Value configurations for balancing standardization and customization in chronic care: a qualitative study
Journal article, 2021

Background: Demands for both customization and standardization are increasing in healthcare. At the same time, resources are scarce, and healthcare managers are urged to improve efficiency. A framework of three value configurations – shop, chain, and network – has been proposed for how healthcare operations can be designed and organized for efficient value creation. In this paper, use of value configurations for balancing of standardization and customization is explored in the context of care for chronic mental conditions. Methods: A typical case is presented to illustrate the manifestations of conflicting demands between customization and standardization, and the potential usefulness of the value configurations framework. Qualitative data were collected from managers and care developers in two focus groups and six semi-structured interviews, completed by a national document describing a care pathway. Data were coded and analysed using an insider-outsider approach. Results: Operationalization of the balance between standardization and customization were found to be highly delegated and ad hoc. Also, the conflict between the two demands was often seen as aggravated by scarce resources. Value configurations can be fruitful as a means of discussing and redesigning care operations if applied at a suitable level of abstraction. Applied adequately, all three value configurations were recognized in the care operations for the patient group, with shop as the overarching configuration. Some opportunities for improved efficiency were identified, yet all configurations were seen as vital in the chronic care process. Conclusions: The study challenges the earlier proposed organizational separation of care corresponding to different value configurations. Instead, as dual demand for customization and standardization permeates healthcare, parallel but explicated value configurations may be a path to improved quality and efficiency. Combined and intermediate configurations should also be further investigated.

Quality in healthcare

Value in healthcare

Mental healthcare

Customization

Individualization

Organizational architecture

Personalization

Standardization

Value configurations

Author

Christian Colldén

Chalmers, Technology Management and Economics, Service Management and Logistics

Sahlgrenska University Hospital

Andreas Hellström

Sahlgrenska University Hospital

Ida Gremyr

Sahlgrenska University Hospital

BMC Health Services Research

1472-6963 (ISSN)

Vol. 21 1

Subject Categories

Health Care Service and Management, Health Policy and Services and Health Economy

Other Engineering and Technologies not elsewhere specified

Nursing

Areas of Advance

Health Engineering

DOI

10.1186/s12913-021-06844-z

More information

Latest update

9/3/2021 2