Healthcare rebels: Moving between regulation and the workfloor
Runtime: 2016 – 2018
Client: Healthcare institute of the Netherlands and the Dutch federation of university hospitals
There is an increasing attention for the pitfalls of over-regulation in public service organisations, with professionals and organisations complaining about the extent to which governments and regulators try to micro-manage professionals work as well as about the increase of red tape that comes with this regulation. Likewise, it is increasingly recognised that high-quality services are not created by top down management but are the effect of a dynamic interplay between top down and bottom up processes. Organisational learning for example is often created at the margins of organisations and occurs through practice variation. Within top down regulated systems such variation however often stays invisible in the grey zones of the organisation.
In this project we were interested in how high reputation groups within hospitals 'do' quality, how they create contexts form making this possible and if and how the hospital organisation learns from them. We used a qualitative, ethnographic design, studying three hospitals in the Netherlands.
Roland Bal, Iris Wallenburg & Anne Marie Weggelaar
Further information on the project:
Can be found on the project page at ResearchGate