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The purpose of this paper is to explore how functional and appropriateness arguments influence the adoption of modularity principles during the design of a professional service architecture.

Action design research was conducted to examine the design process of a modular service architecture for specialised elderly care by a multi-professional group. Data collection methods included, partly participatory, observations of the interactions between professionals during the design process, interviews and document analysis. Data analysis focussed on the emerging design choices and the arguments underlying them.

A wide range of both functional and appropriateness considerations were enlisted during the design process. The three core modularity principles were adapted to varying degrees. In terms of the design outcome, the interdependencies between the modularity principles necessitated two trade-offs in the modular design. A third trade-off occurred between modularity and the need for professional inference where services were characterised by uncertainty. Appropriateness was achieved through the professionals reframing and translating the abstract modularity concept to reconcile the concept’s functionality with their professional norms, values and established practices.

The study adds to service modularity theory by formulating three trade-offs that are required in translating the core modularity principles into a functional set of design choices for a multi-professional service environment. Moreover, the inherent intertwinedness of the core modularity principles in professional services requires an iterative design process. Finally, the authors saw that the ambiguity present in the service modularity concept can be used to develop a design that is deemed appropriate by professionals.

This paper aims to investigate the forces that influence the shifting of professional boundaries on the entry of a new medical occupation in Dutch hospitals – non‐specialist emergency physicians.

Five case studies of Dutch hospitals were conducted and the emergency physicians' implementation process was analyzed by means of force field analysis.

Emergency physicians were conceptualized as being the answer to unequivocal contextual changes. However, their contribution to better performance varies due to problems in the implementation process. Strong socio‐political forces between traditional specialties and these new doctors mediate the intended improvement. The emergency physicians aim to establish their own organizational‐, patient‐ and knowledge‐domain by redrawing professional boundaries but they are not on a par with the specialists who set these boundaries. Consequently, emergency physicians only gradually redraw the existing boundaries, resulting in limited added value. Their reaction is to obtain power by striving to develop into a recognized specialty; ironically, by becoming an additional layer in the traditional medical hierarchy they might lose their envisaged added value.

This paper is based on the first Dutch hospitals that implemented emergency physicians. The number of cases is therefore limited. Moreover, the study took place at an early stage of emergency physician implementation.

The extent of successful redrawing depends on the implementation's transition logic, the existing degree of differentiation and boundary permeability and on the ideological power developed by the leaders.

The introduction of emergency physicians is currently being discussed in many countries worldwide, and some countries consider following the Dutch example of non‐specialist doctors. This paper supports health professionals and hospital managers in not falling prey to the same pitfalls as some Dutch hospitals.

In today’s aging world online communication is often viewed as a means to enhance social connectivity, and therefore well-being, of older adults. However, previous research on the influence of online communication on social connectivity largely disregards older adults, yields conflicting results and fails to assess the – debatable − causal direction of relationship. The purpose of this paper is to overcome these issues by developing four hypotheses related to who uses what, how, with whom.

The authors use a panel data study to test the hypotheses, including 302 older adults. Response rates are between 62 and 75 percent.

The authors find, first, that older adults differentiate between social connectivity with other village members, i.e., village connectivity, and connectivity with friends. Second, the impact of online communication varies among these two types of social connectivity. Where e-mail use has a negative impact on village connectivity, it does not affect connectivity with friends. Facebook use on the other hand has a negative impact on connectivity with friends, but not on village connectivity. The negative effects were not found among those older adults that were already well-connected on forehand, indicating a buffer effect.

Policy makers’ implementing online communication tools to strengthen social connectivity of older adults, may want to carefully select tools based on the type of connectivity they aim to enhance. Impact needs to be monitored.

The authors contribute by analyzing how characteristics of online communication tools, i.e., information richness and privacy protection, as well as social connectivity, i.e., geographical proximity and emotional closeness jointly shape older adults’ social connectivity.

Applying “modularity” principles in services is gaining in popularity. The purpose of this paper is to enrich existing service modularity theory and practice by exploring how services are being decomposed and how the modularization aim and the routineness of the service(s) involved may link to different decomposition logics. The authors argue that these are fundamental questions that have barely been addressed.

The authors first built a theoretical framework of decomposition steps and the design choices involved that distinguished six decomposition logics. The authors conducted a systematic literature search that generated 18 empirical articles describing 16 service modularity cases. The authors analysed these cases in terms of decomposition logic and two main contingencies: modularization aim and service routineness.

Only three of the 18 articles explicitly addressed the service decomposition by reflecting on the underlying design choices. By unravelling the decomposition in each case, the authors were able to identify the decomposition logic and found four of the six theoretically derived logics: single-level process oriented; single-level outcome oriented; multilevel outcome oriented; and multilevel combined orientation. Although the authors did not find a direct relationship between the modularization aim and the decomposition logic, the authors did find that single-level decomposition logics seem to be mainly applied in non-routine service offerings whereas the multilevel ones are mainly applied in routine service offerings.

By contributing to a common understanding of modular service decomposition and proposing a framework that explicates the design choices involved, the authors enable an enhanced application of the modularity concept in services.

From a contingency perspective and by using the principles of self‐organization described by Morgan (1986), this essay relates the amount of variety in transactions and transformations to the requisite of self‐organization. Self‐organization is defined in terms of the local autonomy to make decisions on both the transactions to be realized and the way transformation processes are organized to achieve these transactions. Appropriate Human resource management (HRM) systems and policies can help to achieve the level of self‐organization aimed at. When the amount of variety in transactions is relatively low, an organization can easily standardize and control work processes. In this case, there is no need to develop self‐organization. The focus of HRM will be on standardization, behavioral control systems and the social needs of workers. In the case of a moderate level of variety in transactions, management may obtain responsiveness by creating self‐organizing teams which have the local autonomy to deal with variety in customer demand. HRM instruments can help these teams by supporting integrated management, the multifunctionality of workers, team development, and the introduction of a skill‐based assessment and reward system. When the amount of variety becomes high, it is more effective to assign responsibilities to individuals and to apply HRM practices aimed at the problemsolving capacity of workers and the commitment of workers to the organization.

Hospital managers are constantly confronted with capacity and continuity problems that tempt them to investigate the possibility of further job differentiation. In The Netherlands, the hospital physician represents a new breed of physicians who are not oriented towards a medical specialism but towards a patient domain. The hospital physician represents a controversial kind of job differentiation that is expected to stimulate more continuity. This case study shows how medical specialists themselves are starting to address the fragmentation caused by specialization. According to the professionals involved, the hospital physician constitutes a solution that does not threaten their professional values. They report a number of ways in which this job type can contribute to solving the problems reported. However, concerns have been raised about the risks of developing these new jobs without changing the existing professional and work structures.