges with which companies pursuing international manufacturing strategies are faced, if their output also contains a service dimension, are addressed. A theoretical framework is proposed based on three virtually complementary perspectives by integrating international production, demand, and contemporary ICT‐based theory. Subsequently, an exploratory case study in a pure service environment is described that illustrates the value of the framework. The present study provides a starting‐point for further research in the international manufacturing sector. It is possible, for example, to apply the theoretical framework to case studies in internationally‐operating companies delivering a mix of goods and services. Moreover, the framework has proven to be useful in improving the European structure of the case company. This is a notable and promising side‐effect of the exploratory study, at least from a managerial point of view.
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Bert Meijboom, Hans Voordijk and Henk Akkermans
The relevance of “industry clockspeed” to supply chain co‐ordination (SCC) has recently been stressed but hardly been researched. Taking an information‐processing perspective, the…
Abstract
Purpose
The relevance of “industry clockspeed” to supply chain co‐ordination (SCC) has recently been stressed but hardly been researched. Taking an information‐processing perspective, the purpose of this paper is to examine the development of SCC theory under varying clockspeed circumstances.
Design/methodology/approach
This exploratory research project investigated four Dutch multinational firms operating in industries with different “clockspeeds”.
Findings
The main findings of this exploratory research suggest that, with increasing clockspeed, the use of inventory as a means of providing slack against uncertainty decreases, whereas the use of lateral relations increases. Remarkably, the role of outsourcing is substantial in both low‐ and high‐clockspeed settings, but limited in the intermediate group. Opposite to this, the role of vertical information systems is limited in low‐ and in high‐clockspeed industries, but substantial in medium‐clockspeed firms. These findings are consistent with the basic theory of organisational life‐cycle patterns.
Research limitations/implications
More data should be collected and analysed in subsequent research, e.g. data relating to more companies, investigated over longer periods of time, paying attention to multiple dimensions such as company age and size. Organisational solutions that may deal with accelerating industry clockspeeds are platform‐based product development, time and form postponement, and modular production networks.
Practical implications
Supply chain managers should be wary of one‐size‐fits‐all solutions irrespective of current industry settings or company maturity stage.
Originality/value
Previous research argues that the shorter the life cycles of the products that firms sell, the more rapidly they have to invent not just new products, but new ways of organising as well. This study is a follow‐up to this work with a focus on the co‐ordination within a supply chain in response to varying levels of industry clockspeed, an issue hardly considered in earlier work.
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Bert Meijboom, Laurens Van den Bosch and René Schalk
Providers of healthcare services face increasing performance demands in terms of cost-efficiency as well as client centeredness. Dementia care is an illustrative example in this…
Abstract
Purpose
Providers of healthcare services face increasing performance demands in terms of cost-efficiency as well as client centeredness. Dementia care is an illustrative example in this respect. Due to the aging society, the number of dementia clients is expected to grow significantly, which implies increasing costs. At the same time, demands in terms of coherent and high-quality care for dementia clients are increasing, putting a stronger emphasis on demand driven, responsive care and service processes. Literature shows that case management in dementia care is beneficial for persons with dementia and caregivers, but costly. Using insights from operations management (OM), the purpose of this paper is to develop a new model for case management in dementia care.
Design/methodology/approach
To address both cost containment and customer orientation, insights from OM, in particular front/back office (FO/BO) configuration and modularity theory, are used to develop an innovative conceptual model for case management in dementia care.
Findings
This framework offers a new way of conceptualizing care provision throughout the different phases of a chronic disease process. Linking FO/BO configurations and modular organizing with case management makes it possible to create a cost-effective and client-centered system of healthcare management.
Originality/value
A new model is developed to address both cost containment and customer orientation based on insights from OM, in particular FO/BO configuration and modularity theory.