Broekhuis Manda, de Blok Carolien, Meijboom Bert
Department Operations, University of Groningen, The Netherlands.
J Adv Nurs. 2009 May;65(5):971-80. doi: 10.1111/j.1365-2648.2009.05014.x.
This paper is a report of a study conducted to explore the application of designing front- and back-office work resulting in efficient client-centred care in healthcare organizations that supply home care, welfare and domestic services.
Front/back-office configurations reflect a neglected domain of design decisions in the development of more client-centred processes and structures without incurring major cost increases.
Based on a literature search, a framework of four front/back-office configurations was constructed. To illustrate the usefulness of this framework, a single, longitudinal case study was performed in a large organization, which provides home care, welfare and domestic services for a sustained period (2005-2006).
The case study illustrates how front/back-office design decisions are related to the complexity of the clients' demands and the strategic objectives of an organization. The constructed framework guides the practical development of front/back-office designs, and shows how each design contributes differently to such performance objectives as quality, speed and efficiency.
The front/back-office configurations presented comprise an important first step in elaborating client-centred care and service provision to the operational level. It helps healthcare organizations to become more responsive and to provide efficient client-centred care and services when approaching demand in a well-tuned manner. In addition to its applicability in home care, we believe that a deliberate front/back-office configuration also has potential in other fields of health care.
本文报告了一项研究,旨在探讨在提供家庭护理、福利和家政服务的医疗保健组织中,设计前台和后台工作以实现高效的以客户为中心的护理的应用情况。
前台/后台配置反映了在开发更以客户为中心的流程和结构时被忽视的设计决策领域,且不会导致成本大幅增加。
基于文献检索,构建了一个包含四种前台/后台配置的框架。为了说明该框架的实用性,在一个大型组织中进行了一项单一的纵向案例研究,该组织在2005 - 2006年期间持续提供家庭护理、福利和家政服务。
案例研究说明了前台/后台设计决策如何与客户需求的复杂性和组织的战略目标相关。构建的框架指导了前台/后台设计的实际开发,并展示了每种设计如何对质量、速度和效率等绩效目标做出不同贡献。
所呈现的前台/后台配置是将以客户为中心的护理和服务提供细化到运营层面的重要第一步。它有助于医疗保健组织在以良好协调的方式应对需求时,变得更具响应性,并提供高效的以客户为中心的护理和服务。除了在家庭护理中的适用性外,我们认为精心设计的前台/后台配置在其他医疗保健领域也具有潜力。