Reconceptualizing Regulation: Formative evaluation of an experiment with System-Based Regulation in Dutch healthcare

Runtime: 2012 - 2014
Client: Inspectie Gezondheidszorg en Jeugd (Dutch Health and Youth Care Inspectorate)

Project description

In an experimental project of the Dutch Health and Youth Care Inspectorate, we ethnographically followed how this public regulator changes the focus from prescriptive regulation based on quality and safety indicators to the supervision of the management system of a regulated organization. We call this type of regulation system-based regulation (SBR).

The Inspectorate experimented with SBR through a process of ‘experimentalist governance’. The process of ‘experimentalist governance’ was strengthened by qualitative formative evaluation that documented and reflected on the process as it progressed. The evaluation helped to translate and communicate learning so as to better understand regulation and to reform and reconceptualize SBR in today’s healthcare context.

By using SBR, a regulator can identify several forms of decoupling. Interestingly, we found indications that, by applying SBR and thus recognizing decoupling, a process of recoupling was supported. With SBR the government can reclaim its influence on the meta level whilst maintaining the level of freedom of management at the organizational level. Instead of aiming for more or stricter regulation, the public regulator redefines its role as an assessor and stimulator of the quality of governance in terms of self-regulation. Team:

Team

Dr. Annemiek Stoopendaal, dr. Martin de Bree, Prof. dr. Paul Robben, Prof. dr. Roland Bal

Activities

We presented our work several times at the colloquia of the Dutch Health and Youth Care Inspectorate and at a variety of events of other Dutch regulators (NZA,NVTZ, AFM, Inspectieraad, VIDE, WRR , ARK, Inspectie voor het Onderwijs)

In June 2015, a conference was organized for supervisors, administrators, scientists and quality care staff: ‘Safety 2 and beyond—resilience meets regulation’.

Internationally we presented at the conference of 4S in 2016 and at EGOS in 2017.

Publications

  • M. de Bree & A.M.V. Stoopendaal (2018). De- and Recoupling and Public Regulation. Organization Studies. doi: 10.1177/0170840618800115
  • A.M.V. Stoopendaal, M.A. de Bree & P.B.M. Robben (2016). Reconceptualizing regulation: Formative evaluation of an experiment with System-Based Regulation in Dutch healthcare. Evaluation. The International Journal of Theory, Research and Practice, 22 (4), 394-409.
  • A.M.V. Stoopendaal (2016). Al doende leren. Een essay over de experimentele zoektocht naar toezicht op zorgbesturing door de Inspectie voor de Gezondheidszorg. (Extern rapport). Rotterdam: iBMG
  • R.A. Bal, A.M.V. Stoopendaal & H.M. van de Bovenkamp (2015). Veerkracht en Veiligheid: hoe kan regulering van de zorg daaraan bijdragen? Nederlands Tijdschrift voor Geneeskunde, 159 (A9614).
  • A.M.V. Stoopendaal, M.A. de Bree, F. Keuter & P.B.M. Robben (2014). Systeemtoezicht in de Nederlandse gezondheidszorg. Een experimentele innovatie van toezicht. Tijdschrift voor Toezicht, 5 (2), 27-46.
  • A.M.V. Stoopendaal & M.A. de Bree (2014). Evaluatieonderzoek Systeemtoezicht op kwaliteit en veiligheid in de zorg; Fase 1. Ontwikkeling van het instrumentarium en eerste ervaringen. (Extern rapport). Rotterdam: IBMG

Awards

Dr Annemiek Stoopendaal and Dr Martin de Bree of Rotterdam School of Management (RSM)  were awarded the publication price by VIDE on 17 January 2019. VIDE is the Dutch association of supervisors, law enforcers, inspectors and evaluators. The article that was awarded, De- and Recoupling and Public Regulation, describes how public inspectors can assess the level of self-assurance of quality and compliance within a regulated organisation. Furthermore, the article demonstrates that this way of inspecting stimulates organisations to improve this assurance resulting in an improved performance.

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