Complex Service Systems Research Articles

Technician assignment in multi-shift maintenance schedules in an offshore wind farm

Offshore wind farms are becoming more and more important to sustainable energy strategies, yet their maintenance presents unique logistical challenges. The focus of this research is the Technician Assignment Problem (TAP) which involves a complicated and fluctuating scheduling problem. The key objective is to determine the most effective assignment of technicians to maintenance tasks to maximize operational efficiency and ensure reliable service. This study introduces a mathematical optimization model that processes numerous variables—technician availability, skill sets, and temporal constraints—to minimize unmet maintenance needs and ensure equitable workload distribution. The model is based on assumptions derived from actual operational conditions and human resource practices, guaranteeing that its results are not only theoretically valid but also practically feasible. TAP adheres to labor regulations, employs human resource capabilities, and aims for a smart assignment of workforce. It complies with restrictions that prevent excessive work, require breaks, and ensure that technicians are assigned tasks that match their skills, thus promoting the well-being of the workforce and the efficiency of operations. The computational investigation of the model shows that it has a remarkable ability to improve scheduling decisions which effectively reduce unassigned positions and uniformly distribute work hours. In essence, this research contributes a methodologically robust framework to the field of workforce scheduling, with the potential to inform the maintenance strategies of offshore wind farms and similar complex service systems.

Development and psychometric evaluation of the Implementation Support Competencies Assessment

BackgroundImplementation support practitioners (ISPs) are professionals that support others to implement evidence-informed practices, programs, and policies in various service delivery settings to achieve population outcomes. Measuring the use of competencies by ISPs provides a unique opportunity to assess an understudied facet of implementation science—how knowledge, attitudes, and skills used by ISPs affects sustainable change in complicated and complex service systems. This study describes the development and validation of a measure—the Implementation Support Competencies Assessment (ISCA)—that assesses implementation support competencies, with versatile applications across service contexts.MethodsRecently developed practice guide materials included operationalizations of core competencies for ISPs across three domains: co-creation and engagement, ongoing improvement, and sustaining change. These operationalizations, in combination with recent empirical and conceptual work, provided an initial item pool and foundation on which to advance measurement development, largely from a confirmatory perspective (as opposed to exploratory). The measure was further refined through modified cognitive interviewing with three highly experienced ISPs and pilot-testing with 39 individuals enrolled in a university-based certificate program in implementation practice. To recruit a sample for validation analyses, we leveraged a listserv of nearly 4,000 individuals who have registered for or expressed interest in various events and trainings focused on implementation practice offered by an implementation science collaborative housed within a research-intensive university in the Southeast region of the United States. Our final analytic sample included 357 participants who self-identified as ISPs.ResultsAssessments of internal consistency reliability for each competency-specific item set yielded evidence of strong reliability. Results from confirmatory factor analyses provided evidence for the factorial and construct validity of all three domains and associated competencies in the ISCA.ConclusionsThe findings suggest that one’s possession of high levels of competence across each of the three competency domains is strongly associated with theorized outcomes that can promote successful and sustainable implementation efforts among those who receive implementation support from an ISP. The ISCA serves as a foundational tool for workforce development to formally measure and assess improvement in the skills that are required to tailor a package of implementation strategies situated in context.

Analyzing Patterns of Service Utilization Using Graph Topology to Understand the Dynamic of the Engagement of Patients with Complex Problems with Health Services

Background: Providing care to persons with complex problems is inherently difficult due to several factors, including the impacts of proximal determinants of health, treatment response, the natural emergence of comorbidities, and service system capacity to provide timely required services. Providing visibility into the dynamics of patients’ engagement can help to optimize care for patients with complex problems. Method: In a previous work, graph machine learning and NLP methods were used to model the products of service system dynamics as atemporal entities, using a data model that collapsed patient encounter events across time. In this paper, the order of events is put back into the data model to provide topological depictions of the dynamics that are embodied in patients’ movement across a complex healthcare system. Result: The results show that directed graphs are well suited to the task of depicting the way that the diverse components of the system are functionally coupled—or remain disconnected—by patient journeys. Conclusion: By setting the resolution on the graph topology visualization, important characteristics can be highlighted, including highly prevalent repeating sequences of service events readily interpretable by clinical subject matter experts. Moreover, this methodology provides a first step in addressing the challenge of locating potential operational problems for patients with complex issues engaging with a complex healthcare service system.

A cross exploratory analysis between nursing working conditions and the occurrence of errors in the northeast region of Brazil

ObjectivesAnalyze and verify the association between working conditions and the occurrence of errors in nursing work. BackgroundMany of the known errors in nursing are based on the structural failure of the complex health service system. Our study addresses the question “Is there an association between errors made by nursing workers and working conditions?” MethodsThe study was carried out through a cross-sectional exploratory analysis of 19 ethical-disciplinary processes focused on errors made by nursing workers. The articles were processed, judged, and archived at the Regional Nursing Councils of the Northeast Region of Brazil from 2000 to 2018. The chi-square test or Fisher's exact test was used to verify the relationship between the variables through multivariate analysis. ResultsThe analyzes show that working conditions can interfere at occurrence in error. This increases the chance of an “inconsequential” error occurring for the patient in poor/very poor working conditions. The most serious errors, “with consequences irreversible” for the patient, only occur from more severe working conditions. Adversely, it was found that there is no statistically significant difference in the frequency of errors in hospitals (33.33 %) compared to “other places” (28.58 %) when these occurred in poor working conditions. When conducting the incident in poor working conditions, there was a minimum of 52 % protection OR = 0.48 % [0.16; 11.80]; (1–0.48)) against these errors in general in the nursing area. ConclusionThe strong association was exposed in working conditions classified as bad/very bad/very bad, resulting in the most serious errors and with irreversible consequences for patients. However, a level of protection for different types of workers was noticed in the field, which shows that there is hope that if the work environment changes with more organization, management, and standards of care, we can prevent future errors.

Analysis of excellent service systems from co-creation and emergent synthesis perspective

In recent years, excellent service systems across industries stimulate the economy and also contribute to solving social problems. However, it is essentially difficult to design a complex service system in which the resources of various stakeholders are integrated and the desirable goal is achieved through mutual interaction and co-creation. This paper analyzes the characteristics of the 109 excellent services in various industries that have received the Nihon Service Award in Japan. It analyzed how each firm realized excellent service system through the combination of three service design strategies based on the perspective of emergent synthesis concept. The results showed that each company combined strategies that met their own challenges to realize excellent services. Many firms are exploring new markets through Class III (openness and co-creation) service design strategies, while others are providing excellent service using Class I (optimization) and Class II (learning and adaptation) strategies by clarifying problem structures to be addressed.

Seeing, Sharing and Supporting: Assertive Outreach as a Partial Solution to Rough Sleeping

Abstract Assertive outreach is becoming an increasingly salient feature of policy responses to homelessness—and particularly rough sleeping—with the aim of supporting people to access secure housing. Despite its demonstrated successes, existing research points to structural challenges practitioners face in navigating complex and fragmented service systems to provide people sleeping rough with a continuum of care. This study examines an Australian organisation’s efforts to collaboratively and systematically overcome these challenges by bringing together government, community and service practitioners from multiple sectors in their delivery of an assertive outreach programme. Using an ethnographic research design, this article draws on observations of outreach practices and service provider administrative quantitative data, as well as qualitative interviews and focus groups conducted with assertive outreach service providers. Our findings demonstrate that through flexible and collaborative social work practices, practitioners were able to see people sleeping rough, share information across services and support people into a range of housing, health and other forms of services. Critically, however, structural barriers such as a lack of affordable and social housing prevented assertive outreach from ending people’s homelessness. We foreground the critical implications of these findings for social work.

Supporting Service Recipients to Navigate Complex Service Systems: An Interdisciplinary Scoping Review

This scoping review aimed to identify potential factors from across eight disciplines’ approaches to complexity that could be positively applied to supporting services users to navigate health and social care. The illustrative example of families where a parent has mental health challenges is used as those families often have a wide range of complex needs both for the parent/s and children. These complexities can result in the involvement of multiple services and interventions. However, in attempting to respond to complex family needs, health and social care services may unintentionally increase the complexity and associated stress for the family. Two broad themes were identified within the multidisciplinary literature including testing service developments with a view to reduce or manage complexity and approaches to support service users to navigate complexity. Specific learning from the scoping review can be applied to health and social care services to encourage a focus on service users’ expectations, understandings, and experiences of services; carefully consider the relationship between the service design and the service user’s behaviour; and finally reinforce the importance of service user involvement (or coproduction) within service development and consideration of the relationship between the service user and provider. The knowledge drawn from this scoping review can inform the development and evaluation of current services and guide the development of future services. It can also help consider approaches to empower service users to navigate the complexity of services.

Ensuring social equity through service integration design

ABSTRACT This article poses the question, how can a design-led approach help managers and professionals in public-service systems recognize and reduce barriers to social equity? It introduces a service integration design (SID) model, a co-creative process for public-service managers and professionals in complex service system settings. The study shows how a structured and designed process can benefit the social equity of vulnerable groups, contributing to a timely discussion regarding the role of design in advancing the just and fair provision of public services in complex systems.

Perceptions of families with adolescents utilizing augmentative and alternative communication technology: A qualitative approach

PurposeAlthough family involvement is critical to successful augmentative and alternative communication (AAC) device utilization, little is known about how families adapt to technology. The aim of this qualitative study was to explore parent-reported factors contributing to family adaptation among families with adolescents diagnosed with autism and/or Down syndrome (DS) utilizing AAC technology. This study describes families' experiences related to several interacting variables of the Resiliency Model, including demand, type, appraisal, resources, and problem-solving/coping, that helped shape the outcome of adaptation to AAC technology. Nurses are well-positioned in a variety of practice settings to assess vulnerable families and assist with identifying resources and navigating complex service systems. Design and methodsSemi-structured interviews were conducted with eight parents of adolescents with autism and/or DS (aged 13–18) recruited through online research registries, support organizations, and a social networking site. Recorded interviews were transcribed, and two independent reviewers coded and analyzed the data. Comparisons across all families' thematic summaries were examined for patterns. ResultsFive themes described aspects of family adaptation: Contextual Strains and Influences, Continuum of Person-First Approach, Opening Doors, Facilitators of Support, and Planning Is Key. ConclusionsFindings highlighted the challenges and demands associated with raising an adolescent using an AAC device, as well as the attributes, resources, perceptions, and strategies that either contributed or hindered family adaptation. Practice implicationsAAC technology is readily available for adolescents with developmental disabilities. It is essential that nurses assess key adaptation components to support families in integrating and using the technology.

The importance of information acquisition to settlement services literacy for humanitarian migrants in Australia.

Due to the diversity and range of services provided to humanitarian migrants during the settlement phase of migration, acquiring information across multiple service domains is intrinsic to the effective utilisation of settlement services. There are research gaps investigating how humanitarian migrants experience and navigate unfamiliar, multiple, and often complex information and service systems of host countries. This study seeks to understand the impediments to humanitarian migrants' effective utilisation of information about settlement services and to identify strategies that can be implemented to overcome these barriers. Service providers were purposively recruited from organisations funded by the Australian Government to deliver settlement programs. The study applied an inductive thematic analysis approach to identify key themes that emerged from the data. From the perspective of service providers, the themed findings identified how humanitarian migrants gain knowledge about services, their information needs, information seeking practices and skills, and information specific to service domains. The findings illustrate the importance of acquiring information, knowledge, and skills across multiple information platforms and service domains as being integral to the effective utilisation of settlement services for humanitarian migrants. The study identifies systemic barriers to information and service access and suggests different strategies and approaches to improve access to context specific key information. The study identifies factors that inhibit the effectiveness of the Australian settlement service provision model and emphasises the need for targeted training of mainstream referral services. The study highlights the important role that settlement service providers play as mediators of information, adept at tailoring information to humanitarian migrants' individual and community information needs. The findings provide important insights that highlight the different roles that policymakers, researchers, and service providers can play to inform new approaches that improve the effectiveness of information and settlement service provision, as part of contributing to optimum settlement outcomes for humanitarian migrants.

State-Dependent Estimation of Delay Distributions in Fork-Join Networks

Problem definition: Delay announcements have become an essential tool in service system operations: They influence customer behavior and network efficiency. Most current delay announcement methods are designed for relatively simple environments with a single service station or stations in tandem. However, complex service systems, such as healthcare systems, often have fork-join (FJ) structures. Such systems usually suffer from long delays as a result of both resource scarcity and process synchronization, even when queues are fairly short. These systems may thus require more accurate delay estimation techniques than currently available. Methodology/results: We analyze a network comprising a single-server queue followed by a two-station FJ structure using a recursive construction of the Laplace–Stieltjes transform of the joint delay distribution, conditioning on customers’ movements in the network. Delay estimations are made at the time of arrival to the first station. Using data from an emergency department, we examine the accuracy and the robustness of the proposed approach, explore different model structures, and draw insights regarding the conditions under which the FJ structure should be explicitly modeled. We provide evidence that the proposed methodology is better than other commonly used queueing theory estimators such as last-to-enter-service (which is based on snapshot-principle arguments) and queue length, and we replicate previous results showing that the most accurate estimations are obtained when using our model result as a feature in state-of-the-art machine learning estimation methods. Managerial implications: Our results allow management to implement individual, real-time, state-dependent delay announcements in complex FJ networks. We also provide rules of thumb with which one could decide whether to use a model with an explicit FJ structure or to reduce it to a simpler model requiring less computational effort. Funding: This work was supported by the Dutch Research Council (NWO) Gravitation Programme NETWORKS [Grant 024.002.003], the Israel Ministry of Science and Technology [Grant 880011], and the Israel Science Foundation [Grant 1955/15]. Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2022.1167 .

Commentary – The ServCollab Perspective on Elevating Human Experience

PurposeThis commentary describes ServCollab’s perspective on Elevating Human Experience and urges researchers to join in collaborating on research to reduce suffering and improve human well-being.Design/methodology/approachThis commentary is based on ServCollab’s pioneering approach to building a serving humanity logic and growing service research capacity to work on the hardest service systems problems humanity faces.FindingsServCollab’s ongoing efforts to Elevate the Human Experience are described. First, ServCollab seeks to develop a serving humanity logic. Second, ServCollab seeks to coalesce divergent perspectives on service. Third, ServCollab seeks to build a serving humanity movement capable of addressing complex service systems problems.Practical implicationsPractical ideas are offered for serving humanity through collaboration.Social implicationsBecause human life depends on service systems, this ServCollab commentary has broad application to all human experience.Originality/valueThis commentary offers a unique approach to building collaborative service research projects capable of addressing service inclusion, service language and climate change.

Integration of Care in Complex and Fragmented Service Systems: Experiences of Staff in Flexible Assertive Community Treatment Teams.

Introduction:To provide more integrated care, several countries have implemented the Flexible Assertive Community Treatment (FACT) model. However, this model does not guarantee full integration, especially in complex and fragmented service systems like in Norway. Hence, we investigated which barriers that might reduce the potential for integrated care in the Norwegian system, as described by staff in FACT teams, and how they adjust their way of working to increase the opportunities for integration.Methods:Online focus group interviews involving 35 staff members of five Norwegian FACT teams were conducted using a semi-structured interview guide. The material was analysed using thematic text analysis.Results:Six themes described the barriers to integrated care in the service system: fragmentation, different legislation and digital systems, challenges in collaboration, bureaucracy and limited opening hours. Three themes described adjustments in the teams’ way of working to enhance integration: working as the responsible co-ordinator, being a collaborator, and the only entry channel into the service system.Conclusion:The FACT team staff described several barriers to integration within the system. However, they made some adjustments in their way of working that might provide opportunities for integrated care within complex and fragmented service systems.

Modular Service Design of Information Technology-Enabled Services

The literature has proposed ways to modularize information-technology-enabled services (ITeS) with limited success. We argue that applying design principles (DPs) can address this gap and revitalize the service modularization literature. With a qualitative research study, we develop exemplar DPs and a set of prioritized DPs for ITeS. We contribute to the literature by demonstrating how complex service systems, specifically ITeS, can be modularly designed. Our DPs show how different ITeS design elements or service attribute combinations impact the outcome-driven design of service experience. Based on the findings, we present a modular service design framework and a service design method that adopts DPs to create effective modular ITeS designs. We also offer ways to conceptualize and apply service modularization to improve the adoption of the modular service design by service designers and managers.

Assistive Healthcare Robotics – Challenges in Nursing Service Innovation: Critical Review

Healthcare robots assist older people and caregivers. Many scientists and researchers have been looking at the use of robotic technology to help not only elderly people but also their care providers. Through a review of the literature and an in-depth study of published papers, we include a timely overview of care robotics. In this study, we review what we know about the use of assistive robots in the elderly care context, their benefits and potential challenges. These humanoid resources offer a range of physical, cognitive, and social tasks in the aim of improving health outcomes. Service Science calls for understanding complex service systems, our Sociotechnical system (STS) lens applied to the use of robotics in the nursing function aims at learning the underlying trajectories of socio-technical dynamics within the nursing service system and the complexity introduced by their humanoid counterpart. This presents a significant contribution to Service Science. In essence, the research introduces the STS lens to understand the interaction between human and machine in the nursing ecosystem, while proposing learnings on a better design in practice. We focus on the current and potential future challenges of healthcare robotics as well as how such technology can help healthy aging, healthcare staff, especially nurses, and our healthcare system as a whole. We conclude that, despite the potential advantages, the adoption of care robots is still shy. Using the lens of the sociotechnical perspective and concepts of service innovation roadmaps, we pave the way for identifying factors of adoption that may influence the proliferation of care robots.

Creating Value for a Sustainable Healthcare: The Role of Digital Platforms

Currently, healthcare is worldwide one of the most critical service domains, dealing with human being health and well-being. Its importance and significance are also reflected through the Agenda 2030 and its SDGs, which point to guarantee health and well-being for all at all ages. In this sense, this article aims to better investigate if and how specific paths of value creation contribute to healthcare sustainability. The analysis has been conducted assuming a system perspective, which led to approach those dynamics, supported digital technologies and platforms, that boost the sustainability of complex service systems such as healthcare. To this end, a case study analysis has been conducted, investigating the potential of a digital platform in boosting an ongoing path of value creation able to contribute to short- and long-term sustainability of healthcare domain and of the related services. The results of this analysis pointed out that digital platforms can acts as value generation enablers, paving the way for the definition of sustainable paths of value creation.

Flexible assertive community treatment teams can change complex and fragmented service systems: experiences of service providers

BackgroundImplementing innovative health service models in existing service systems is complicated and context dependent. Flexible assertive community treatment (FACT) is a multidisciplinary service model aimed at providing integrated care for people with severe mental illness. The model was developed in the Netherlands and is now used in several countries, such as Norway. The Norwegian service system is complex and fragmented, with challenges in collaboration. Limited research has been performed on FACT teams and other new integrative health service models as part of such systems. However, such knowledge is important for future adjustments of innovation processes and service systems. Our aim was to explore how FACT teams are integrated into the existing formal public service system, how they function and affect the system, and describe some influencing factors to this. We sought to address how service providers in the existing service system experience the functioning of FACT teams in the system.MethodsFive focus group interviews were undertaken 3 years after the FACT teams were implemented. Forty service providers representing different services from both levels of administration (primary and specialist healthcare) from different Norwegian regions participated in this study. Team leaders of the FACT teams also participated. Service providers were recruited through purposeful sampling. Interviews were analysed using thematic text analysis.ResultsThe analysis revealed five main themes regarding FACT teams: (1) They form a bridge between different services; (2) They collaborate with other services; (3) They undertake responsibility and reassure other services; (4) They do not close all gaps in service systems; and (5) They are part of a service system that hampers their functioning.ConclusionsThe FACT teams in this study contributed to positive changes in the existing service system. They largely contributed to less complex and fragmented systems by forming a bridge and undertaking responsibility in the system and by collaborating with and reassuring other services; this has reduced some gaps in the system. The way FACT teams function and needs of the existing system appear to have contributed positively to these findings. However, complexity and fragmentation of the system partly hamper functioning of the FACT teams.

Facilitating inter-professional integration in palliative care: A service ecosystem perspective

A paradigm shift toward healthcare inter-professional collaboration is leading to searches for ways to better facilitate integration. However, policy rhetoric often fails to acknowledge the complexity of healthcare service systems, and the difficulties involved in achieving successful collaborations. Consequently, more research is called for. We utilize the concept of a service ecosystem, a perspective currently prominent in service science, which is transforming the ways service systems are studied. This research aims to examine palliative care provision through a service ecosystem lens in order to uncover previously unidentified insights and opportunities for improvement. The palliative care ecosystem under study encompasses a defined geographical area of the UK. Data comprises pathographies (i.e., narratives of illness) with patients and their families (n = 31) and in-depth interviews with a variety of palliative care providers (n = 21), collected between 2017 and 2018. Capability issues comprising collaboration, coordination, and resource integration, together with communicating value all emerged as common themes impacting palliative care services. Taking a service ecosystem perspective, we also found shared intentionality for better integration and collaboration, with a desire among palliative care providers for the ecosystem's hospice organization to take the role of leader and facilitator. Acting on these findings, we demonstrate the ways new institutional arrangements provide a foundation for value cocreation. We make a contribution to the burgeoning service ecosystem literature which currently lacks empirical insights, particularly in health. We argue that in complex service systems such as healthcare, the focus must be on service design rather than organizational design, approached from the perspective of aggregation of service providers. We demonstrate empirically how reconfiguring resources and developing new institutional arrangements at the meso level can change micro-macro level interaction, enabling the emergence of new and enhanced value cocreation in palliative care.

Resource Integration process in Complex Service Systems: Examining Value Co-Creation at Higher Education Institutions

Resource Integration process in Complex Service Systems: Examining Value Co-Creation at Higher Education Institutions

Complex Service Process Optimization Based on Service Touchpoint Association and the Design Structure Matrix

Service process optimization is conducive to the innovation of enterprise services, but the poor logic design of multiple touchpoints can easily lead to problems in the service process, such as scattered layouts and repeated paths. Aiming at the promotion of service innovation and user experience, this paper takes the optimization of a single service touchpoint as the prerequisite and proposes a service process optimization method based on service touchpoint association and the design structure matrix (DSM). The association of service touchpoints is categorized into two types, namely, noncoupled and coupled association. The DSM is used to describe the two types of association between service touchpoints, and the matrix operation is used for modular identification and layering of the two kinds of association. Finally, through the above steps, the problematic service process was replanned. By using the service process optimization of a new retail convenience store as an example, the service process is divided into 6 relatively independent modules, and the order of module execution is arranged. Moreover, the optimal service process of the convenience store system is determined, and the method is verified to be feasible. Through optimization both from single service touchpoint and service process modularization, the study provides a reference for process optimization of the complex service system.