Responsible management in Finnish home care environment - Modeling societal and company level effects
Mäkinen, Markus (2018)
Mäkinen, Markus
2018
Automaatiotekniikka
Teknisten tieteiden tiedekunta - Faculty of Engineering Sciences
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Hyväksymispäivämäärä
2018-04-04
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:tty-201803231421
https://urn.fi/URN:NBN:fi:tty-201803231421
Tiivistelmä
Finnish public home care providers will confront major challenges due to the aging of society. The change in the operational environment is predicted to be drastic. As a result, the workload in the home care services will increase, the availability of skillful work-force will decrease, and there are fewer people to support public services. Furthermore, the financial crisis in 2008 caused a sustainability gap in the Finnish government finance, which has led to a political decision to decrease the costs of healthcare. Therefore, the public home care providers will meet a challenge to serve more customers with less resources, which requires innovation of novel methods to maintain the service quality in public elderly care. System dynamics modeling was used to enhance the understanding of the operational environment of public home care providers, and to evaluate responsible management as a potential solution for the challenges. The modeling was guided by the case home care organizations’ primary interest in the governance part of responsible management, and their ultimate target to maintain customers’ quality of life.
The structural analysis of the model discovered that the dynamics of the system mainly results from the interaction of three balancing and four self-reinforcing feedback loops. According to the structural analysis, the work pressure is an important variable in the system. The analysis proposes that home care providers should have adequate resources to avoid vicious cycles. If the system ended up in a vicious cycle, the elderly care system would produce poor quality and high costs. The simulation analysis evaluated the outcomes of three budget policies and two technology policies. The analysis revealed that the dynamic budget was the only budget policy that allowed adequate resources for the home care provider to manage the increased workload. Both static budget and constant resources policies were not able to prevent the system from drifting to a vicious cycle. The selected technology policy had a smaller impact on the functioning of the elderly care but affected the overall costs.
The policy design suggested that the budget policy should take into account the changes of key indicators in the operational environment. This would allow a budget policy that ensures sufficient resources for the home care provider but prevents overspending due to a careless management. The trends of customers and their health are potential key indicators. The policy design also proposed that technological applications should be included in the home care operations to improve the cost efficiency. Another discovered method to improve the cost efficiency is to recruit sufficient number of employees to avoid the need for costly temporary workforce.
The structural analysis of the model discovered that the dynamics of the system mainly results from the interaction of three balancing and four self-reinforcing feedback loops. According to the structural analysis, the work pressure is an important variable in the system. The analysis proposes that home care providers should have adequate resources to avoid vicious cycles. If the system ended up in a vicious cycle, the elderly care system would produce poor quality and high costs. The simulation analysis evaluated the outcomes of three budget policies and two technology policies. The analysis revealed that the dynamic budget was the only budget policy that allowed adequate resources for the home care provider to manage the increased workload. Both static budget and constant resources policies were not able to prevent the system from drifting to a vicious cycle. The selected technology policy had a smaller impact on the functioning of the elderly care but affected the overall costs.
The policy design suggested that the budget policy should take into account the changes of key indicators in the operational environment. This would allow a budget policy that ensures sufficient resources for the home care provider but prevents overspending due to a careless management. The trends of customers and their health are potential key indicators. The policy design also proposed that technological applications should be included in the home care operations to improve the cost efficiency. Another discovered method to improve the cost efficiency is to recruit sufficient number of employees to avoid the need for costly temporary workforce.