Value-in-Context of Healthcare: What Human Factors Differentiate Quality of Nursing Services?

With social issues such as an aging society and the sustainability of health service systems becoming of greater concern, decision makers in health service sectors need to identify the human factors that differentiate the performance of health service professionals such as nurses. However, the fact remains that a nursing shortage has hindered such efforts in many countries.What brings about value in nursing services? How is value cocreated in clinical settings by nurses, patients, and other agents? Given that service is the application of competencies for the benefit of another entity, this work is an attempt to identify the typology of competencies as operant resources where value is idiosyncratic, experiential, contextual, and meaning-laden. In so doing, this paper explores meaningful relations among service quality, human competency, and contextualization. Therefore, the objective of this study, conducted in one of the leading university hospitals that employs 1,448 nurses, and with the support of the Japanese government, was to identify the characteristics of human activity systems, focusing on the relationships between service quality, human competency, and value-in-context. This work used the original transcript text obtained by combining the critical incident technique and behavioral event interview approaches. After collecting qualitative data, text coding was performed on the interview transcripts.The findings of the present work contribute to practitioners and theoreticians by providing a bridging concept between human resources management and service systems management. First, our ethnographical research reveals that nurses in different role groups applied different sets of competencies in their diverse job contexts, where there exist commonly applied differentiating competencies as well as other threshold competencies. Second, in an attempt to explore the features of value cocreation, this paper explores the relationship between competencies in action and dynamic contexts translation. Third, to address value cocreation systems in value-in-contexts focusing on nursing and caring services, this paper proposes a meta value-in-context translational model.