Zoekresultaten

The Non-existence of Failure

Complete works of Matthijs Hammer

Current practice of hospital-based palliative care teams

BackgroundSpecialist palliative care teams are consulted during hospital admission for advice on complex palliative care. These consultations need to be timely to prevent symptom burden and maintain quality of life. Insight into specialist palliative care teams may help improve the outcomes of palliative care.MethodsIn this retrospective observational study, we analyzed qualitative and quantitative data of palliative care consultations in a six-month period (2017 or 2018) in four general hospitals in the northwestern part of the Netherlands. Data were obtained from electronic medical records.ResultsWe extracted data from 336 consultations. The most common diagnoses were cancer (54.8%) and organ failure (26.8%). The estimated life expectancy was less than three months for 52.3% of all patients. Within two weeks after consultation, 53.2% of the patients died, and the median time until death was 11 days (range 191) after consultation. Most patients died in hospital (49.4%) but only 7.5% preferred to die in hospital. Consultations were mostly requested for advance care planning (31.6%). End-of-life preferences focused on last wishes and maintaining quality of life.ConclusionThis study provides detailed insight into consultations of palliative care teams and shows that even though most palliative care consultations were requested for advance care planning, consultations focus on end-of-life care and are more crisis-oriented than prevention-oriented. Death often occurs too quickly after consultation for end-of-life preferences to be met and these preferences tend to focus on dying. Educating healthcare professionals on when to initiate advance care planning would promote a more prevention-oriented approach. Defining factors that indicate the need for timely palliative care team consultation and advance care planning could help timely identification and consultation.

Entrepreneurial Selling

Purpose: Preventing business failure remains a significant challenge for small businesses in the Netherlands. Given their importance for the Dutch economy, understanding the causes of business failure and equipping business owners with strategies for resilience is imperative. This dissertation seeks to address this challenge by examining the sales role of business owners, referred to as ‘Entrepreneurial Selling,’ within the context of small-scale Dutch businesses. The goal is to identify how business owners can develop effective sales behaviors to mitigate the risk of failure and enhance the long-term viability of their businesses. The research into Entrepreneurial Selling is rising, yet further advancements, including this dissertation, are required to better support business owners in their continuous sales responsibilities. The main research question, therefore, is: How do small-scale business owners in the Netherlands behave in their Entrepreneurial Selling role and how can they become more effective in their sales behavior? Methods: To address the research question, a multimethod research approach is utilized. The research design comprises a literature review, three progressively linked studies, and practical applications. The first study (Chapter 4) involves a content re-analysis of 55 interviews to underscore the pivotal nature of Entrepreneurial Selling in preventing business failure. The second study (Chapter 5) conducts 12 semi-structured interviews, employing thematic analysis to categorize business owners' sales behaviors based on their entrepreneurial motivations. In the third study (Chapter 6), quantitative methods are employed (N=276) to explore the relationship between Entrepreneurial Selling Role Orientation (ESRO) and effective sales behavior. These studies provide the foundation for the practical applications developed in collaboration with practitioners (Chapter 7).Findings: The first study found that Entrepreneurial Selling is a crucial activity for preventing business failure and one that business owners recognize. Reasons for underperformance can include business owners allocating inadequate time to selling, deficient sales skills, and procrastination of sales activities. The subsequent studies build on this foundation. The second study introduces an Entrepreneurial Selling typology, linking business owners' motivations with their sales role strategies, offering insights into how motivations influence sales behavior. The third study introduces the concept of ESRO and substantiates its impact on sales behavior. Furthermore, a positive connection is identified between sales training and effective sales practices. The findings of the studies are individually applied to Sarasvathy’s Bird-in-Hand principle of Effectuation theory and are synthesized within the Entrepreneurial Selling Matrix. Originality/Value: This dissertation contributes to the Entrepreneurial Selling field by advancing our understanding of the business owners’ sales role in enhancing business resilience. It underscores the connection between ineffective sales practices and business failure and delves deeper by investigating the interplay between entrepreneurial motives and ESRO on sales behavior. Additionally, this study bridges the gap between entrepreneurship- and sales research by applying the Bird-in-Hand principle to business owners' sales behavior. In practical terms, the research's outcomes are twofold. First, it refines the Entrepreneurial Selling Matrix, providing a pragmatic typology that aids sales training practitioners in guiding business owners toward aligning sales behaviors with entrepreneurial goals. Second, it introduces an Entrepreneurial Selling Training Program, accompanied by tools, facilitating sales trainers in evaluating and improving current and desired sales behaviors. This practical approach contributes directly to nurturing resilient and thriving businesses.

The productive role of innovation in a large tourism organisation (TUI).

This paper studies the productive role of innovation in organisations. Using the post-structuralist insight that innovation is an open concept that can become performative, we shift the emphasis from analysing innovations themselves to analysing how the concept of innovation affects the organisational practices through which it acquires meaning. Deploying this framework, we studied the development of an innovation unit within TUI, a corporate tour operator. We found that actors interpreted innovation in different ways and that initially the innovation unit was considered a failure. The subsequent dramatisation of this failure resulted in a new version of this innovation unit that strengthened established actors and institutions within the organisation. Our study shows how the use of the concept of innovation in an organisation can both stimulate and hamper its innovativeness. Addressing this paradox requires sensitivity to the concept's productive role and evaluations of innovation that look beyond accomplished results.

Care transformation defined by conditions, mechanisms, and outcomes: a systematic literature review

Wastewater management by citizens

Self-organisation in environmental service delivery is increasingly being promoted as an alternative to centralised service delivery. This article argues that self-organised environmental service delivery must be understood in the context of legal rules, especially environmental legislation. The article’s aim is twofold: first, to understand the changing relationship between the government and citizens in self-organised service delivery, and second, to explore how self-organised environmental service delivery complies with environmental quality requirements stipulated in legislation. The empirical study focuses on wastewater management in Oosterwold, the largest Dutch urban development that experimented with self-organisation. The results show that while individual wastewater management was prioritised and implemented at scale, the applicable legal rules were not adequately considered and integrated. Consequently, the experiment led to a deterioration of water quality. The article concludes that the success or failure of self-organisation in delivering environmental services such as wastewater management critically hinges on ensuring compliance with environmental legislation.