The impact of the organisational structure on person-centred care Master thesis Organisational Design and Development
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2022-08-29
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en
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The Radboud university medical centre is about to implement a major organisational change and is curious about the influence of this change on their vision of person-centred and innovative care therefore, this intervention-oriented research is conducted to provide overview of the current situation. This research assesses the impact of the current organizational structure on person-centered care in the Radboudumc. The research has two objectives, the first is to show the difference between the desired and the current state on person-centered care and the second objective is to see how the structure affects this. Because person-centredness is not a meaningful term at his own, first is looked for an interpretation of the term, using a policy document of the Radboudumc itself. To get a picture of the current situation, interviews with employees from different departments and different care flows in the organization were held. The biggest difference between the desired and current situation was not that the employees did not work person-centred, but that the policy as the Radboud describes it is not known by the employees. The impact of the organizational structure on not achieving person-centered care is caused by; the high degree of functional concentration which has a negative impact on person-centered work, it creates a dynamic work field which inducing that there is no time for personal attention and creates differences in how well prepared the patients arrive at a department, which causes that adjustments are needed which sometimes are not possible in short term. Also, the high degree of specialization of operational tasks which requires a lot of consultation between departments, and which means that an employee only has a short moment of contact with a patient so the medical act takes priority over the social and psychological side. Along with this, the high degree of specialization of regulating tasks caused by the divided departments results that previous departments in the process do not take advanced measures affecting the patient's journey in a negative way. Due to the separation of executive and regulating tasks, employees that may bring in or want to bring in improvements in line with person-centred policies, do not come through. These gaps and causes are based on the knowledge of the employees where they think the organisation hinders in providing person-centered care. Because only seven interviews are held for this study, these gaps structural causes found are indicative. From these findings, I would recommend that in the first place the policy on person-centred working should come to attention among the staff, as described in the 2018 annual report. I also suggest to keep the relevant findings in mind while implementing the structural changes of fit for the future. Furthermore, for follow-up research, conduct a similar survey to identify the differences in the gaps, so the Radboudumc after the implementation of a change in the organisational structure can see the effect on these points.
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Faculteit der Managementwetenschappen