Innovation and Culture in Public Services
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Innovation and Culture in Public Services

The Case of Independent Living

Steven DeMello and Peder Inge Furseth

There is a growing trend toward the integration of public and private entities in the delivery of public services. This book aims to improve the ability to innovate successfully in large-scale public/private endeavors. The authors develop an underpinning theory of innovation, and extend it to address key issues in public/private collaboration. As an example, they explore the subject of independent living for seniors and disabled people across four countries – the US, UK, Norway and Japan. The resulting model provides a vehicle for all major stakeholders to better understand the dynamics of innovation, which will in turn offer the opportunity to improve performance and successful adoption.
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Chapter 3: In-home care services for independent living

Steven DeMello and Peder Inge Furseth


In this chapter we make the case for in-home care services to support independent living as a critical social issue, and one that lends itself to the use of models of innovation. Specifically, we will expand the discussion begun on p. 14 in Chapter 1 (‘Why Study Independent Living’), by focusing on demand for services, supply conditions, and public policy issues associated with in-home care. These are driven by five dynamics that we believe emphasize the role and potential value of in-home care: 1. Demographics. The ageing of the population is a fundamental force shaping our world. 2. Disease. The concurrent, rapid rise in chronic conditions is generating a wave of demand that cannot be met by current supply. 3. Human resources. There is substantial evidence to suggest that the supply of licensed caregivers of all types will fall increasingly short of the increased demands of ageing and chronic disease. 4. Technology. Many in the industry believe that disruptive innovation can come from technology-enabled services in the home and community. While there is some evidence of successful technology-driven innovation, particularly in telehealth, adoption has been slow and regulation cumbersome. 5. Politics. The policy debates that arise from the budgetary and wealth redistribution effects of entitlement and other programs.

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