Modularizing specialized hospital services : Constraining characteristics, enabling activities and outcomes

Purpose Modularity promises to relieve problems of complexity in service systems. However, limited evidence exists of its application in specialized hospital services. The purpose of this paper is to identify enablers, constraints, and outcomes of modularization in specialized hospital services. Design/methodology/approach A qualitative comparative study of a hematology unit with modular service architecture and an oncology unit with integral service architecture in a university hospital is performed to analyze the service architectures, enablers and constraints of modularization, and outcomes. Findings A framework and five propositions combining the characteristics of specialized hospital services, enabling activities, and outcomes of modularization were developed. Modular service architecture was developed through limiting the number of treatment components, reorganizing production of standardized components into a separate service unit, and standardizing communication and scheduling in interfaces. Modularization increased service efficiency but diluted ownership of services, decreased customization, and diminished informal communication. This is explained by the specific characteristics of the services: fragmented service delivery, professional autonomy, hierarchy, information asymmetry, and requirement to treat all. Research limitations/implications Modularization can increase efficiency in specialized hospital services. However, specific characteristics of specialized care may challenge its application and limit its outcomes. Practical implications The study identifies enabling activities and constraints that hospital managers should take into account when developing modular service systems. Originality/value This is the first empirical study exploring the enablers, constraints, and outcomes of modularization in specialized hospital services. The study complements literature on service modularity with reference to specialized hospital services.