Despite all improvement initiatives such as the national action plan [De-]Regulate Healthcare by the Dutch Ministry of Health, Welfare and Sport in 2018 to create more time for care within the Netherlands, the administrative burden for care workers is still increasing. Managers of healthcare institutes struggle with efficiently implementing government legislations in day-to-day operations. They indicate that the time spent on administrative tasks demanded by municipalities and national authorities is too much. In addition, they also indicate that there is a lack of consistency and uniformity when it comes to the way care workers handle administrative tasks. This way of working causes additional, and often ad hoc, work in the run-up to an audit. It seems that before laws and regulations are effectively implemented, new laws or regulations again demand attention. This looks like a vicious circle, but research to confirm this is not found yet. Therefore, the following research question is formulated: "What is the impact of laws and regulations on the administrative burden with regard to the primary and supportive processes of Dutch long-term care?" An explanatory multiple case study was conducted to answer the research question. Three case studies were carried out during September 2019 to January 2020. Based on these studies, we have concluded that between 29% and 62% of the total perceived administrative burden by long-term care professionals can be related to legislation.
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Background: To be accountable to laws and regulations, healthcare professionals spend more than 40% of their time on administrative tasks. The Compulsory Mental Healthcare Act (CMHA) was introduced in Dutch mental healthcare in 2020. It was hypothesized that this legislative amendment would raise the administrative burden for some care professionals. Pilot studies in 2020 and 2021 visualized the exponentially rise of the administrative burden for care professionals, especially psychiatrists due to the transition. However the total response was too small and not generalizable. Aim: gain more nationwide insight in the hypothesized raise of administrative burden of psychiatrists due to the implementation of the CMHA. Method: Under the leadership of an advisory board of three medical director psychiatrists, a Likert scale questionnaire was further developed to investigate the administrative burden of psychiatrists in the Netherlands before and after transition. Open-ended questions provided the opportunity for feedback from the psychiatrists. The study was supported by the Department of Medical Directors (DMD) of The Netherlands Psychiatric Association (NPA). Results: all mental health institutions members of the DMD of the NPA received an invitation to participate. 14 institutions (total N=158) responded. The data show a significant change in the time spent on administrative tasks, the usefulness of the administrative actions, the fit for use and ease of use of supporting systems. The forementioned all decreased significantly after the implementation. Conclusion and discussion: Psychiatrists spend more time on administration than before the legislative amendment instead of helping vulnerable patients. None of the institutions has been able to use the transition to its advantage given the time spent on administrative tasks and the usefulness of these tasks. This is an unacceptable development in the field of mental health in the Netherlands and should be addressed to those who are responsible for the decision making, especially policy makers. These results show that the introduction of the CMHA have made the field of Dutch mental health an impossible area to work for. , Administrative burden, Legislative amendment, Public governance, Information Management
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Abstract: The need for mental healthcare professionals in the Netherlands is increasing caused by the growth of patient complexity. The administration burden causes outflow of professionals and therefor they become increasingly scares. Improvement initiatives are aimed as the intended strategy and starts with (re)-structuring organizations through legislation and regulations. They entail both experienced and measured administration burden for healthcare professionals working in Long-Term Care (LTC). However, most studies only provide insight into the current administration burden or the impact of legislation and regulations on the administration burden from a broad perspective. These insights are useful to LTC managers, but more in-depth research is needed to implement laws and regulations to reduce the administration burden for LTC professionals in the future. The Compulsory Mental Healthcare Act (CMHA) was implemented in the Dutch mental healthcare and replaced the Special Admissions Act in Psychiatric Hospitals (SAAPH) on January 1, 2020. The aim of this study is to investigate the effect of the legislative transition and to determine the effect on the administration burden of Dutch mental healthcare professionals. A survey concerning the administration burden for especially psychiatrists before and after the transition was distributed to an addiction institute with a diversity of different mental healthcare professionals and a psychiatric institute that has been led by psychiatrists. Also some interviews with the lead professionals where held. The results show that the administration burden among psychiatrists has increased due to the contact with external healthcare providers and contact with the patient, family and their loved ones (a consequence of the amendment of the law). This effect was significant and in line with the results of the interviews. Therefor we conclude that the administration burden has increased as a result of the legislative amendment.
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Abstract Healthcare organizations operate within a network of governments, insurers, inspection services and other healthcare organizations to provide clients with the best possible care. The parties involved must collaborate and are accountable to each other for the care provided. This has led to a diversity of administrative processes that are supported by a multi-system landscape, resulting in administrative burdens among healthcare professionals. Management methods, such as Enterprise Architecture (EA), should help to develop and manage such landscapes, but they are systematic, while the network of healthcare parties is dynamic. The aim of this research is therefore to develop an EA framework that fits the dynamics of network organizations (such as long-term healthcare). This research proposal outlines the practical and scientific relevance of this research and the proposed method. The current status and next steps are also described.
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from the article: "In this paper, we explore the characteristics of posters as an efficient and effective probing tool for hospital nurse participation in the development of processes, services or products. The main challenge in this respect is the limited time and attention available to nurses during their work shifts. For this, we analysed the design and effectiveness of posters from earlier projects and used existing knowledge on probing for preliminary guidelines focused on design elements, context of placement, and fit with work process. We then designed a poster for gathering insights during nurses’ work shifts into their administrative tasks and perceived relevance. To evaluate, this table poster design was consecutively placed on three nursing units in a Dutch hospital. Activities of nurses with the poster and necessary interventions were analysed and used for further insights into the characteristics of effective posters for this specific target group. The research raised new questions about how best to elicit nurses’ participation during work shifts."
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Data is widely recognized as a potent catalyst for advancing healthcare effectiveness, increasing worker satisfaction, and mitigating healthcarecosts. The ongoing digital transformation within the healthcare sector promises to usher in a new era of flexible patient care, seamless inter-provider communication, and data-informed healthcare practices through the application of data science. However, more often than not data lacks interoperability across different healthcare institutions andare not readily available for analysis. This inability to share data leads to a higher administrative burden for healthcare providers and introduces risks when data is missing or when delays occur. Moreover, medical researchers face similar challenges in accessing medical data due to thedifficulty of extracting data from applications, a lack of standardization, and the required data transformations before it can be used for analysis. To address these complexities, a paradigm shift towards a data-centricapplication landscape is essential, where data serves as the bedrock of the healthcare infrastructure and is application agnostic.In short, a modern way to think about data in general is to go from an application driven landscape to a data driven landscape, which willallow for better interoperability and innovative healthcare solutions.
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Bij het netwerk Businet is een workshop gefaciliteerd over bedrijven die toekomstbestendig zijn.
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Background: The number of people with multiple chronic conditions demanding primary care services is increasing. To deal with the complex health care demands of these people, professionals from different disciplines collaborate. This study aims to explore influential factors regarding interprofessional collaboration related to care plan development in primary care. Methods: A qualitative study, including four semi-structured focus group interviews (n = 4). In total, a heterogeneous group of experts (n = 16) and health care professionals (n = 15) participated. Participants discussed viewpoints, barriers, and facilitators regarding interprofessional collaboration related to care plan development. The data were analysed by means of inductive content analysis. Results: The findings show a variety of factors influencing the interprofessional collaboration in developing a care plan. Factors can be divided into 5 key categories: (1) patient-related factors: active role, self-management, goals and wishes, membership of the team; (2) professional-related factors: individual competences, domain thinking, motivation; (3) interpersonal factors: language differences, knowing each other, trust and respect, and motivation; (4) organisational factors: structure, composition, time, shared vision, leadership and administrative support; and (5) external factors: education, culture, hierarchy, domain thinking, law and regulations, finance, technology and ICT. Conclusions: Improving interprofessional collaboration regarding care plan development calls for an integral approach including patient- and professional related factors, interpersonal, organisational, and external factors. Further, the leader of the team seems to play a key role in watching the patient perspective, organising and coordinating interprofessional collaborations, and guiding the team through developments. The results of this study can be used as input for developing tools and interventions targeted at executing and improving interprofessional collaboration related to care plan development.
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Health care professionals have extremely busy work schedules. Unfortunately, they need to spend a lot of their time on administrative tasks, whereas they would like to devote it to helping patients, which is what they were trained for in the first place. Properly designed technology could help to lessen the burden of administration and provide more quality time with patients. In the project COUNT (Communication and Operation on the Unit Between Nurses and Technology), we are working on developing this type of technology for hospital nurses. To make sure we are developing technology that is really helpful to and usable by nurses, we involve them in co-design activities. This is a challenge in itself, similar to the reason why the project was started: nurses have very little time, and it is hard to plan activities since chances of something unexpected coming up are high. Because nurses are so engrossed in their daily activities, it is difficult for them to take some distance to think about innovations, and moreover, technology is generally not of particular interest to them. In COUNT, we have developed and applied a number of techniques to involve nurses in co-design and to stimulate them to think of possible technological innovations in their daily work. Although the techniques were primarily targeted at hospital nurses, lessons learned apply to a much wider target group of health care professionals.
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Every year I talk to many entrepreneurs about business transfers and acquisitions. Only rarely do they tell me that it was a cinch. Buying or selling a business is complex. For a start, a business should be shipshape from an organizational and administrative perspective, while several legal and fiscal matters also affect the transaction. Moreover, many parties are involved in a business transfer: the buyer and the seller, of course, but also the employees, the spouse and/or family of the entrepreneur, the customers and suppliers. Emotions and trust also play a central role in selling a firm. Many owner/managers find it hard to abandon their business. The fact that a transaction of fixed assets may also be involved is another complicating factor. Is it a good thing to include fixed assets in the sale, or in fact the reverse? Considering that most people find it quite hard to sell their own house, engaging an estate agent to do it for them, it is understandable that buying and selling a business is a transaction fraught with difficulties.
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