Qualitative Research (Quality study on social work services)





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work service

The interconnection in double contingency between the person and the collective personality of the services

1 Studies of quality in the current evaluation practice
2 Qualitative indicators for the recognition of the needs of customers and their personality
3 Indicators of climate and internal relations at the service (the collective personality)
4 Interconnections in double contingency and saturation database

INTRODUCTION
The first essential considerations to play in relation to the study of quality of services concerning some issues to be answered, namely:
  1. Quality is historical and is linked to what a company is going through (the amount of production, the strength, customer satisfaction, the analysis of the processes, procedures and their standardization up to the quality of the reports)
  2. The continuous improvement in services is one aspect of social change to be interpreted in the direction of harmonization of relations
  3. The product of a service, in fact, are the social relations the medium is the operator. Operator and customer are two lives and two humanities who meet and who must understand in their personal identity and needs in affinity with the mission and vision of the service.
  4. In order to assess these problems, not to be self-referential, you can make use of "social reports" (that integrates the individual projects for users and service projects) integrated with the social impact assessment (the ratio of service with the primary networks).

In response to these considerations on the quality of social services should be observed as models of quality assessment in health services contain the question of the relationship is the model.
1. Control of strategic direction - excellence in effectiveness and appropriateness -: management processes and analysis of the patient
2. Theoretical approach professional: through the perceived quality and continuous improvement (ease of access, hospitality, convenience, timeliness, respect for the personality of the patient and staff)
3. Perceived quality and satisfaction questionnaires (tree quality)

In these three areas organizational and managerial, technical and professional and humanistic participatory flow studies on:
  1. Total quality and continuous improvement (quality circles, Deming cycle) Total Quality Management and Control Quality Improvement
  2. ISO 9000 The International Organization for Standardization is a worldwide federation of organizations of 130 countries founded in 1947 to promote the spread of standards in facilitating communication and exchanges. The acronym ISO also means "equal"; as well as they have been standardized in the same way by the ISO credit cards, calling cards, etc. It is proposed guidelines to ensure equality of systems and procedures to compare the processes of production and evaluation of product quality. But, warns the ISO in its official website that: "The standards Which make up the ISO 9000 and ISO 14000 families are among the Thousands of voluntary International Standards developed and published by ISO ... ISO itself does not carry out its assessments to Check That standards are being Implemented by users in conformity with the requirements of the standards ... ISO itself has no authority to control These activities. A point Which logically follows on from the above remarks Is that it is false to describe a company as "ISO-certified", "ISO-registered", or to use phrases such as "ISO certification", "ISO certificates" and "ISO registration "... Both ISO 9000 and ISO 14000 auditing and certification are the carried out independently of ISO by certification bodies Under Their own responsibility." (www.iso.ch).
  3. Drawing up quality manuals through the criteria of Responsibility - Management - Design - "Mission" - Improvement.

Studies of quality may occur as a place of integration between social and health care because of the skills that the social sector can transmit about the production of relational goods.
   
Studies of quality in the current evaluation practice
The evaluation is a sociological approach to scientific knowledge that becomes practice of action and guidance to facilities that provide services implemented through a survey that evaluates knowledge services and redirect the action. This process of working itself as an "interface" between institutions erogratrici services, people and customers their worlds of life.

Studies of quality move generally in the difficulty of combining indicators "strong" the structure of the service with the "weak" customer satisfaction.

The first study: the process (implemented in phases through the decomposition of service) - the procedure (task list, forms used, mean duration of treatment or intervention, protocols, resolutions or reference standards) - the structure of the staff (manager and operator involved in activities, their training and their professionalism) - products (process analysis combined the objectives achieved, productivity) - the effectiveness and efficiency (cost / effectiveness, cost / utility, cost / benefit analysis)

The point of view of the customer is assessed and monitored through the quality perceived by the citizens-customers in its visible aspects: Easy access - Timeliness - Jurisdiction - Trust - Safety - Appropriateness - Customer orientation and information (through complaint handling, internal audits, quality questionnaires, survey sampling, examination of the direction or audits).

The entire analysis is carried out through direct observation of the processes of service delivery supported by several modules prepared presenting, mixed, indicators of the structure of the service and customer satisfaction, through statistical reprocessing to verify and propose the revision of Quality.

The preparation of models for the analysis of quality must solve, in the conjugation between strong and weak indicators, three problems:
  1. Can not only benefit from the experience of quality studies experienced companies in transforming you from "assisted" to "buyer". This alternative dry fact requires great maturity of the "citizen expert" or "competent community". The choice (exit) and voice (voice) citizens, obtained through the provision of "good" that allow the direct purchase of social services, through the resolution of the problem of orientation of the user. Users of the assistance are those who generally have fewer opportunities for evaluation and choice of services and they need to protect competent. Otherwise the choice of spending the "good" may depend on mechanisms of dependence or cronyism, or orientation on the basis of occasional impromptu and not suitable for long-term resolution of problems.
  2. must be coherence between the views of the professional or technician with surveys on user satisfaction through innovative methods, simple, "read" and economic, that will contribute to the training of the operators and the improvement of their operations, without adding new handling the paperwork, new bureaucracy weighing down their work.
  3. it is necessary, in terms of methodology, to integrate qualitative and quantitative data, indicators of effectiveness / efficiency (system-service) and indicators index of the client, identify specific indicators for each service category (with a difficult comparison between them, too. eg. between public services and the third sector)

Examples of quality assessment in some services (collected in the web).
Daycare. Indicators: organizational methods of service, professionalism of the operators, access policies, external communication, organization and promotion of children's experiences, organizational services, environment, family participation, activities of individual care, the child's behaviors in with lyrics.
Tools: questionnaire to the responsible municipal departments, the questionnaire for the educator referent single frame, tab to the observation of the organization of the environmental, card for observing the behavior of adults and children.

At the background are accompanied by other indicators such as "non-compliance" than normal choice, the degree of customer satisfaction (family) detected through periodic questionnaire and any claims of the families, the satisfaction of internal personnel detected through periodic questionnaire and interviews, judgment on suppliers expressed numerically according to supply non-conforming (canteen, maintenance, heating, materials, etc.), the hours of training and the number of actions to improve each year.

Communities for children. Indicators: Structural features (custom spaces, n. Guests per room, security environments, neighborhood services and environment, rules of procedure, method of operation), equipment operators (professionals, update, qualification, team work, coordination, relationship op / res, supervision), project characteristics (individual relationships with the child, family involvement, implication territory, timing and stages of the project, acceptance and resignation), features educational program (developmental milestones, personal analysis on sleep, nutrition, motor skills, fears, anxieties, self-control, responsibility, relationship with peers and adults, emotional needs, respect rules, self-esteem, initiative, reaction to frustration, perseverance in the task).

Tools: Observation of the process and direct observation of the environment, self-declaration of the entities, interview managers, observation of the child, testing compiled by lower (with evaluation on the comprehensibility of the questions), weekly diary.

Integrated structure of home care and hospitality for the elderly. Indicators: social participation in management, organizational structure, organizational climate and human relations, planning and control system, constant search for improvement, checks and corrective action for the quality, availability of facilities and equipment, adequacy and compliance structures, financial self-sufficiency, staff profile, staff training, family involvement and volunteering, working with individuals and organizations in the area, capacity for analysis of the territory and its needs, external relations and communication.

Assessment tools home care: survey on working hours, telephone contacts with clients, visits to patients, analysis of the way of life of the clients, interviews to patients and families on the operation of the service, assessment of the adequacy of the service in connection with home care service, assessment tools canteen hospitality, service, customization, bathrooms, intimacy, humanization, hotel services, local collective, recreational activities, local and garden, animation, flexible schedules visits, telephone communications.

For drug addicts. Indicator: Effectiveness of the standards, access policies, stages and duration of the program, rules of procedure, responsible participation in the management structure, internal hierarchy, customization of the program, the process of social reintegration, family involvement, career guidance, vocational training, relationship op / res., follow up on discharged. Tools: talks with the team, analysis of the labor process, coordination, personal folders, methods of meeting, discussion cases, supervision, input cards, diary, longitudinal study on the course, climate group, analysis Regulation and traditions.

Qualitative indicators for the recognition of the needs of customers and their personality
In these examples, the asymmetry between the data description of the facility and also customer satisfaction, seems completely hanging from the side of the dispensing structure that equips himself through accrediting indicators, also with quality checks technical and professional trust in peer groups.

But the difficulty comparative services, the relative absence of competition because of their scarcity, the presence of traditional models of care alongside innovative experiences and addiction services the skills and social sensitivity of the directors, makes it even more difficult to understand quality assessment and its use aimed to change.
Data on customer satisfaction, therefore, can have influence only if defended by consumer organizations, but, in such cases, any dissatisfaction with the service can be ambivalent.
On the one hand with the excesses of dissatisfaction: the same dissatisfaction with social, personal, relational and existential, which led these people to be "users" can express demands and overly critical or opportunistic behavior (overprotective parents Porter h. That oppose the autonomy process triggered by the service, the TD conflict on substitute drugs..).

With the other excesses of dependence: the attachment to service has made such users clinging to the same emptying the potential constructive comments that could come from them.

We then arrived at the center of the problem of the quality analysis of relational goods produced by a service. The solution can not but take into account the psychological and social aspects of the client's personality and size of the collective personality of the service.
Alongside the indicators of effectiveness and efficiency, which is flanked by almost all other indicators used in traditional quality ratings, and more specific indicators of the target (which relate to the specific sector of the population, defined by type of problems and analyze the ' fairness, equality and impartiality evaluated on the basis of equal access, care and treatment based on the relative severity of the problems) can be introduced indicators of relatedness studying the relationship between personality and PC users of the service, in relation to the double contingency.
   
The model of personality indicators
The subjectivity of the social, customer service, it is recognized through the analysis of the needs and lifestyle (diet, lifestyle and working conditions), the network of relationships, the expectations towards the service and its staff attitude. Such investigation needs to be carried out through indicators that detect his personal "script" in relating to others, the world and himself.
The ideal-typical dimensions in which to collect the types of script affect the size of:
1) control over oneself and others (realism, distrust, self),
2) activation (commitment, initiative, responsiveness)
3) detachment (emotional distance, detection, prevalence of mental self)
4) emotional involvement (dramatization, effervescent fusion)
5) apathy (lack of motivation resignation)
6) shame (shame discretion inferiority)
7) attachment (affective search of certainties, prevalence of body-self).

The relative strength of each of the dimensions can be evaluated quantitatively and ratings of each allow forming a graph polarized, more or less intensely, on one or more dimensions. The ideal types of scripts mentioned are carriers of values (and negative values) depending on their internal balance and the degree of self-knowledge and self-acceptance (verifiable with interviews, short self-assessment test, self-description of visual sociology using a passport photo, ...) and capacity of a grasp of the empathic experience of others (verifiable through the weight given to staff sensitivity / impressionability, proximity / fusion to the experience of others and distancing / objectification by two degrees the previous process).
The seven dimensions are the ideal-typical characteristic to stand in a continuum of transmutation into one another, are not explicitly opposed polar (indeed each has two opposite dimensions that limit: 1 to 4:05; 2 to 5:06; 3 to 6 and 7; 4 from 7 and 1; 5 from 1 and 2; 6 from 2 and 3; 7 from 3 and 5), are constructed on the basis of the processes of expression of basic emotions and reveal the different provisions for participation groups can be described as a leader, opponent, independent, gregarious, opportunistic scapegoating and mascot.
The ideal types mentioned appear in numerous tests, especially those of pedagogy orientation with the terms realistic, enterprising, investigative, expressive, formal, social, relational, also in relation to the seven types of intelligence described by cognitive psychology.
This allows a view of subjectivity in relating to customer service and in its interaction with the operators. The systems the recognition of basic attitudes may be those of the personality questionnaire, the analysis of the history of life, the techniques of visual sociology and equip themselves with the tools of qualitative analysis applied to the customer. On this basis it is possible to identify the effectiveness of access policies and "customer satisfaction" through the subsequent application of traditional indicators, adding to them the evaluation of the change of the customer and his process of personal empowerment (self-knowledge , behavior modification, problem solving).
The definition of the attitude of the customer, often connected to the nature of its problems, as taught by the categories of psychosomatic medicine or homeopathy, allows you to understand the modulation of its relatedness to the service and the provision of service to him.
   
Personality indicators and processes of social change
The path of care is intimately related to the process of change of the customer who has taken over from the service side of its features in place but driven by relationships with operators and redecision a revision of its attitudes. When this is not done the customer becomes a "user" caught in a double bind (if evolves loses the protection and benefits of "assisted") or drop out (often critical of the service).

One side of the double contingency (the behavior of service according to the customer's expectations) invests the entire dispensing structure by pushing the flexibility and diversification of taking charge, in line with the potential of the structure in terms of its resources and its humanization climate socio-relational interior. Not all facilities may be able to modulate their pc depending on the different personality of customers, particularly as long as do not become aware of this need.

To solve the problems of double bond (chronic) and drop out (abandonment), avoiding typing of institutionalizing role de-motivation and social work of operators "burned" by the failures, it is necessary that the margin of tolerance inside the double contingency extends progressively to allow tilting of the relational positions, favoring the processes of change of customer (the client behaves as expected by the service). This second process is implemented through customer participation and moving the pc of the service on the relational side opposite to that in which it was taking charge.

This is the meaning of "process art and craft of care" (care) in service. A satisfied customer from the point of view of the humanization and personalization will be the one that made anxious by its propensity to control, first find reassurance and security in the pc of the service and, later, it will be directed towards the tranquilization and tolerance; or one who described in a condition of passivity and failure will initially support and respect for their dignity in service but will subsequently encouraged to take a more leading role; or one who appearing disoriented by the turmoil in his emotional experiences, from exaltation to anguish, will find understanding at first but, later, will be oriented to take more responsibility; and so on down the processes of change of each dimension, with all the different interconnections and overlaps.

Indicators of the collective personality of the service (social climate, values and relationships)

The collective personality of the service is determined by the relational operators between them, from the business sector in which the service is added, the sharing of the mission and the personal satisfaction and collective comes from work. Collective personality is a term introduced to make visible the outcomes of social processes supplementary and / or disassociate in a social formation.
The vantage point, the analysis of the collective personality, is that studies the interaction of the individual personality of the operators. This view is connected to the known indicators "strong" the quality analysis that contextualize the service, in relationship of mutual interpenetration with those of the collective personality.

The "indicators" strong "are:
1) those that refer to the sub-sector and area in which it is inserted, the processes "aggregations" about the role of the service, the chain of command in which it is inserted, with other communications services, to its identity and its functions, the participation in decision-making structures, the presence and recognition in the territory, from which the image of himself, the specific power and exercising that mobilizes the economy, to the financial structure.
2) The ones mentioned above in the analysis of quality, which directly concern the specific service and that is what the organizational structure, the system of planning and control, the availability of facilities and equipment, quantity and quality of staff, pay and staffing levels, the profile of personnel, staff training, the amount of meetings, supervisions. Furthermore, the analysis of the organization (centrality index of the different positions), the analysis of communication flows (communication bottlenecks, coalitions, diagonal communication, subgroups and antileader) and performance analysis.
The indicators of collective personality are aggregated around some axes that describe the structure of internal relations. Among the first relationships between colleagues (detectable through stories or questionnaires that investigate on the contacts between them after work, on their interpersonal ties and kinship, personal contact, leisure, vacation, phone, etc.), The presence subgroup status, more or less corresponding to the hierarchical lines, the bond of solidarity inside the service (verifiable through life stories involving some operator to which they are manifested forms of affection or, resentment), on the history of the nucleus history of the service and its stability (time series operators entering and leaving the service), and the historical memory of the service (counted maintained with the exiles), the reasons for the change of location or function (burn out or seeking promotion or personal reasons or family), changes of leadership and careers, busy staff to replace, on the understanding that the other operators of the work of each, on mutual trust and choices directed toward one or the other person (effectively the ever-present sociogram Morenian, revisited depending on the type of service). Some of the indicators on the relationships between colleagues are placed on the axes of the collective personality of the collective personality of affiliation or differentiation, other axes of the collective personality conflict or dissolving, others on the collective personality of control or of collective effervescence fusion, typical phase of state nascent structures.

All ground level manifested by cyclical fluctuations but the two models of pc control and ground level effervescence show wavelike perturbations most visible phase of innovation / transformation or consolidation that the service lives. The quality analysis can not dispense with that lesson E. Mayo on the modifications of the collective behavior of a group under observation. For this reconnaissance quality analysis must take into due account the impact that the same researchers on the service by implementing precautions and guidelines aimed all'imprimere a virtuous direction to the effects of their investigation. In terms of methodology, as we shall see, we are valuable indications of the research-action and intervention research.

The graph structure that results from the intersection of the characteristics of the specific pc the service is indicative of its specific climate and relational propensities towards different attitudes towards customers. The humanization and personalization of care are therefore not detectable in the abstract, as if they were interchangeable for every need of every human being, instead apply as necessary relational most effective and most appreciated by the client in articulating relationships for reassurance, encouragement to 'operation, information, involvement, tranquilization, support and participation. The ductility and the ability to empathetic understanding of individual operators typically disposes them towards the relational position more fine to the need but, to orient in that the ductility pcs service specification requires that all operators become aware of such possible arrangements and are able to intentionally move towards those congruent. Where in fact the overall attitude of service is raised inconsistently can occur a negative effect on the customer: an intervention of tranquilization about who has strong need for support is in fact perceived as indifference, the distribution of information to those who need to tranquilizer is experienced as disqualification, the emotional involvement to those who need encouragement is seen as attractive or seductive proposal, the proposal of participation or reassurance to those in need of information is perceived as manipulation or conditioning.
In this context only the understanding of the way of being and customer mix between his needs and personality of those connected to his specific problem can be arranged to correct the collective personality of the service.

At this point they can be taken into account and compared with the graph of pc all indicators that express the quality of the services ordered in a pattern that interpenetrates strong data (industry or service) with those of pc (A nursery has a basic emotional affective determined by the culture industry and the impact with small clients, but it can produce effects of excessive dependence or an excessive sense of separation according to the relational atmosphere inside and procedures adopted; l ' interpenetration between procedures and climate is fundamental to understanding the quality. A community exists in an affiliate system that decreases the individual differentiation, but, depending on the pc of the structure can have outcomes of excess of control and oppression or effective empowerment of customers . A home care service for the elderly is a face to face with poor attendance of the operators, the organizational structure of the service can then be transformed into PC exclusive control, burocratizzandosi with outcomes of disruption in the supply of information, integration with other services and on time waiting or, where the propensity to relational operators between them is encouraged, there may be exchanges of important information to help you effectively respond to customer needs).

The ductility of the surface level then the functional processes of change and customer satisfaction through the process of polarization of the customer to the service (the client behaves as expected by the service). This reversal is the second horn of double contingency and occurs when the needs and customer requirements are met at the stage of taking charge by the service. The real satisfaction is in fact determined by three clusters of factors: the available relational humanizing, the objective quality of service and the effects on customer becomes aware. When an elderly person feels the affectionate available operators, it decreases its fear of loneliness and, therefore, can live better its natural moments of solitude; when the attitude of a nurse is not dictated by the operational needs of the nursery and then does not force the process of weaning the baby, even in opposition to the provisions given by the mother, the child feels less intense separation anxiety, perceived a reassuring climate and off with ease his tensions. When a Td warns that his anxiety is empathically understood by the operator, feels supported and is already stronger in fighting the calls of his addiction.


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