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.
DOCUMENT
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.
MULTIFILE
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
MULTIFILE
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.
DOCUMENT
With regard to the increasing global competition for highly-skilled labour, the group of mobile international students is becoming more and more prominent in the considerations of national policy-makers. One concrete idea is to develop policies in order to bind international students and foreign knowledge workers and make them valuable contributors to the country, economically but also in terms of social and cultural aspects. The Dutch government has put this issue on the agenda and emphasized their interest in binding international talent to the Netherlands. Therefore, it is crucial to learn about the factors, which are decisive in staying and going and which are particularly appealing or unappealing about the Netherlands. In order to contribute to this process, a study was done among international students, alumni, and staff at The Hague University of Applied Sciences. This study's findings have been validated and enriched by the results of a broader survey which has been conducted among the talented international students participating in the Nuffic NL4Talents conference of 4 February 2013 in The Hague. This study suggests that two principal reasons are relevant in residence decisions: career perspective and personal factors, such as having a Dutch partner or circle of friends. Additionally, a number of further factors seems to influence whether internationals want to stay in the Netherlands. All these factors are classified in four groups: those related to the Netherlands in general, to the region/city of residence, personal aspects and aspects related to the university. With regard to the Netherlands, appealing factors appear to be the standard of living, the socio-political environment in the Netherlands and the supposedly welcoming Dutch culture. There are, however, people - in particular those who cannot fully enjoy all rights of the EU citizenship - who feel underprivileged in terms of administrative procedures and in their everyday life in the Netherlands. When it comes to the regional aspects in The Hague, appealing factors are apparently the clean and safe environment to live as well as the availability of several offers for leisure time, including an attractive cultural agenda. Here, the housing situation - more precisely the cost and quality of accommodation - appears as a rather unappealing aspect. In terms of personal considerations, the family-friendly environment in the Netherlands has been rated as particularly appealing. Also having a Dutch partner or Dutch friends may encourage international students to stay and work in the Netherlands. The findings suggest, however, that international students are more embedded in an international circle of friends than linked with the locals. Only few respondents felt being actively excluded from Dutch circles, but a majority agrees that it is difficult to establish bonds with the local population. At the same time, it has been raised that international students voluntarily live in their expat bubble. Lastly, the university experience can contribute to retaining international students. Here, appealing factors were the international study environment which makes the foreign student feel at home, as well as the level and focus of education at The Hague University of Applied Sciences. By contrast, critical views have been raised in relation to a suggested lack of career counselling and support in learning the Dutch language at university. Based on these findings, the report concludes with some recommendations which might serve as a springboard to develop strategies to bind international talent. As the discussion of findings shows, the insights of this study can be validated by insights of a related study that has recently been conducted by Agentschap NL and the advice of the Social and Economic Council of the Netherlands. Based on the findings, the report concludes with a number of recommendations outlining how national, regional, local authorities as well as universities can help to retain more international talent in the Netherlands.
DOCUMENT
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."
LINK
This study focuses on SME networks of design and high-tech companies in Southeast Netherland. By highlighting the personal networks of members across design and high-tech industries, the study attempts to identify the main brokers in this dynamic environment. In addition, we investigate whether specific characteristics are associated with these brokers. The main contribution of the paper lies in the fact that, in contrast to most other work, it is quantitative and that it focuses on brokers identified in an actual network (based on both suppliers and users of the knowledge infrastructure). Studying the phenomenon of brokerage provides us with clear insights into the concept of brokerage regarding SME networks in different fields. In particular we highlight how third parties contribute to the transfer and development of knowledge. Empirical results show, among others that the most influential brokers are found in the nonprofit and science sector and have a long track record in their branch.
DOCUMENT
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.
DOCUMENT
Clinical decision support systems (CDSSs) have gained prominence in health care, aiding professionals in decision-making and improving patient outcomes. While physicians often use CDSSs for diagnosis and treatment optimization, nurses rely on these systems for tasks such as patient monitoring, prioritization, and care planning. In nursing practice, CDSSs can assist with timely detection of clinical deterioration, support infection control, and streamline care documentation. Despite their potential, the adoption and use of CDSSs by nurses face diverse challenges. Barriers such as alarm fatigue, limited usability, lack of integration with workflows, and insufficient training continue to undermine effective implementation. In contrast to the relatively extensive body of research on CDSS use by physicians, studies focusing on nurses remain limited, leaving a gap in understanding the unique facilitators and barriers they encounter. This study aimed to explore the facilitators and barriers influencing the adoption and use of CDSSs by nurses in hospitals, using an extended Fit Between Individuals, Tasks, and Technology (FITT) framework.
MULTIFILE
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.
DOCUMENT
