A practice change study: How a healthcare decentralization affects the practices of youth care practitioners

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2016-08-31
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en
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In this thesis, I explore how the decentralization of the Dutch youth care system affected the practices of the youth care practitioners. This exploration is performed via a qualitative interview study, in which interviews were performed with youth care practitioners of several different youth care organizations in Gelderland (a province in the Netherlands). By applying a template analysis to the gathered data, I identified five practices that underwent the largest changes as experienced by the participants: youth care provision, care worker – client positioning, external relation management, result management and team management. The healthcare decentralization affected those practices (partially) via an increased influence of the institutional market logic. Based on those changes, four types of practice changes occurred: a goal adjustment, an introduction of new practices, an increased influence of administrative and managerial practices on the professional practice and a shift in the balance of different practices. The main contribution of this thesis to the practice literature therefore is twofold: I confirmed that a change in the institutional logics of a sector affects the practices, and I showed that a specific set of practices might change in different types of practice changes. The main practical contribution made by this thesis lies in the insights given on the actual change in practices, which shows Dutch youth care organizations what actual practice changes have taken place and how they themselves have a role of guidance in creating these practice changes.
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Faculteit der Managementwetenschappen