A framework to evaluate the complexity of home care services

The purpose of this paper is to assess the potential factors that may generate complexity in managing operations in home care (HC) organizations. Hence, a framework which might assist decision making regarding complexity‐driven issues in HC organizations is developed.

Based on a systems thinking view, a framework was developed identifying complexity factors in HC organizations. The paper is based on field research to explore the practical challenges of managing operations in HC structures. The authors additionally give a state of the art in many scientific domains; definition of complexity and its implications; complexity in health care; description of home care operations and their management. The literature review enlightens the lack of consensus on HC complexity and thus provides a broad view and a critical analysis of the underlying concepts.

Proposal of a HC operations complexity model (and validation due to a practical application).

The framework developed by the authors permits one to identify rapidly the existing complexity factors which may create potential damages regarding value creation and cost improvement in HC. Two kinds of HC complexity are identified: HC organization complexity and HC individual patients' therapeutical projects complexity. Complexity factors are grouped into five categories: factors related to size; factors related to variety; interdependence factors; factors related to uncertainties; and factors related to context. By identifying the factors, decision support systems and response plans may be more adapted to the potential existing short comings of operations.

Based on authors' extensive knowledge of HC practices, as well as an international systematic review of literature, this paper contributes to a better characterization of factors inducing complexity in the HC context. To the best of the authors' knowledge, operations management literature lacks a general framework enabling a better identification and understanding of what makes HC operations specific. The paper presents an innovative way to analyze HC complexity using a systems thinking‐based approach. In this sense, its contribution is very complementary to traditional operations management models.