Improving client-centred care and services: the role of front/back-office configurations

• Published in: Journal of advanced nursing 2009-05, Vol.65 (5), p.971-980
• Main Authors: Broekhuis, Manda, De Blok, Carolien, Meijboom, Bert
• Format: Article
• Language: English
• Subjects: case study; client-centred care; framework; front/back office; Health care; Health Facility Environment - organization & administration; Health services; Home Care Services - organization & administration; Home Care Services - standards; Humans; Longitudinal Studies; Models, Organizational; Nursing; objectives; organizations; Patient Satisfaction; Patient-Centered Care - organization & administration; Patient-Centered Care - standards; Professional-Patient Relations; Studies
• ISSN: 0309-2402; 1365-2648
• DOI: 10.1111/j.1365-2648.2009.05014.x

Title.  Improving client‐centred care and services: the role of front/back‐officeconfigurations. Aim.  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. Background.  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. Method.  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). Findings.  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. Conclusions.  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.