Zoekresultaat: 12 artikelen

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Duwtjes of druk?

De percepties van zorgprofessionals aangaande ‘nudging’ in ziekenhuizen

Tijdschrift Bestuurskunde, Aflevering 4 2020
Trefwoorden nudging, ethics, autonomy, healthcare, professionals
Auteurs Nienke Maria Huis in ’t Veld MSc, Rosanna Nagtegaal MSc en Prof. dr. Mirko Noordegraaf
SamenvattingAuteursinformatie

    ‘Nudging’ has been introduced as a policy and management tool as a way to influence behaviour without limiting choice. Nudging is mainly used to influence citizens’ behaviour but can also be used to influence the behavior of healthcare professionals. Examples include posters used to improve hand-hygiene compliance, or ‘default’ options in systems to reduce excessive prescriptions of specific medication. However, using nudges raises major worries and ethical issues, also in relation to the independence of healthcare professionals. While the scientific discussion about the desirability of nudges is extensive, the voices of healthcare professionals, who are the subjects of nudges, remain unheard. In this qualitative research we explore the perceptions of nudging held by various healthcare professionals. The interviews reveal that healthcare professionals are generally unfamiliar with the concept of nudging, but they do recognize nudges in their own field of practice. Furthermore, while they are predominantly positive about nudging, they also express concerns about the pressure on their autonomy. These concerns are related to changing professionalism and regulatory pressures in healthcare.


Nienke Maria Huis in ’t Veld MSc
N.M. Huis in ’t Veld, MSc is alumna aan de Universiteit Utrecht, departement Bestuurs- en Organisatiewetenschap.

Rosanna Nagtegaal MSc
R. Nagtegaal, MSc is promovenda aan de Universiteit Utrecht, departement Bestuurs- en Organisatiewetenschap.

Prof. dr. Mirko Noordegraaf
Prof. dr. M. Noordegraaf is hoogleraar Publiek Management aan de Universiteit Utrecht, departement Bestuurs- en Organisatiewetenschap.
Artikel

Verschillend organiseren, verschillend functioneren?

De invloed van de organisatie van Jeugd- (en Gezins)teams op het teamfunctioneren

Tijdschrift Beleid en Maatschappij, Aflevering 1 2020
Trefwoorden Youth Care, Youth Team, Team functioning, Self-management, Organization
Auteurs Laura Nooteboom MSc, Janna Eilander MSc, Dr. Joris van der Voet e.a.
SamenvattingAuteursinformatie

    Objective: there are regional differences in the organization of local Youth Teams, that have been given a crucial role in delivering Youth Care since the transition of Youth Care in 2015. The aim of this article is to examine the influence of the organization of Youth Teams on several aspects of their functioning.
    Method: self-managing teams in Holland Rijnland and teams in The Hague that are led by a team manager are compared on several aspects of team functioning. This mixed-methods study is based on an online questionnaire among 237 professionals and interviews with 32 professionals. Quantitative data have been analyzed by conducting a t-test of group means, qualitative data by means of framework-analysis.
    Results: the organization of Youth Teams seems to influence certain aspects of the perceived team functioning. For example, professionals in the self-organizing teams Holland Rijnland experience more self-management and more informational elaboration. However, there are also similarities on several aspects. Professionals from both regions have similar expectations of leaders.
    Discussion: municipalities and Youth Care organizations should be aware of the influence of the organization of Youth Teams on team functioning. Future research must demonstrate which aspects of team functioning contribute to improved care for families.


Laura Nooteboom MSc
Laura Nooteboom is onderzoeker bij de Academische Werkplaats Gezin aan Zet, en promovenda bij Curium-LUMC het Academisch Centrum voor Kinder- en Jeugdpsychiatrie in Oegstgeest.

Janna Eilander MSc
Janna Eilander is onderzoeker bij de Academische Werkplaats Gezin aan Zet, bij Curium-LUMC, Academisch Centrum voor Kinder- en Jeugdpsychiatrie.

Dr. Joris van der Voet
Dr. Joris van der Voet is universitair docent aan het Instituut Bestuurskunde, faculteit Governance and Global Affairs van de Universiteit Leiden.

Dr. Ben Kuipers
Dr. Ben Kuipers is universitair hoofddocent aan het Instituut Bestuurskunde, faculteit Governance and Global Affairs van de Universiteit Leiden, en organisatieontwikkelaar en bestuurder bij Verbetervermogen in Amsterdam.

Prof. dr. Bram Steijn
Prof. dr. Bram Steijn is hoogleraar humanresourcesmanagement in de publieke sector, afdeling Bestuurskunde en Sociologie aan de Erasmus School of Social and Behavioral Sciences van de Erasmus Universiteit Rotterdam.

Prof. dr. Robert Vermeiren
Prof. dr. Robert Vermeiren is directeur patientenzorg en hoofd van de afdeling Onderzoek en Onderwijs bij Curium-LUMC, Academisch Centrum voor Kinder- en Jeugdpsychiatrie.

Dr. Eva Mulder
Dr. Eva Mulder is projectleider bij de Academische Werkplaats Gezin aan Zet en Senior onderzoeker bij Curium-LUMC, Academisch Centrum voor Kinder- en Jeugdpsychiatrie.
Thema-artikel

Positieve beleidsevaluatie: hoe evaluatieonderzoek kan bijdragen aan beter beleid

Tijdschrift Bestuurskunde, Aflevering 3 2019
Trefwoorden positive public administration, positive evaluation, positive psychology, success, policy oriented learning
Auteurs Dr. Peter van der Knaap en Dr. Rudi Turksema
Samenvatting

    New insights from the field of positive psychology led to the insight that people learn more effectively from positive feedback. Policy evaluation aims to improve public policy programmes through contributing to both accountability and learning. This ambiguous ambition has contributed to a considerable body of research into the impact of policy evaluation. Too often the conclusion is that the outcomes of policy evaluations – which are often negative by nature – are sparsely used by policy makers. This has led to series of improvements in the way we carry out evaluations. First through technical improvements and then by more responsive approaches. Both have not led to the desired breakthrough. Building on a number of positive evaluation studies, we advance a more positive approach in policy evaluation. Focussing on the successes in policy programmes rather than on its failures may contribute to evaluation impact. Consequently, we think a more positive, appreciative approach and using data to find success in policy making is necessary for policy evaluators to be more effective. This article presents practical examples of positive policy evaluations and successful use of data in the domain of policy evaluation.


Dr. Peter van der Knaap

Dr. Rudi Turksema
Article

Access_open What Is Left of the Radical Right?

The Economic Agenda of the Dutch Freedom Party 2006-2017

Tijdschrift Politics of the Low Countries, Aflevering 2 2019
Trefwoorden radical right-wing populist parties, economic policies, welfare chauvinism, populism, deserving poor
Auteurs Simon Otjes
SamenvattingAuteursinformatie

    This article examines the economic agenda of the Dutch Freedom Party. It finds that this party mixes left-wing and right-wing policy positions. This inconsistency can be understood through the group-based account of Ennser-Jedenastik (2016), which proposes that the welfare state agenda of radical right-wing populist parties can be understood in terms of populism, nativism and authoritarianism. Each of these elements is linked to a particular economic policy: economic nativism, which sees the economic interest of natives and foreigners as opposed; economic populism, which seeks to limit economic privileges for the elite; and economic authoritarianism, which sees the interests of deserving and undeserving poor as opposed. By using these different oppositions, radical right-wing populist parties can reconcile left-wing and right-wing positions.


Simon Otjes
Assistant professor of political science at Leiden University and researcher at the Documentation Centre Dutch Political Parties of Groningen University.
Article

Transformative Welfare Reform in Consensus Democracies

Tijdschrift Politics of the Low Countries, Aflevering 1 2019
Trefwoorden consensus democracy, welfare state, social investment, transformative reform, Belgium and the Netherlands
Auteurs Anton Hemerijck en Kees van Kersbergen
SamenvattingAuteursinformatie

    This article takes up Lijphart’s claim that consensus democracy is a ‘kinder, gentler’ form of democracy than majoritarian democracy. We zoom in on contemporary welfare state change, particularly the shift towards social investment, and argue that the kinder, gentler hypothesis remains relevant. Consensus democracies stand out in regard to the extent to which their political institutions help to overcome the politically delicate intricacies of governing for the long term. We theorize the features that can help to solve the problem of temporal commitment in democracy through processual mechanisms and illustrate these with short case studies of the contrasting welfare state reform experiences in the Netherlands and Belgium.


Anton Hemerijck
Anton Hemerijck is Professor of Political Science and Sociology at the European University Institute (EUI) in Florence, Italy.

Kees van Kersbergen
Kees van Kersbergen is Professor of Comparative Politics at the Department of Political Science of Aarhus University, Denmark.
Artikel

Naar bestuursgericht toezicht in de zorg: een zoektocht naar passendheid

Tijdschrift Bestuurskunde, Aflevering 4 2018
Trefwoorden healthcare governance, management-oriented regulation, experimenting, recoupling, reflective regulation
Auteurs Dr. Annemiek Stoopendaal en Dr. Hester van de Bovenkamp
Samenvatting

    In this article, we discuss how regulation of governance in healthcare has been shaped over the past decade. We describe the presuppositions under this movement. Searching and balancing was needed to meet the complexity of care management. This has to do with the fact that the external pressure on the regulator after incidents is high. Due to this pressure, it is necessary to constantly ensure that management-oriented regulation does not narrow to the supervision on the actor with final responsibility. The regulation of good governance requires reflectivity of the inspectors and is aimed at stimulating recoupling between management and shop floors. This requires space for experimentation for both managers and inspectors. To provide this space, we do not only need a political and social debate about the quality of care and its management, but also attention and appreciation for the difficult considerations of organizing care.


Dr. Annemiek Stoopendaal

Dr. Hester van de Bovenkamp
Artikel

Herstel en vertrouwen: professionals, ervaringswerkers en de herstelvisie in de Nederlandse geestelijke gezondheidszorg

Tijdschrift Beleid en Maatschappij, Aflevering 3 2018
Trefwoorden Trust, Recovery, Professionals, Peer specialists, Habermas
Auteurs Marijn Kester MSc en Mr. dr. Olivier Lingbeek
SamenvattingAuteursinformatie

    This text wants to draw attention to the question: How do peer specialists build a bridge between the modus operandi of health care professionals and the lifeworld problems of clients receiving mental health care? The Dutch mental healthcare system has recently been host to a range of new developments. Two new trends can be distinguished, going by the name of ‘Recovery-oriented healthcare’ and the introduction of ‘Peer Specialists’. These coincide with changes in budget and organization of treatment. There is an increased awareness of the need for efficiency and cost reduction in the organization of care. The meaning and use of recovery-centered approaches and working with peer specialists remain fairly marginal enterprises due to ever increasing pressure emanating from execution of regulations and administrative procedures, and an accompanying decrease of professional autonomy. In the light of Habermas’ theoretical framework, it is an emphasis on a system-oriented organization of care that cause new approaches to barely be able to find a considerable place in the contemporary practice of mental healthcare in the Netherlands. Trust is identified as an essential foundation on the basis of which future principles of organization should be developed.


Marijn Kester MSc
Marijn Kester MSc is medisch socioloog.

Mr. dr. Olivier Lingbeek
Mr. dr. Olivier Lingbeek heeft een eigen adviesbureau op het gebied van bestuurlijke vraagstukken met betrekking tot planologie en sociologie.
Artikel

Lokale netwerken als instrument voor centraal beleid?

De relativiteit van metagovernance

Tijdschrift Bestuurskunde, Aflevering 2 2018
Trefwoorden metagovernance, Local networks
Auteurs Filip De Rynck, Caroline Temmerman en Joris Voets
Samenvatting

    Collaboration between public actors and social partners is becoming increasingly important as an administrative solution for complex societal challenges in health care, spatial development, mobility management or water management. In this article we focus on the relationship between the central Flemish government and local networks that are set up by this government. In the scientific literature much attention is paid to the concept of metagovernance as analytical perspective to analyze the relationship between the government and networks. The concept offers the government a toolbox with roles and instruments from which it can choose to support and stimulate networks in order to achieve the desired network results. However, our research shows that such an approach is not sufficient to capture the relationship between the central government and local mandated networks in Flanders. We argue for a broader interpretation of the concept of metagovernance, in which the dynamics of local networks are viewed as the outcome of power relations between actors that are represented at both local and central level and that are intertwined with each other. Only in this way will we we understand why certain choices are made about local mandated networks, why local networks show a lack of dynamism and why local actors in local networks also do not want local networks to become more dynamic and effective. We do notice that the pressure on these arrangements is increasing, partly due to new actors who are not involved in these arrangements.


Filip De Rynck

Caroline Temmerman

Joris Voets
Artikel

Gezocht: Burgerparticipatie (voor vaste relatie)

Een vergelijkende gevalsstudie naar 26 lokale netwerken in het sociale domein in de regio Arnhem

Tijdschrift Bestuurskunde, Aflevering 1 2016
Trefwoorden citizen participation, co-production, local networks, decentralization, collaboration
Auteurs Rigtje Passchier MSc en Dr. Jelmer Schalk
SamenvattingAuteursinformatie

    In 2015, Dutch local governments have become responsible for youth care, social welfare, employment and income assistance programs, as a result of decentralization. Many municipalities have set up service delivery networks and community teams, in which they collaborate with healthcare providers and civic organizations to build integrated care services. It is assumed that these networks will improve outcomes in terms of enhanced people’s self-reliance and healthcare cost control; by operating close to citizens they are in a position to know the client, activate a client’s social network and mobilize specialized professional expertise if necessary. However, a comparative case study of 26 emerging local networks in the Arnhem area indicates that healthcare providers use the networks mainly for presentation purposes in an effort to secure business continuity, that the role of local governments is fuzzy, and that citizen participation only thrives when actively encouraged in a climate of trust.


Rigtje Passchier MSc
R. Passchier MSc is interim manager voor de publieke zaak en promovenda aan de Universiteit Leiden.

Dr. Jelmer Schalk
Dr. J. Schalk is universitair docent aan de Universiteit Leiden.
Artikel

Vertrouwen in toezichtbeleid

Tijdschrift Beleid en Maatschappij, Aflevering 3 2014
Trefwoorden Trust, regulatory policy, accountability, control, supervision regime
Auteurs Lydia Paauw-Fikkert MSc, Dr. ir. Frédérique Six en Prof. dr. Paul Robben
SamenvattingAuteursinformatie

    Regulatory supervision and inspection have become key features of public governance, some authors even talk about the ‘audit society’ or the age of ‘regulatory capitalism’. Despite international research showing the importance of trust in supervisory relations, there is still a fierce debate about the role of trust in Dutch supervisory relations. Several inspectorates have incorporated trust as a central theme in their supervisory policy. This article describes the role of trust within the policy of the Dutch Healthcare Inspectorate (IGZ). This research addresses four themes in dealing with the concept of trust in supervisory relations: from transparency to accountability, from output performance to performance and risk management, from trust or control to trust and control, and, finally, a special regime for reliable inspectees. The empirical analysis in this paper contributes to the knowledge about the role of trust in supervision (policy) and to the debate about the role of trust in regulatory supervision policy.


Lydia Paauw-Fikkert MSc
Lydia Paauw-Fikkert MSc is senior adviseur bij de Inspectie voor de Gezondheidszorg.

Dr. ir. Frédérique Six
Dr. ir. Frédérique Six MBA is universitair docent aan de VU Amsterdam.

Prof. dr. Paul Robben
Prof. dr. Paul Robben is adviseur bij de Inspectie voor de Gezondheidszorg en bij iBMG-Erasmus Universiteit Rotterdam
Artikel

Verandermanagement en beleid: waarom vertonen professionals weerstand tegen nieuw beleid?

Tijdschrift Bestuurskunde, Aflevering 2 2014
Trefwoorden public policy,, change management, policy implementation, public management, resistance to change
Auteurs Lars Tummers
SamenvattingAuteursinformatie

    Professionals often have problems with governmental policies they have to implement. This can lead to diminished legitimacy and lower policy performance. The goal of this article is to identify the main reasons why professionals resist implementing new policies. An interdisciplinary approach is taken. From public administration literature, I use the policy alienation model, which consists of five dimensions: strategic, tactical and operational powerlessness, societal meaninglessness and client meaninglessness. These are possible reasons why professionals resist public policies (‘resistance to change’, a concept drawn from change management literature). I test these assumptions using a survey among 1,317 healthcare professionals. The results show that when professionals experience that a policy is meaningless for society or for their own clients, they show strong resistance. A lack of perceived influence is much less important in explaining resistance, although this is partly dependent on the particular profession someone belong to. The policy alienation model can help policy makers and managers to develop policies which are accepted by professionals. The article ends with practical recommendations for policy makers, managers and professionals.


Lars Tummers
Dr. L.G. Tummers is verbonden aan de opleiding bestuurskunde van de Erasmus Universiteit Rotterdam en het Center for the Study of Law & Society van de University of California, Berkeley.
Artikel

Van optimale schaalgrootte naar legitieme schaalgrootte

Een analyse van het publieke debat over schaalgrootte in de zorg

Tijdschrift Bestuurskunde, Aflevering 4 2012
Trefwoorden scale, healthcare organization, legitimacy, values
Auteurs Jeroen Postma, Kim Putters en Hester van de Bovenkamp
SamenvattingAuteursinformatie

    Over the last decades an increasing number of mergers and acquisitions between Dutch healthcare organizations has taken place (up scaling). More recently there is a rise in the numbers of new small-scale healthcare organizations and small-scale care facilities (down scaling in the numbers). The wide variety of scales, each with its pros, cons and (historical) contexts, makes the existence of one optimal scale an illusion. Our research question is: when, and on the basis of which values, is scale of healthcare organizations legitimate? We answer this question by analyzing 650 newspaper articles from fourteen national newspapers. By using theory about legitimacy and values, we argue that five values underlie the public discussion on scale: governance, the human size, quality of care, market power and efficiency. We conclude that achieving legitimate scale involves dealing with those five values, which are not always commensurable and sometimes conflicting. With this article we contribute to the scientific debate about scale and values. We also give recommendations to policy makers and executives that can be used to improve the legitimacy of scale decisions.


Jeroen Postma
J.P. Postma MScBA is adviseur bij BMC AdviesManagement en promovendus aan het instituut Beleid en Management Gezondheidszorg (iBMG) van de Erasmus Universiteit Rotterdam (EUR).

Kim Putters
Prof. dr K. Putters is bijzonder hoogleraar Management van instellingen in de gezondheidszorg aan het iBMG.

Hester van de Bovenkamp
Dr H. van de Bovenkamp is universitair docent aan het iBMG.
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