BackgroundAn important element of value-based health care (VBHC) is interprofessional collaboration in integrated practice units (IPUs) for the delivery of the complete cycle of care. High levels... Show moreBackgroundAn important element of value-based health care (VBHC) is interprofessional collaboration in integrated practice units (IPUs) for the delivery of the complete cycle of care. High levels of interprofessional collaboration between clinical and nonclinical staff in IPUs are assumed rather than proven. Factors that may stimulate interprofessional collaboration in the context of VBHC are underresearched.PurposeThe aim of this study was to examine relational coordination (RC) in VBHC and its antecedents.ApproachA questionnaire was used to examine the association of both team practices and organizational conditions with interprofessional collaboration in IPUs. Gittell's Relational Coordination Survey was drawn upon to measure interprofessional collaboration by capturing the relational dynamics in coordinated working. The questionnaire also included measures of team practices (team meetings and boundary spanning behavior) and organizational conditions (task interdependence and time constraints).ResultsThe number of different professional groups participating in team meetings is positively associated with RC in IPUs. Boundary spanning behavior, task interdependence, and time constraints are not associated with RC.ConclusionsIn IPUs, the diversity within interprofessional team meetings is important for establishing high-quality communication and relationships.Practice ImplicationsHospital managers should prioritize facilitating and encouraging shared meetings to enhance RC levels among professional groups in IPUs. Show less
Staalduinen, D.J. van; Bekerom, P.E.A. van den; Groeneveld, S.M.; Stiggelbout, A.M.; Van den Akker-van Marle, M.E. 2023
Background: An important element of value-based health care (VBHC) is interprofessional collaboration in integrated practice units (IPUs) for the delivery of the complete cycle of care. High levels... Show moreBackground: An important element of value-based health care (VBHC) is interprofessional collaboration in integrated practice units (IPUs) for the delivery of the complete cycle of care. High levels of interprofessional collaboration between clinical and nonclinical staff in IPUs are assumed rather than proven. Factors that may stimulate interprofessional collaboration in the context of VBHC are underresearched.Purpose: The aim of this study was to examine relational coordination (RC) in VBHC and its antecedents.Approach: A questionnaire was used to examine the association of both team practices and organizational conditions with interprofessional collaboration in IPUs. Gittell’s Relational Coordination Survey was drawn upon to measure interprofessional collaboration by capturing the relational dynamics in coordinated working. The questionnaire also included measures of team practices (team meetings and boundary spanning behavior) and organizational conditions (task interdependence and time constraints).Results: The number of different professional groups participating in team meetings is positively associated with RC in IPUs. Boundary spanning behavior, task interdependence, and time constraints are not associated with RC.Conclusions: In IPUs, the diversity within interprofessional team meetings is important for establishing high-quality communication and relationships.Practice Implications: Hospital managers should prioritize facilitating and encouraging shared meetings to enhance RC levels among professional groups in IPUs. Show less
Staalduinen, D.J. van; Bekerom, P.E.A. van den; Groeneveld, S.M.; Franx, A.; Stiggelbout, A.M.; Akker-van Marle, M.E van den 2023
Introduction: An important aspect of Value-Based Healthcare (VBHC) is providing the full cycle of care for a specific medical condition through interprofessional collaboration. This requires... Show moreIntroduction: An important aspect of Value-Based Healthcare (VBHC) is providing the full cycle of care for a specific medical condition through interprofessional collaboration. This requires employees from diverse professional backgrounds to interact, but there is limited knowledge on how professionals perceive such interprofessional collaboration. We aimed to provide insight into how different professionals perceive Integrated Practice Unit (IPU) composition and what factors influence the quality of interprofessional collaboration within IPUs.Methods: A survey was administered to employees from different professional backgrounds (medical specialists, nurses, allied health professionals, administrative employees) working in IPUs to assess their perception of the composition of their IPU and the quality of the interactions. Subsequently, semi-structured interviews were conducted to gain a deeper understanding of the findings of the survey.Results: Medical specialists and nurses were most frequently considered to be part of an IPU and indicated that they have high quality interactions. Allied health professionals were less often considered part of the team by all other professional groups and all report low quality interaction with this group. The extent to which a professional group is perceived as a team member depends on their visibility, involvement in the treatment of the patient, and shared interest. Differences in the quality of interprofessional collaboration are influenced by organizational structures, knowledge of each other’s expertise, and by ways of communication.Conclusions: In VBHC, there seems to be a lack of common perception of an IPU’s composition and a failure to always achieve high quality interprofessional collaboration. Given the importance of interprofessional collaboration in VBHC, effort should be invested in achieving a shared understanding and improved collaboration. Show less
Introduction: An important aspect of Value-Based Healthcare (VBHC) is providing the full cycle of care for a specific medical condition through interprofessional collaboration. This requires... Show moreIntroduction: An important aspect of Value-Based Healthcare (VBHC) is providing the full cycle of care for a specific medical condition through interprofessional collaboration. This requires employees from diverse professional backgrounds to interact, but there is limited knowledge on how professionals perceive such interprofessional collaboration. We aimed to provide insight into how different professionals perceive Integrated Practice Unit (IPU) composition and what factors influence the quality of interprofessional collaboration within IPUs.Methods: A survey was administered to employees from different professional backgrounds (medical specialists, nurses, allied health professionals, administrative employees) working in IPUs to assess their perception of the composition of their IPU and the quality of the interactions. Subsequently, semi-structured interviews were conducted to gain a deeper understanding of the findings of the survey.Results: Medical specialists and nurses were most frequently considered to be part of an IPU and indicated that they have high quality interactions. Allied health professionals were less often considered part of the team by all other professional groups and all report low quality interaction with this group. The extent to which a professional group is perceived as a team member depends on their visibility, involvement in the treatment of the patient, and shared interest. Differences in the quality of interprofessional collaboration are influenced by organizational structures, knowledge of each other's expertise, and by ways of communication.Conclusions: In VBHC, there seems to be a lack of common perception of an IPU's composition and a failure to always achieve high quality interprofessional collaboration. Given the importance of interprofessional collaboration in VBHC, effort should be invested in achieving a shared understanding and improved collaboration. Show less
Heteren, F. van; Raaphorst, N.J.; Groeneveld, S.M.; Bussemaker, J. 2023
Background: The aim of this study was to identify and summarize how value-based healthcare (VBHC) is conceptualized in the literature and implemented in hospitals. Furthermore, an overview was... Show moreBackground: The aim of this study was to identify and summarize how value-based healthcare (VBHC) is conceptualized in the literature and implemented in hospitals. Furthermore, an overview was created of the effects of both the implementation of VBHC and the implementation strategies used.Methods: A scoping review was conducted by searching online databases for articles published between January 2006 and February 2021. Empirical as well as non-empirical articles were included.Results: 1729 publications were screened and 62 were used for data extraction. The majority of the articles did not specify a conceptualization of VBHC, but only conceptualized the goals of VBHC or the concept of value. Most hospitals implemented only one or two components of VBHC, mainly the measurement of outcomes and costs or Integrated Practice Units (IPUs). Few studies examined effects. Implementation strategies were described rarely, and were evaluated even less.Conclusions: VBHC has a high level of interpretative variability and a common conceptualization of VBHC is therefore urgently needed. VBHC was proposed as a shift in healthcare management entailing six reinforcing steps, but hospitals have not implemented VBHC as an integrative strategy. VBHC implementation and effectiveness could benefit from the interdisciplinary collaboration between healthcare and management science. Show less
Bernards, B.J.T.H.; Groeneveld, S.M.; Pas, S. van der; Voet, J. van der 2022
Despite efforts to increase gender diversity and equality, worldwide, women are still underrepresented in leadership positions in public bureaucracies. This paper speaks to the debate on how... Show moreDespite efforts to increase gender diversity and equality, worldwide, women are still underrepresented in leadership positions in public bureaucracies. This paper speaks to the debate on how organizational context, more specifically organizational decline, may influence gender representation in such leadership positions. Based on role congruity theory and glass cliff theory this paper empirically examines whether and how excessive workforce reductions are associated with changes in the representation of women in leadership positions in Dutch civil service organizations. Panel analyses on administrative data show that women's representation in leadership positions varies over time, but is not significantly affected by excessive workforce reductions. Overall, the analyses do not provide evidence for a glass cliff for women in Dutch civil service organizations. Implications for theory and future research are discussed. Show less
Increasing demands and competing values force public organizations to introduce new organizational forms that veer away from rigid bureaucratic structures while remaining in control. How do public... Show moreIncreasing demands and competing values force public organizations to introduce new organizational forms that veer away from rigid bureaucratic structures while remaining in control. How do public managers and their employees deal with the dilemmas that these decentralized and organic ways of organizing entail? On the one hand it must be prevented that public managers fall back too quickly on structures that rely on control and formalization, while, on the other hand, they themselves as managers are still primarily held accountable based on those bureaucratic principles. New organizational forms also assume that leadership is shared and distributed. This not only asks for a higher degree of self-management of employees, but also requires from formal leaders that such behavior is supported and encouraged. In our research and teaching on these changes in public organizations, we work closely with practice. That too is a matter of balancing, this time of public engagement with scientific independence Show less
