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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The vast literature on accountability in the public sector (usually called ‘public accountability’originating from political science and public administration tends to emphasize the positive dimension of holding authorities to account. As formulated by one prominent scholar in the field, ‘[a]ccountability has become an icon for good governance’: it is perceived as ‘a Good Thing, and, so it seems, we can’t have enough of it’ (Bovens, 2005: 182, 183). Accountability has, thus, become one of the central values of democratic rule – varying on a well-known American slogan one could phrase this as ‘no public responsi bility without accountability’.
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Zuid-Afrika is een complex land met een turbulente (recente) historie. Het is ook een land met een lange gemeenschappelijke geschiedenis met Nederland. In hoeverre zijn de ontwikkelingen in de publieke sector van Zuid-Afrika vergelijkbaar met dat wat er in Nederland gebeurt? Zijn er voor het Nederlandse openbaar bestuur lessen te leren? In deze bijdrage kijken we naar opvallende ontwikkelingen in de Zuid-Afrikaanse publieke sector.
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More than 25!years after Moore’s first introduction of the public value concept in 995, the concept is now widely used, but its operationalization is still considered difficult. This paper presents the empirical results of a study analyzing the application of the public value concept in Higher Education Institutions, thereby focusing on how to account for public value. The paper shows how Dutch universities of applied sciences operationalize the concept ‘public value’, and how they report on the outcome achievements. The official strategy plans and annual reports for FY2016 through FY2018 of the ten largest institutions were used. While we find that all the institutions selected aim to deliver public value, they still use performance indicators that have a more narrow orientation, and are primarily focused on processes, outputs, and service delivery quality. However, we also observe that they use narratives to show the public value they created. In this way this paper contributes to the literature on public value accounting.
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De focus binnen het lectoraat is gericht op botsende waarden. Publieke organisaties onderscheiden zich op vele punten van private organisaties en hebben unieke publieke waarden. In vele westerse en niet westerse landen zien wij New Public Management opkomen. De kern van deze benadering is dat de verschillen tussen publieke en private organisaties helemaal niet zo groot zijn en dat publieke organisaties kunnen leren van het bedrijfsleven. In het onderzoek van het lectoraat wordt, aan de hand van het thema prestatiemeting, nagegaan in hoeverre er sprake is van botsende waarden, hoe deze botsing tot uitdrukking komt en welke alternatieven er zijn. Het onderzoek van het lectoraat richt zich vooral op prestatiemeting in de publieke sector, waarbij prestatiemeting zowel wordt beschouwd op het niveau van de individuele werknemer als op het niveau van de publieke organisatie als geheel.
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Introduction: Retrospective studies suggest that a rapid initiation of treatment results in a better prognosis for patients in the emergency department. There could be a difference between the actual medication administration time and the documented time in the electronic health record. In this study, the difference between the observed medication administration time and documentation time was investigated. Patient and nurse characteristics were also tested for associations with observed time differences. Methods: In this prospective study, emergency nurses were followed by observers for a total of 3 months. Patient inclusion was divided over 2 time periods. The difference in the observed medication administration time and the corresponding electronic health record documentation time was measured. The association between patient/nurse characteristics and the difference in medication administration and documentation time was tested with a Spearman correlation or biserial correlation test. Results: In 34 observed patients, the median difference in administration and documentation time was 6.0 minutes (interquartile range 2.0-16.0). In 9 (26.5%) patients, the actual time of medication administration differed more than 15 minutes with the electronic health record documentation time. High temperature, lower saturation, oxygen-dependency, and high Modified Early Warning Score were all correlated with an increasing difference between administration and documentation times. Discussion: A difference between administration and documentation times of medication in the emergency department may be common, especially for more acute patients. This could bias, in part, previously reported time-to-treatment measurements from retrospective research designs, which should be kept in mind when outcomes of retrospective time-to-treatment studies are evaluated.
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Many quality aspects of software systems are addressed in the existing literature on software architecture patterns. But the aspect of system administration seems to be a bit overlooked, even though it is an important aspect too. In this work we present three software architecture patterns that, when applied by software architects, support the work of system administrators: PROVIDE AN ADMINISTRATION API, SINGLE FILE LOCATION, and CENTRALIZED SYSTEM LOGGING. PROVIDE AN ADMINISTRATION API should solve problems encountered when trying to automate administration tasks. The SINGLE FILE LOCATION pattern should help system administrators to find the files of an application in one (hierarchical) place. CENTRALIZED SYSTEM LOGGING is useful to prevent coming up with several logging formats and locations. Abstract provided by the authors. Published in PLoP '13: Proceedings of the 20th Conference on Pattern Languages of Programs ACM.
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The growing prevalence of AI systems in society, has also prompted a growth of AI systems in the public sector. There are however ethical concerns over the impact of AI on society and how this technology can impact public values. Previous works do not connect public values and the development of AI. To address this, a method is required to ensure that developers and public servants can signal possible ethical implications of an AI system and are assisted in creating systems that adhere to public values. Using the Research pathway model and Value Sensitive Design, we will develop a toolbox to assist in these challenges and gain insight into how public values can be embedded throughout the development of AI systems.
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