Organizational structure and patient safety

Redesigning healthcare organizations and paying attention to patient care, can result in better quality and cheaper care. This is what endowed professor Rob Slappendel and endowed professor Jo Caris stated in a double lecture on Friday, 6 September 2013.

The organization of professional healthcare

Care for patients or clients with more complex conditions should focus more on integral treatments and less on specialized activities. An external focus is always a point of concern for care sector companies. Care sector companies should focus more on the interests of client groups, insurers, inspections, ICT, training, the public and science. Good patient care also requires attention to quality standards, costs, communication, reporting and privacy, etc.
Instead of the existing structure of care organizations towards internal specialization they should be run according to the interests of external parties. This requires the expertise for translating those external interests into internal procedures. It also requires coordination of the corresponding tasks. There are three styles for doing so. Administrative and management authority (hierarchy), important for the formal decision-making process, the influence of experts (heterarchy) for substantive issues and collegiality (networks) for mutual coordination and cooperation. Control can be increased by carefully combining these styles.

Patient safety will result in better quality and cheaper care.

Active and effective patient safety will ensure that preventable harm and deaths decrease, resulting in better quality and cheaper care. Improvements can be made especially in the area of the delayed effects of a medical error. With regard to the direct effects of a medical error (operating on the wrong leg, gauze left in the stomach during an operation), many issues have improved dramatically. They occur far less often than they did a decade ago. Indirect errors are more difficult to trace. The consequences are detrimental to the patient and the hospital because they always result in a longer hospital stay than initially planned or re-admittance and therefore involve unnecessary costs.

Prof. Dr. Jo Caris is an endowed professor of 'Organizational development in the care sector' at TIAS School for Business and Society
Prof. Dr. Rob Slappendel, anesthesiologist, is an endowed professor of 'Quality and safety in the care sector' at TIAS School for Business and Society.
Both professorships are funded by Amphia Hospital.