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Service Management 4, Lecture notes of Service Management

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Meeting 4: Transformative services
Seamless Service? On the Role and Impact of Service Orchestrators in Human-Centered
Service Systems
Breidbach, C. D. Antons, T. Salge (2016)
HCSS (Human Centered Service Systems)
Service orchestrators dedicated actors who facilitate and orchestrate resource integration, and thereby value
cocreation, between other interdependent actors in HCSS.
a. Orchestrating value cocreation through case managers enhances patient satisfaction as well as financial and
operational performance of the firm.
b. Service orchestrators increase the perception of employees that customers are actively involved in the
cocreation process.
FP11 (Vargo & Lusch): value cocreation is coordinated through actor-generated institutions.
This study examines the impact of case managers as service orchestrators from each HCSS dimension of actors and
structure.
Background and hypotheses
Health service is inherently human centered, and complex.
Limit of precedent studies: there was an assumption that actors are willing and capable to engage in the process,
whereas in reality actors are limited by their bounded rationality, limited info, inherent complexity of the network.
Service Orchestration and customer outcomes (actor dimension)
Case managers organize the interactions of the customer + facilitate the flow of info + act as primary point of ref.
Hypothesis 1a: Customers in HCSS with a dedicated service orchestrator experience higher satisfaction with the
service than customers in HCSS without a service orchestrator.
Hypothesis 1b: The effect of a service orchestrator on customer satisfaction will be mediated by customers’
perceptions of their own involvement in the value cocreation process.
Service Orchestration and employee outcomes (actor dimension)
With an altruistic mind-set (clinical pro), a greater ability to focus on patient care should enhance job satisfaction.
Case managers’ orchestration efforts reduce the coordination cost of clinical staff and eases info flow.
Hypothesis 2a: Frontline employees in HCSS with a dedicated service orchestrator experience higher job satisfaction
than those in HCSS without a service orchestrator.
With a case orchestrator, employees have more time to cocreate value with the customer which forges new
interpersonal relationships + enhance staff exposure to patient feedback + improve staff responsiveness to needs.
Hypothesis 2b: The effect of a service orchestrator on job satisfaction will be mediated by frontline employees’
perceptions of patient involvement in the value cocreation process.
Service Orchestration and organizational outcomes (structure dimension)
Service orchestrators increase process efficiency, reduces unexpected incidents, etc.
Hypothesis 3a: Introducing a service orchestrator into an HCSS will increase its operational performance over time.
Expectation that service orchestrators increase financial performance (decreasing risks and costs, gain in productivity)
Hypothesis 3b: Introducing a service orchestrator into an HCSS will increase its financial performance over time.
Exploring the role and impact of service orchestrator in HCSS
Patient Perspective (actor dimension)
The study validates hypothesis 1a.
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Meeting 4: Transformative services

Seamless Service? On the Role and Impact of Service Orchestrators in Human-Centered

Service Systems

Breidbach, C. D. Antons, T. Salge (2016)

HCSS (Human Centered Service Systems) Service orchestrators  dedicated actors who facilitate and orchestrate resource integration, and thereby value cocreation, between other interdependent actors in HCSS. a. Orchestrating value cocreation through case managers enhances patient satisfaction as well as financial and operational performance of the firm. b. Service orchestrators increase the perception of employees that customers are actively involved in the cocreation process. FP11 (Vargo & Lusch): value cocreation is coordinated through actor-generated institutions. This study examines the impact of case managers as service orchestrators from each HCSS dimension of actors and structure. Background and hypotheses Health service is inherently human centered, and complex. Limit of precedent studies: there was an assumption that actors are willing and capable to engage in the process, whereas in reality actors are limited by their bounded rationality, limited info, inherent complexity of the network. Service Orchestration and customer outcomes (actor dimension) Case managers organize the interactions of the customer + facilitate the flow of info + act as primary point of ref. Hypothesis 1a: Customers in HCSS with a dedicated service orchestrator experience higher satisfaction with the service than customers in HCSS without a service orchestrator. Hypothesis 1b: The effect of a service orchestrator on customer satisfaction will be mediated by customers’ perceptions of their own involvement in the value cocreation process. Service Orchestration and employee outcomes (actor dimension) With an altruistic mind-set (clinical pro), a greater ability to focus on patient care should enhance job satisfaction. Case managers’ orchestration efforts reduce the coordination cost of clinical staff and eases info flow. Hypothesis 2a: Frontline employees in HCSS with a dedicated service orchestrator experience higher job satisfaction than those in HCSS without a service orchestrator. With a case orchestrator, employees have more time to cocreate value with the customer which forges new interpersonal relationships + enhance staff exposure to patient feedback + improve staff responsiveness to needs. Hypothesis 2b: The effect of a service orchestrator on job satisfaction will be mediated by frontline employees’ perceptions of patient involvement in the value cocreation process. Service Orchestration and organizational outcomes (structure dimension) Service orchestrators increase process efficiency, reduces unexpected incidents, etc. Hypothesis 3a: Introducing a service orchestrator into an HCSS will increase its operational performance over time. Expectation that service orchestrators increase financial performance (decreasing risks and costs, gain in productivity) Hypothesis 3b: Introducing a service orchestrator into an HCSS will increase its financial performance over time. Exploring the role and impact of service orchestrator in HCSS Patient Perspective (actor dimension) The study validates hypothesis 1a.

The study invalidates hypothesis 1b, insignificant correlation has been noticed between case management and patients’ perception of their own involvement in cocreation. Employee perspective (actor dimension) The study invalidates hypothesis 2a, no significant relation between case management and the satisfaction of frontline employees. They can feel a loss of autonomy + expect work intensification. The study validates hypothesis 2b. Financial performance (structure perspective) The study validates hypothesis 3b. Introduction of case managers increase staff productivity over time. Operational performance (structure perspective) The study validates hypothesis 3a. Departments with case managers can utilize their resource more efficiently + be quicker about in delivering the service. Discussion – theoretical implications With service orchestrators, the customer no longer acts as the primary resource integrator, their perception of effort is reduced. A lower perception of efforts creates a higher satisfaction. Limitations and future research

  • Extend the work to a conceptual ground (not focussed on health care).
  • Advance the understanding of the service orchestration from a methodological stand point.
  • Broaden the context insights, cross-industries researches…
  • Advance the theoretical studies of the service orchestrator by exploring micro practices and tools he uses.
  • Identify which factors trigger organizations to introduce the role a of a case manager.

Co-creation culture in Health Care Organizations

Sharma, S. and J. Conduit (2016)

a. Identify and explicate the characteristic of an organizational culture that supports cocreation. b. Provide a framework for cocreation culture types, with core cocreation behaviors, supportive cocreation behaviors, and organizational values. CVF (Competing Value Framework), clearly discriminates between an internal and external focus for organizations. Value cocreation  the integration of a service provider’s and a customer’s resources and processes to mutually create a desired outcome. Expend the dyadic approach to a broader social context. CVF values dimensions

  • An organizational positioning can take either an internal (emphasizing on integration) or external (emphasizing on differentiation) focus.
  • An organizational process is either flexible or mechanistic. These two dimensions are limited in their ability to describe contemporary organizational cultures. Organizational culture  the pattern of shared values and beliefs that help individuals understand organizational functioning and thus provides them with norms for behaviour in the firm. Findings RED company: ‘sharing the journey’ is there motto. Value cocreation processes are adopted in the firm’s culture. YELLOW company: its culture contrasts and is more market-oriented. Core cocreation behaviours Coproduction  customers’ participation in direct service provision, integrating resources to achieve a desired outcome. Example: medical patient has a say in designing their programs + staff helps customers to implement this program. Codevelopment  cocreation behavior that enhances the service offering.

Limitations and future research

  • Is this model generalizable beyond health care sector?
  • For future researches place also emphasize on other actors in the network (suppliers, government, etc).
  • Include more caregiver and family members to the study.
  • Could be interesting to produce a scale of cocreation culture characteristics.
  • Examine the impact of a cocreation culture on the well-being of an organization’s customers.
  • Explore financial and performance benefits of developing a cocreation culture.

Customer Effort in Value Cocreation Activities: Improving Quality of Life and Behavioral

Intentions of Health Care Customers

J., T. Danaher & J. McColl-Kennedy (2015)

a. Exploration of customers’ value cocreation in health care, identifying a hierarchy of activities representing varying levels of customer effort. EVCA (Effort in Value Cocreation Activities)  the degree of effort that customers exert to integrate resources, through a range of activities of varying levels of perceived difficulty. Customer value cocreation Customers participate in value cocreation through an integration of resources obtained through a range of activities and interactions. Customer value cocreation  the benefit realized from integration of resources through activities and interactions with collaborators in the customer’s service network. Activities  the cognitive and behavioural performance or active doing of things. Interactions  the engagement of an individual with others in the service network Value cocreation activities within and beyond the firm The study examine customer value cocreation activities that include not only activities with the focal firm but also those that go beyond the firm, as well as the customer’s self-generated activities. Vargo & Lusch: Value cocreation activities include activities with the firm + activities that goes beyond (other firms, family, etc). Indeed, the customer experience extends beyond the event that happens within the firm. Ego depletion  less effortful value cocreation activities are undertaken, resource depletion occurs and there are less available resources for conducting more effortful activities. This is the ego depletion, which moderates the dynamic theory of action supporting an individual’s motivation to move “up” the hierarchy to more difficult tasks depending on their success for each previous task. Stage 1: identifying value cocreation activity themes (13 themes for value cocreation activities in health care). Focal firm based activities: actively sharing info, compliance with basic requirements, proactive involvement in decision making, interactions with clinic staff. Beyond focal firm activities: relationships with family and friends, connecting with others with illness, diversionary activities, healthy diet, managing the practicalities of life, seeking information. Self-generated activities: positive thinking, spiritual relationship/emotional regulation. Stage 2: measuring customer EVCA Rasch model: recognizes the different intensity levels of items (each activity corresponds to an item). The higher a customer’s EVCA score relative to the difficulty of a specific activity, the higher the probability that he or she will perform the activity. Thus, many people engage in easy activities, however, as activities become more demanding, relatively fewer people undertake them. Results of Rasch Modelling:

  • Compliance with basic requirements represents the lowest end of the scale such as basic clinic requirements.
  • Next step is putting efforts in relationships with family and friends.
  • Next step includes connecting with others (seeking support from other people with same illness)
  • The last step of difficulty is emotional regulation. The customers who have undertaken effortful activities are more likely to have also done less demanding activities. Stage 3: investigating the effect of customer EVCA on quality of life, satisfaction, and behavioural intentions Customer EVCA outcome model Greater quality of life is associated with value cocreation practices (partnering, or team management) VS passive compliance, insular controlling. Customer EVCA is thus likely to drive customer’s quality of life perception. Hypothesis 1: Health care customer EVCA increases quality of life. The expanded role of customers in service is likely to directly affect service evaluations. Hypothesis 2: Health care customer EVCA increases satisfaction with the service. Service satisfaction may enhance behavioural intentions (positive word of mouth, loyalty). Hypothesis 3: Health care customer EVCA increases favourable behavioural intentions. Satisfaction with the service should also contribute directly to quality of life perceptions. Hypothesis 4: Satisfaction with the service is partial mediator of the health care customer EVCA to quality of life relationship. Satisfaction with the service should affect behavioural intentions toward the service provider. Hypothesis 5: Satisfaction with the service is a partial mediator of health care customer EVCA to positive behavioural intentions relationship. Results of the study It confirms the links of customer EVCA with quality of life, with satisfaction with the service, with behavioural intentions. Customer EVCA also impacts quality of life independently of satisfaction. Managerial implications
  • (Health care) implementation of models: collaborative care, home-based and patient-centered models.
  • Developing a medical-home
  • Implement a single coordinator (the case manager)
  • Understanding activities in order to encourage the customer’s efforts to get involved in the cocreation value. Limitations and further researches
  • Customer perspective is taken here, would be interesting to take the network perspective.
  • Found a linear relationship between EVCA and outcomes such as quality of life, there might be thresholds of efforts over which the correlation is reversed.
  • Are there circumstances in which more effort demanding activities are taken before or without the easier ones?
  • Extend the study to other health care setting that chronic illness.
  • Antecedents that enhance customer EVCA need exploration.
  • The degree to which a customer participates in value cocreation activities may change over time.