The impact of patient recovery flexibility on service experience in public healthcare

DOIhttps://doi.org/10.1108/JABS-03-2018-0099
Published date19 December 2019
Pages159-179
Date19 December 2019
AuthorPradeep Kumar
Subject MatterStrategy,International business
The impact of patient recovery exibility on
service experience in public healthcare
Pradeep Kumar
Abstract
Purpose This study aims to identify the dimensions of patient recovery flexibility in the public
healthcare contextand its impact on the service experience. The studyalso explores the strategies and
contextualinfluences to attain patient recovery flexibility.
Design/methodology/approach This paper uses a case study method based on a semi-structured
interviewwith healthcare professionals, observationsand informal discussions.
Findings In the present study, severaldimensions of patient recovery flexibilityare reported. Different
internal and externalstrategies to exhibit patient recovery flexibility, as well as two contextualinfluences,
are identified. An integrative framework is developed to establish the relationship of patient recovery
flexibilitywith service experience in public healthcare.
Research limitations/implications The study was conductedin a public healthcare setting in India.
The sample size for the semi-structured interview was limited to healthcare professionals, and the
patient’sperspective is missing.
Originality/value This paper contributes to the growing need for patient recovery flexibility as a
strategy in the publichealthcare delivery system. It offers new insightsto address the gap in the literature
regarding the linkage of patient recovery flexibility and service experience. The study provides an
integrative framework of dimensions of patient recovery flexibility, strategies, contextual influences and
the impact on the service experience.The framework and propositions presented in the study will guide
future research that is needed in this area.This study provides an overview to shape and redesign the
after-service support from a flexibility perspective in public healthcare for the improved service
experience.
Keywords Uncertainty, Service experience, Complaints, Public healthcare, Patient recovery flexibility
Paper type Research paper
1. Introduction
Emerging healthcare markets are characterized by the uncertainty of a high order. As a
service-based sector of society, public healthcare organizations are challenged to develop
the capabilities to cope with uncertainty and deliver high-quality services. The services
provided to the patients do not end after discharge. After-service support to the patients
and management of complaints(recovery) are crucial in healthcare delivery. In India,public
healthcare organizationsare continuously trying to improve their social imageand providing
an enhanced experience of services(Narayanamurthy et al.,2017). The capabilities to cope
with uncertain and varied patient complaints improves the experience of services (Powers
and Jack, 2008). Public healthcare organizations, therefore, need a focus on after-service
support and management of patient complaints. Thus, a competitive strategy is required to
provide efficient after-servicesupport and recover the patients quickly.
With the emergence of globalization and growth of information technology (IT), customers
(patients) are an active part of the service delivery systems. The public healthcare
organizations in India have adopted technology to provide after-service supports and
management of complaints (NSSO, 2015). Technology increases the capabilities to cope
Pradeep Kumar is based at
the Department of
Marketing, Indian Institute
of Management Ranchi,
Ranchi, India.
Received 15 March 2018
Revised 11 April 2018
30 October 2018
Accepted 5 November 2018
DOI 10.1108/JABS-03-2018-0099 VOL. 14 NO. 2 2020, pp. 159-179, ©Emerald Publishing Limited, ISSN 1558-7894 jJOURNAL OF ASIA BUSINESS STUDIES jPAGE 159
with uncertainties and promotes flexibility in service delivery (De Groote, 1994). Flexible
capabilities of the organizations enable them to respond quickly and effectively (Koste
et al.,2004
). Gerwin (1993) argues that flexibility is neededacross the value system to deal
with several types of uncertainties. Therefore, flexibility is required as an inbuilt mechanism
in after-service supports to the patients that could satisfy them by handling several
complaints efficiently. Patient recovery flexibility (PRF) provides an effective adaptation
technique to recover the patients if something wrong has happened (Correa and Gianesi,
1994). The adaptability of the service delivery system facilitates managing the resources of
the organizations to various customer requirements and complaints to enhance the
experience and satisfaction(Aranda, 2003).
Flexibility is crucial in the application of marketing and relationship with customers;
however, very little systematic research explores the flexibility of after-service support and
recovery of patients. The initial emphasis on the field of flexibility was centered on the
dimensions of flexibility (Browne et al.,1984;Sethi and Sethi, 1990;Gupta and Somers,
1992) and performance outcomes of flexibility (Volberda, 1996;Zhang et al.,2003). Slack
(2005) suggests that the concepts of flexibility must be explored in services to create value
for the customers. Few studies have advocated the importance of flexibility in healthcare
(Butler et al., 1996;Butler and Ewald, 2000) and its relationship with patient satisfaction
(Powers and Jack, 2008;Vredenburg and Bell, 2014). However, a dearth of information
exists regarding the dimension of PRF, strategies and contextual influences that moderate
PRF, and its impact on the service experience.
To address the research gap, the present study proposes a taxonomy of PRF in the public
healthcare delivery context and derives a conceptualization of the linkages between PRF
and service experience. This paper focuses on identifying the dimensions of PRF and
exploring the strategies that are used by public healthcareorganizations to extend the after-
service support and handle several patient complaints to improve the service experience.
The main research questionsfor the study are:
RQ1. What are the dimensionsof PRF in public healthcare context?
RQ2. What are the contextualinfluences that moderate PRF?
RQ3. What strategiesdo public healthcare organization use to achievePRF?
RQ4. What is the impact of PRF on service experience?
The research is based on a review of the literature and semi-structured field interviews with
healthcare professionalsin a public healthcare setting in India. The findings contribute to an
integrative framework of PRF describing the dimensions and strategies as well as
contextual influences thatmoderate PRF, and its linkage with the service experience.
2. Literature review
Flexibility has largely been studied at various levels in management discipline
(Swamidass and Newell, 1987;Gupta and Somers, 1992;Sushil, 2015). The extant
literature on manufacturing, operations strategy and marketing has explored the
multidimensional view of flexibility over time (Cox, 1989;Badri et al., 2000;Combe,
2012). The concepts of flexibility are closely related to adaptability under uncertainty
(Brill and Mandelbaum, 1985;Schwarz, 2008). Sethi and Sethi (1990) define flexibility as
“[...] an ability to respond effectively to the changing need of customers in an uncertain
environment.” Saurez et al. (1996) suggest that flexibility involves the adjustment of
service capacity and providing customized services rapidly. Many authors have
contributed to the three distinctive elements of flexibility, namely, range, responsiveness
and uniformity (Koste et al., 2004). The range indicates the number of tasks or operations
that can be performed effectively, mobility is the ability to change from one state to
another, and uniformity is the similarity of performance across the range or the ability to
PAGE 160 jJOURNAL OF ASIA BUSINESS STUDIES jVOL. 14 NO. 2 2020

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