SERVICE BLUEPRINTING AND GAP ANALYSIS IN BUSINESS IMPROVEMENT

Service blueprinting and GAP analysis in business improvement

Service blueprinting and GAP analysis in business improvement

Defining value is more than a semantic topic, since beliefs about value administration are reliant on its definition. Afirst step in the direction of characterising value is contemplating dissimilarities between industrial and service part value, discussing those delineations which do or do not encompass cost. Drawing on merchandise value management Morris and chime (1996) identify five distinct perspectives on quality: these transcendent, product-based, user-based, manufacturer-based and value-based outlooks will now be considered.

Asecond outlook is that value is product-based, generally equating increased value with costing more, without contemplating suitability for purpose. Thirdly, a outlook of value may be user-based, equating value with customer approval: a fundamental handicap to this approach is that it directs to quality management that assesses customer perception and answers to it. In healthcare there may well be a mismatch between patient and purchaser demand for services and professional assessment of their grade of need: ethically it could not be supported to assign scarce assets to those who want rather than need them (Doyal 1998: p57). In contrast a manufacturer-based view is worried with adherence to specifications or standards, although these may occasionally contemplate a provider rather than a clientele view of what is important.

As well as weaknesses already considered, first four of Morris and Bell's (1996) views of quality also have strengths, of aspiration to excellence, focus on design, recognising customer's perspective, and achieving consistency and reliability. However, their fifth outlook of a value-based definition embraces value and cost with fitness for reason: this outlook integrates quality with what customers are made to pay, and arrives closest to Ovretveit's (1992:23) delineation that value in wellbeing services is meeting desires at smallest cost to organisation. It does not include final part of Ovretveit's (1992) definition, that quality must also satisfy `higher level' requirements of law and ethics.

Dimensions of qualitySo far in discussing definition of quality two important dimensions have not been considered, firstly structure, process and outcome (Donabedian 2002: p38) and secondly client, professional and management quality (Ovretveit 1992: p147). That outcome alone is not enough to indicate quality is illustrated by a hospital patient's death after receiving blood cross-matched for another patient: rarity of this outcome does not record number of times when only good fortune has prevented fatal error due to an unsatisfactory checking procedure. Thus outcome alone omits to discuss organisational structure and process of care in which cause may be found (Kasper, 1999:12).

Distinguishing between structure, process and outcome varies in importance in assessing quality for different professions: outcome is important for medicine and physiotherapy to measure effectiveness of therapeutic procedures (Kendal 1997). It is less satisfactory for nursing because of that profession's focus on caring rather than remedy: therefore Thomas et al. (1996) suggest that patient satisfaction with process of care is main outcome which is a legitimate measure of nursing quality. For this reason widely used quality measurement tools for nursing focus ...