Wrap-up lecture
Governance and Strategy
Recap
Week 1: What is Governance?
- Wicked problem of staff shortage
- Micro, meso and macro levels of governance
- Micro: OR nurse article
- Meso: hospital governance article
- Macro: network governance (Rhodes article)
o When you talk about these levels, relate it back to governance! What kind of
elements of governance were in these levels. What does it mean from a
governance perspective.
- Decentralization: power to other stakeholders (municipality, EU, etc)
- Inner context (what happens within a hc organization) and outer context (influence
of outside and how the inside relates to the outside!)
Week 2: Decentralization of care
- Dutch layers in society (upper class etc.) What possibilities they have in caring for
themselves.
- Graph of 65+ in 2040. Dubbele vergrijzing.
- Different types of decentralization (Saltman: political etc)
- Neighborhood governance: stay longer at home so neighborhood is important.
Different arrangement of NG.
- Informal caregivers as solution, maybe. Because of staff shortage. What is required
from citizens/you (digital, cultural capital etc).
- Question: what is exactly meant with the challenge of competence in neighborhood
governance?
o The pool of representatives is smaller, so are they chosen because of
competence or scope? The pool is smaller so aren’t u going to be in trouble
with finding comepetent people for NG?
Week 3: Working with layers
- Management perspective, how can we look at it from the steering perspectives
- Institutional layering; instit arrangements being layered on top of each other. Quality
hospitals, self-regulation. Intro of market system. How you can deal with that as a hc
manager. Instit work concept what actors do to deal with this layering. Empirical
example: how hc managers used seom of these arrangemenets to get things done
e.g. how the hc inspectorate and insurers want quality indicators form hospitals, and
hc managers use this to get things done within their hospitals. Doctors think they
know what theyre doing, but hc managers say no you have to adhere to it because of
external need etc.
- Complexity of work of hc manager. All diff actors which want something and need
something from u. e.g. role of banks in the hospital (financing) and media. Complex
to maneouvr this layering.
1
, - Uncertain times article. Don’t have to know it in detail. Diff goals of the manager and
all kinds of models. But it illustrates how complex it is to work as a hc manager with
all diff influences from outer and inner context. That’s the point of this article.
- Institutional work.
- Capacities for collective action by societal actors model:
Week 4: Serious Game
- 1st of May: yellow vests protest movement in Paris. Tried to go into a hospital to
trash the place. Maybe saw hospitals as representatives of the state. This illustrates
what hospitals need to deal with.
- Game was not just for G&S but for the whole master. One of the things that tried to
show us:
o Safety & security in hospital is so much more. Digital, physical. E.g. 20-30
hospitals were hacked couple years ago for bitcoins.
o Responsibilities and dependencies of actors.
o Dec-making: negotiation.
o Uncertainty. Had to make decisions under pressure and uncertainty like irl.
- What is the relation/similarities between the game and what is discussed in G&S?
2
Governance and Strategy
Recap
Week 1: What is Governance?
- Wicked problem of staff shortage
- Micro, meso and macro levels of governance
- Micro: OR nurse article
- Meso: hospital governance article
- Macro: network governance (Rhodes article)
o When you talk about these levels, relate it back to governance! What kind of
elements of governance were in these levels. What does it mean from a
governance perspective.
- Decentralization: power to other stakeholders (municipality, EU, etc)
- Inner context (what happens within a hc organization) and outer context (influence
of outside and how the inside relates to the outside!)
Week 2: Decentralization of care
- Dutch layers in society (upper class etc.) What possibilities they have in caring for
themselves.
- Graph of 65+ in 2040. Dubbele vergrijzing.
- Different types of decentralization (Saltman: political etc)
- Neighborhood governance: stay longer at home so neighborhood is important.
Different arrangement of NG.
- Informal caregivers as solution, maybe. Because of staff shortage. What is required
from citizens/you (digital, cultural capital etc).
- Question: what is exactly meant with the challenge of competence in neighborhood
governance?
o The pool of representatives is smaller, so are they chosen because of
competence or scope? The pool is smaller so aren’t u going to be in trouble
with finding comepetent people for NG?
Week 3: Working with layers
- Management perspective, how can we look at it from the steering perspectives
- Institutional layering; instit arrangements being layered on top of each other. Quality
hospitals, self-regulation. Intro of market system. How you can deal with that as a hc
manager. Instit work concept what actors do to deal with this layering. Empirical
example: how hc managers used seom of these arrangemenets to get things done
e.g. how the hc inspectorate and insurers want quality indicators form hospitals, and
hc managers use this to get things done within their hospitals. Doctors think they
know what theyre doing, but hc managers say no you have to adhere to it because of
external need etc.
- Complexity of work of hc manager. All diff actors which want something and need
something from u. e.g. role of banks in the hospital (financing) and media. Complex
to maneouvr this layering.
1
, - Uncertain times article. Don’t have to know it in detail. Diff goals of the manager and
all kinds of models. But it illustrates how complex it is to work as a hc manager with
all diff influences from outer and inner context. That’s the point of this article.
- Institutional work.
- Capacities for collective action by societal actors model:
Week 4: Serious Game
- 1st of May: yellow vests protest movement in Paris. Tried to go into a hospital to
trash the place. Maybe saw hospitals as representatives of the state. This illustrates
what hospitals need to deal with.
- Game was not just for G&S but for the whole master. One of the things that tried to
show us:
o Safety & security in hospital is so much more. Digital, physical. E.g. 20-30
hospitals were hacked couple years ago for bitcoins.
o Responsibilities and dependencies of actors.
o Dec-making: negotiation.
o Uncertainty. Had to make decisions under pressure and uncertainty like irl.
- What is the relation/similarities between the game and what is discussed in G&S?
2
