Value configurations for balancing standardization and customization in chronic care: a qualitative study

Area of Science:

• Healthcare Management
• Operations Research
• Mental Health Services

Background:

• Increasing demands for both customization and standardization in healthcare operations.
• Scarce resources necessitate improved efficiency for healthcare managers.
• A proposed framework of three value configurations (shop, chain, network) for efficient healthcare value creation.

Purpose of the Study:

• To explore the use of value configurations for balancing standardization and customization.
• To examine these configurations in the context of chronic mental health conditions.

Main Methods:

• A typical case study illustrating conflicting demands and the value configurations framework.
• Qualitative data collection via focus groups, interviews, and a national care pathway document.
• Data analysis using an insider-outsider approach.

Main Results:

• Operationalization of standardization and customization was delegated and ad hoc, often worsened by resource scarcity.
• Value configurations framework proved useful for discussing and redesigning care operations.
• All three configurations (shop, chain, network) were present in chronic mental health care, with 'shop' being overarching.

Conclusions:

• Challenges the concept of organizational separation of care based on value configurations.
• Proposes parallel, explicated value configurations as a strategy for improving healthcare quality and efficiency amidst dual demands.
• Recommends further investigation into combined and intermediate value configurations.