Alternative Organizing Principles for the Design of Service Delivery Systems

Abstract

In the basic design of systems for delivering human services, there is a fundamental choice to be made in how the parts of the system are to be organized or grouped. Systems can be designed to emphasize and pay attention to the total experience of clients as they move through the system, or to the standardization of the individual services that they receive. In many cases, systems have simply evolved without there ever having been a conscious decision. Amid today's concerns with continuity of care, outcome measures, staff turnover, and the influence of managed care, the significance of confronting this choice is becoming more and more important.

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