Zoekresultaat: 3 artikelen

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Jaar 2021 x
Thema-artikel

Waarom burgers coproducent willen zijn

Een theoretisch model om de motivaties van coproducerende burgers te verklaren

Tijdschrift Bestuurskunde, Aflevering 2 2021
Auteurs Carola van Eijk en Trui Steen
Auteursinformatie

Carola van Eijk
Ten tijde van publicatie werkte C.J.A. van Eijk MSc. (research) als promovenda bij het Instituut Bestuurskunde, Universiteit Leiden.

Trui Steen
Dr. T.P.S. Steen was universitair hoofddocent bij het Instituut Bestuurskunde, Universiteit Leiden en bij KU Leuven Instituut voor de Overheid.
Artikel

Rebellerende zorgprofessionals

Improviseren met regels, passie en verantwoording

Tijdschrift Beleid en Maatschappij, Aflevering 2 2021
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.

    From 1964 (until around 1990), political science became the dominant approach within (local) administrative sciences in the Netherlands. This position was taken over from the legal approach. In this period, the concepts of politics, policy and decision-making were central to research and theory. In the period up to 1990, we still see a predominantly administration-centric or government-centric perspective among these political scientists, although we already see incentives from different authors for a broader perspective (the politics, policy and decision-making concepts remain relevant however) that will continue in the period thereafter. This broader perspective (on institutions, management and governance) took shape in the period after 1990, in which Public Administration would increasingly profile itself as an independent (inter)discipline. This essay tells the story of the (local) administrative sciences in this period as envisaged by twelve high-profile professors. The story starts in 1990 in Leiden with the (gradual) transition from classical to institutional Public administration, as is revealed in the inaugural lecture by Theo Toonen. This is followed by eleven other administrative scientists, who are divided into four ‘generations’ of three professors for convenience. In conclusion, the author of this essay argues that there is mainly a need for what he calls a (self-)critical Public Administration.


Rik Reussing
Dr. G.H. Reussing is onderwijscoördinator van de joint degree Public Governance across Borders aan de Universiteit Twente en redactiesecretaris van Bestuurswetenschappen.
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