Evaluation of a pilot with experts by experience in the regulation of elderly care
Runtime: 2016 - 2018
Client: Inspectie Gezondheidszorg en Jeugd (Dutch Health and Youth Care Inspectorate)
To deepen their insights into the quality of long term care delivery, and under pressure of societal debate, the Dutch Health Care Inspectorate (IGJ) experiments with the use of experiential knowledge in the regulation of care for the elderly. As experts-by-experience, clients are thought to give additional information for, and legitimacy to, the IGJ’s regulatory work.
This evaluation tracks an IGJ pilot project with experts-by-experience through a mixed-method qualitative inquiry that involves the ethnographic observation of the pilot project-team, site-visits, and repeated interviews. We find how the project transforms selected clients into experts-by-experience through training and site visits. In this transformation clients attempt, and fail, to bring to the fore their own definitions of quality and safety. Paradoxically, in their attempt to open-up valid new perspectives on the quality of long term care delivery, the pilot project ‘makes-up’ the experts-by-experience in such a fashion that these perspectives are least likely to emerge.
Concurrently, we find how in their attempt to produce valid (objective, rational) knowledge experts-by-experience devalue their own experiential knowledge. We show how dominating, legitimated, interpretations of (knowledge about) quality of care resonate in experimental institutional practices that try to move beyond them. Following from these conclusions we provide the IGJ with concrete recommendations to follow-up on this pilot.
Dr. Bert de Graaff
Ervaringsdeskundigen in de V&V, invited talk, IGJ, Utrecht, 9/11/2017
M.B. de Graaff (2018). Toezicht, ervaring en deskundigheid: een evaluatie van de inzet van ervaringsdeskundigen in het toezicht op de ouderenzorg. ESHPM, Erasmus University Rotterdam (in Dutch - report in which we detail our findings to the IGJ, an English-language paper is currently in draft).