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Aflevering 2, 2021 Alle samenvattingen uitklappen
Van de redactie

Andere Tijden

Auteurs Mark van Ostaijen
SamenvattingAuteursinformatie

    This editorial offers an introduction to the current issue.


Mark van Ostaijen
Dr. Mark van Ostaijen is managing director van het LDE Centre Governance of Migration and Diversity en assistant professor aan de Erasmus Universiteit Rotterdam. Hij is tevens redacteur van Beleid en Maatschappij.

Marianne van Bochove
Dr. Marianne van Bochove is universitair docent, sectie Health Care Governance, Erasmus School of Health Policy & Management aan de Erasmus Universiteit Rotterdam en senior onderzoeker aan De Haagse Hogeschool.

Katja Rusinovic
Dr. Katja Rusinovic is lector grootstedelijke ontwikkeling, faculteit Bestuurskunde, Recht & Veiligheid aan De Haagse Hogeschool.

Suzanna Koops-Boelaars
Suzanna Koops-Boelaars, MSc, is promovendus, sectie Health Care Governance, Erasmus School of Health Policy & Management aan de Erasmus Universiteit Rotterdam.
Artikel

Rebellerende zorgprofessionals

Improviseren met regels, passie en verantwoording

Trefwoorden healthcare rebels, administrative burden, quality of care, etnography, accountability
Auteurs Iris Wallenburg, Hester van de Bovenkamp, Anne Marie Weggelaar-Jansen e.a.
SamenvattingAuteursinformatie

    Bureaucracy and ‘red tape’ are seen as a main annoyance in healthcare practice. ‘Rules’ like guidelines and performance indicators would withdraw professionals from their real work, that is, helping patients. However, rules may also improve quality of care if they foster high quality practices. In this research, we explore how healthcare rebels deal with rules in their everyday work: how rebels ignore, engender and bend rules to build new environments for doing good care. Drawing on ethnographic research in three hospitals in the Netherlands (2017-2018), we reveal how rebels build and care for clinical microsystems containing their own clinical unit and related contexts (e.g. pharmaceutical suppliers, ICT companies, primary care) to evoke alternative and situated practices of good care delivery – i.e. focusing on quality of life and person-centred care. Rebels enact mechanisms of decoupling and recoupling to disconnect rules that embark on good care in specific patient situations, and build new routines that foster good care. However, such caring practices are hard to generalize as they often occur ‘under the radar’ and hence remain hardly noticed to the outside world. We argue that through revising accounting processes, and paying more attention to narratives of good care, more convenient quality systems could be found.


Iris Wallenburg
Dr. Iris Wallenburg is universitair hoofddocent, sectie Health Care Governance, Erasmus School of Health Policy & Management aan de Erasmus Universiteit Rotterdam.

Hester van de Bovenkamp
Dr. Hester van de Bovenkamp is universitair hoofddocent, sectie Health Care Governance, Erasmus School of Health Policy & Management aan de Erasmus Universiteit Rotterdam.

Anne Marie Weggelaar-Jansen
Dr. Anne Marie Weggelaar-Jansen, MCM is universitair docent, sectie Health Services Management and Organization, Erasmus School of Health Policy & Management aan de Erasmus Universiteit Rotterdam.

Roland Bal
Prof.dr. Roland Bal is hoogleraar beleid en bestuur van de gezondheidszorg, sectie Health Care Governance, Erasmus School of Health Policy & Management aan de Erasmus Universiteit Rotterdam.
Artikel

Regels breken in het belang van de burger

Van rebelse leidinggevende naar rebelse professional?

Trefwoorden leadership, pro-social rule breaking, red tape, purpose-driven work, professionals
Auteurs Bernard Bernards en Eduard Schmidt
SamenvattingAuteursinformatie

    The recent decentralization of many healthcare and welfare responsibilities from the national to the municipal level in the Netherlands was aimed at reducing unnecessary bureaucracy and giving discretion to the professional. However, this is not (yet) fully achieved. Therefore, calls have been made for more purpose-driven organizations. Pro-social rule breaking, which refers to acts of rule breaking motivated by the benefits that this creates for citizens, might be a way to make organizations more focused on their organizational purpose. Since little is known about the antecedents of pro-social rule breaking, this article looks at the possible effects of red tape and supportive leadership on pro-social rule breaking behavior of professionals. Based on a quantitative large-n study of professionals in the social domain, the results show that red tape significantly affects pro-social rule breaking. Stimulating leadership does not affect pro-social rule breaking behavior, which may be caused by the fact that intended leader support is not be perceived that way by the professional. The article concludes with a discussion on the desirability of rule breaking in a public sector context, followed by practical implications and further avenues for researchers.


Bernard Bernards
Bernard Bernards, MSc MA is promovendus bij het Instituut Bestuurskunde, Universiteit Leiden.

Eduard Schmidt
Dr. Eduard Schmidt is universitair docent bij het Instituut Bestuurskunde, Universiteit Leiden.
Artikel

Access_open ‘We gaan het gewoon doen!’

Rebelse initiatieven in onderwijs en ouderenhuisvesting

Trefwoorden rebellion, housing for older people, education, rules and regulations, room to manoeuvre
Auteurs Marianne van Bochove, Katja Rusinovic, Suzanna Koops-Boelaars e.a.
SamenvattingAuteursinformatie

    Both education and housing are highly regulated sectors in the Netherlands. According to various stakeholders, regulations and formal and informal rules hinder the development of new initiatives aimed at providing attention to personal needs and wishes of children (in education) and older people (in housing). This article focuses on founders of initiatives in both sectors that, despite institutional obstacles, dare to do things differently. We adopt a rebellion perspective, which focuses on how individual and collective actors aim to create favorable circumstances for providing better services, even if this means they have to disrupt existing institutions. In-depth interviews were conducted with 22 founders of rebellious initiatives in education and housing for older people. According to the founders, what makes them different from others is having a dream, learning by doing, and critically assessing rules and regulations. Founders in both sectors not only interpret rules differently, but also try to change them. In order to do so, they need supportive internal and external contexts, which they create through personal contacts and social media. Although rebellion in both sectors has many similarities, sector-specific institutional settings and past events do shape its appearance.


Marianne van Bochove
Dr. Marianne van Bochove is universitair docent, sectie Health Care Governance, Erasmus School of Health Policy & Management aan de Erasmus Universiteit Rotterdam en senior onderzoeker aan De Haagse Hogeschool.

Katja Rusinovic
Dr. Katja Rusinovic is lector grootstedelijke ontwikkeling, faculteit Bestuurskunde, Recht & Veiligheid aan De Haagse Hogeschool.

Suzanna Koops-Boelaars
Suzanna Koops-Boelaars, MSc, is promovendus, sectie Health Care Governance, Erasmus School of Health Policy & Management aan de Erasmus Universiteit Rotterdam.

Joost van Hoof
Dr. ir. Joost van Hoof is lector urban ageing, faculteit Sociaal Werk & Educatie, aan De Haagse Hogeschool.
Artikel

Rebel-leren: hoe een rebelse sector tot lerend verantwoorden komt

Trefwoorden quality of care, rebels, accountability, organization/sector learning
Auteurs Annemiek Stoopendaal en Wilma van der Scheer
SamenvattingAuteursinformatie

    Healthcare is often dominated by the curative domain. Yet, for a new way of improving of and accounting for quality of care, we have to shift our focus to the care for people with disabilities. Since long, quality of care is translated into performance indicators and standards. This reductive way of measuring quality was pursued for the entire healthcare sector. Where this might fit in with hospital care, it was experienced as constraining in care for the disabled. In this sector it was seen as a poor representation of the plurality of healthcare provision. A number of ‘quality rebels’ aimed to create a more suitable and rich Quality Framework for the sector, with attention for objective, subjective and intersubjective dimensions of care. In this article, we analyze the way in which the sector has realized this aim, and we show how this rebellious sector succeeded in transforming the idea of accountability for quality of care, by emphasizing on the reflection and learning processes that take place at all levels of the sector, and beyond. A new approach which requires a continuous cycle of disrupting, creating, and maintaining institutionalized patterns of thinking and doing. It requires ‘rebel learning’.


Annemiek Stoopendaal
Dr. Annemiek Stoopendaal is organisatieantropoloog en universitair docent/senior onderzoeker, Erasmus School of Health Policy & Management, sectie Health Care Governance aan de Erasmus Universiteit Rotterdam.

Wilma van der Scheer
Dr. Wilma van der Scheer is gezondheidswetenschapper, directeur van het Erasmus Centrum voor Zorgbestuur en leider van de academische werkplaats zorgbestuur, Erasmus Centrum voor Zorgbestuur aan de Erasmus Universiteit Rotterdam.

    In this feature authors discuss recent research findings that are of interest to readers of Beleid en Maatschappij.


Tamara Metze
Dr. Tamara Metze is universitair hoofddocent bij de leerstoelgroep Bestuur en Beleid aan de Wageningen Universiteit en voorzitter van de redactie van Beleid en Maatschappij.

    In this feature authors discuss recent research findings that are of interest to readers of Beleid en Maatschappij.


Frank Hendriks
Prof. dr. Frank Hendriks is hoogleraar vergelijkende bestuurskunde aan Tilburg University.

    In this feature authors discuss recent research findings that are of interest to readers of Beleid en Maatschappij.


Tom van der Meer
Prof. dr. Tom van der Meer is hoogleraar politicologie aan de faculteit der Maatschappij- en Gedragswetenschappen aan de Universiteit van Amsterdam.

    In this feature authors discuss recent research findings that are of interest to readers of Beleid en Maatschappij.


Kristof Jacobs
Dr. Kristof Jacobs is universitair hoofddocent emperische politicologie op de afdeling politicologie aan de Radboud Universiteit Nijmegen.

    In this feature authors review recently published books on subjects of interest to readers of Beleid en Maatschappij.


Coen Brummer
Coen Brummer, MA MSc is directeur van de Mr. Hans van Mierlo Stichting, het wetenschappelijk bureau van D66. Tevens is hij verbonden aan de Rijksuniversiteit Groningen, waar hij een proefschrift schrijft over Samuel van Houten (1837-1930) en het Nederlands liberalisme.