An essential brick of the service4health building is the development of a productivity index which comprises hard ( material, financial) as well as soft (patient and employee satisfaction, quality of teamwork) key performance indicators. This index facilitates a holistic measurement and enhancement of service productivity. A second important brick is the orientation on processes, their redesign, their validation and eventually the optimization of the hospital organization. The third essential brick is the integration of diversity on three levels. Diversities reflect prevailing tendencies of the society, of services and especially of hospitals services. Therefore, an integration of diversities helps to overcome system inherent problems.

Overall, the research project is required to deliver an innovative concept as a foundation for the development and trial of new ways towards process based productivity enhancements in hospital services. The innovative business processes and their support processes must accommodate the human diversity. In order to meet this requirement for hospital services, the three topics of “Service Productivity” (productivity measurement, assessment, and enhancement) have to be combined. Consequently the project can be assigned to the issue of “measuring and designing productivity”.

Diversity describes differences between members of an entity, e. g. concerning relevant attributes like qualification, age, ethnic background or occupational group. A focus is set on three kinds of diversity:

Ethnic diversity
Demographic diversity
Relational diversity

Cultural background variables affect the interactions between members of staff and between members of staff and patients in certain processes and have important effects on productivity. Cultural (ethnic) diversity is rooted in diverse national and ethic affected value and behavior systems. Cultural diversity in hospitals appears at different contact points: between physicians, between nurses, between physicians and nurses as well as between patients and members of the hospital staff.

The impact of demographic factors like sex, age or education on relevant performance and process attributes concerning human resources has been constituted in numerous studies. It is regularly assumed that an enhanced diversity leads to increasing coordination and communication effort while the reciprocal attractiveness and social proximity decline and prejudices and discrimination rise. It is important to note that different degrees and paradigms of demographic diversity can have a positive as well as a negative impact on process time, team performance and other organizational ratios.

Relational diversity comprises the influence of varying employment conditions, e. g. permanent and temporary employment, on interaction quality and on productivity. The traditional long-term employment yields more and more to flexible terms of employment. Hospitals have especially in rural areas problems to recruit e. g. assistant physicians. Consequently the required personnel are hired through personnel service providers (temporary employees). Comparable effects are achieved when nurses are hired by in-house personnel service providers and assigned to different wards according to the demand. Thus, teams and shifts which contain permanent and temporary employees are created in hospitals.

The objective of hospitals is to design the influences of diversity in ways that have only fractional negative or even positive impact on service productivity. Being able to design the influences requires in-depth knowledge of the connected problems and effects and additionally concepts to accomplish the objectives. On this account, the possible problems and effects in praxis have to be systemized, evaluated and design recommendations have to be derived.

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