The publication by Erasmus School of Health Policy & Management (ESHPM) about the research into how the Health and Youth Care Inspectorate (IGJ) deals with so-called ‘soft signals’ won the VIDE publication prize on 21 January 2021. The principal author, Josje Kok, did her doctoral research at ESHPM into the IGJ’s supervision.
The IGJ had commissioned ESHPM in 2018 to research ‘soft signals’. The motivation for this was the UMC Utrecht case, about which the IGJ presented its research report in 2017. Partly as a result of this case, the IGJ felt it was necessary to analyse how the Inspectorate deals with so-called ‘soft signals’ or notifications (formal or informal) that ‘something’ was happening in a care organisation or a department that could have a negative effect on the quality and safety of care, but that did not fall under the legal criteria for mandatory reporting to the IGJ. This case caused the IGJ to question whether it had sufficient control over the process of receiving, analysing and processing ‘soft signals’.
From the research report that ESHPM published in February 2019, it appeared that soft signals as well as hard data were important indicators of the quality of care (see: ‘Soft signals form a valuable addition to IGJ supervision’).
On the basis of this research, the winning scientific article was written under the title ‘The doctor was rude, the toilets are dirty. Utilizing ‘soft signals’ in the regulation of patient safety’ and published in 2020 in the influential journal Safety Science.
Researcher Josje Kok said, “Our research shows that supervision is a task for humans. To be able to estimate safety risks properly, inspectors must examine all sources of information, weigh them and assign value to them. Discussing ‘something not right’ feelings as a group and ‘reading between the lines’ are crucial steps in this work of assigning meaning. In an age of big data, algorithms and society’s demand for strictly independent supervision, the research shows that the human side remains extremely important.”
For the IGJ, the awarding of the VIDE publication prize is a confirmation that supervision is more than just monitoring hard data. It is precisely ‘soft signals’ and other forms of qualitative information that help inspectors to give meaning to ‘hard indicators’ and properly weigh risks so that they can act appropriately towards both the care institutions and their patients.