title: Improving client-centred care and services: the role of front/back-office configurations.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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).
  
  
  RESULTS
  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.
authors.affiliation: Department Operations, University of Groningen, The Netherlands. h.broekhuis@rug.nl
authors.forename: Manda
authors.initials: M
authors.lastname: Broekhuis
authors.forename: Carolien
authors.initials: C
authors.lastname: de Blok
authors.forename: Bert
authors.initials: B
authors.lastname: Meijboom
mesh_terms: D006272:Health Facility Environment / Q000458:organization & administration*; D006699:Home Care Services / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D008137:Longitudinal Studies; D017146:Models, Organizational; D017060:Patient Satisfaction; D018802:Patient-Centered Care / Q000458:organization & administration* / Q000592:standards; D011369:Professional-Patient Relations