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Tot nu toe is casestudyonderzoek vooral gebruikt voor het exploreren van situaties met het doel om over deze situaties theorie te ontwikkelen. Niet eerder is er uitgebreid gepubliceerd over het toetsen van theorie door middel van de gevalstudie. Jan Dul en Tony Hak beschrijven in hun boek Case Study Methodology in Business Research structuren en richtlijnen om proposities te testen door middel van casestudyonderzoek. Op 1 november jongstleden werd er door het Erasmus Research Institute of Management (ERIM) een seminar georganiseerd ter gelegenheid van het verschijnen van dit boek. Vanwege het vernieuwende onderwerp en de aangekondigde sprekers was er zeer veel animo om deze bijeenkomst bij te wonen. De organisatie had een groot aantal aanmeldingen moeten weigeren, maar dankzij mijn vroege aanmelding kon ik, net als zo'n vijftig anderen, hierbij aanwezig zijn.

Abstract Background As in most fields of health care, societal and political changes encourage suppliers of long-term care to put their clients at the center of care and service provision and become more responsive towards client needs and requirements. However, the diverse, multiple and dynamic nature of demand for long-term care complicates the movement towards demand-based care provision. This paper aims to advance long-term care practice and, to that end, examines the application of modularity. This concept is recognized in a wide range of product and service settings for its ability to design demand-based products and processes. Methods Starting from the basic dimensions of modularity, we use qualitative research to explore the use and application of modularity principles in the current working practices and processes of four organizations in the field of long-term care for the elderly. In-depth semi-structured interviews were conducted with 38 key informants and triangulated with document research and observation. Data was analyzed thematically by means of coding and subsequent exploration of patterns. Data analysis was facilitated by qualitative analysis software. Results Our data suggest that a modular setup of supply is employed in the arrangement of care and service supply and assists providers of long-term care in providing their clients with choice options and variation. In addition, modularization of the needs assessment and package specification process allows the case organizations to manage client involvement but still provide customized packages of care and services. Conclusion The adequate setup of an organization's supply and its specification phase activities are indispensible for long-term care providers who aim to do better in terms of quality and efficiency. Moreover, long-term care providers could benefit from joint provision of care and services by means of modular working teams. Based upon our findings, we are able to elaborate on how to further enable demand-based provision of long-term care by means of modularity.

Background: As in most fields of health care, societal and political changes encourage suppliers of long-term care to put their clients at the center of care and service provision and become more responsive towards client needs and requirements. However, the diverse, multiple and dynamic nature of demand for long-term care complicates the movement towards demand-based care provision. This paper aims to advance long-term care practice and, to that end, examines the application of modularity. This concept is recognized in a wide range of product and service settings for its ability to design demand-based products and processes. Methods: Starting from the basic dimensions of modularity, we use qualitative research to explore the use and application of modularity principles in the current working practices and processes of four organizations in the field of long-term care for the elderly. In-depth semi-structured interviews were conducted with 38 key informants and triangulated with document research and observation. Data was analyzed thematically by means of coding and subsequent exploration of patterns. Data analysis was facilitated by qualitative analysis software. Results: Our data suggest that a modular setup of supply is employed in the arrangement of care and service supply and assists providers of long-term care in providing their clients with choice options and variation. In addition, modularization of the needs assessment and package specification process allows the case organizations to manage client involvement but still provide customized packages of care and services. Conclusion: The adequate setup of an organization's supply and its specification phase activities are indispensible for long-term care providers who aim to do better in terms of quality and efficiency. Moreover, long-term care providers could benefit from joint provision of care and services by means of modular working teams. Based upon our findings, we are able to elaborate on how to further enable demand-based provision of long-term ...

PurposeThe purpose of this paper is to show how modularity manifests in a service context, more specifically in the provision of care and services to independently living elderly.Design/methodology/approachFour case studies provide insight into the specification of relevant components and their subsequent assembly into a customized package of care and services.FindingsIn all cases, component specification and package construction take place in two phases: partly before and partly during care delivery. Early client involvement allows for a combination of standard components that have a lower level of customization, whereas late client involvement allows for adaptation of these components resulting in a higher level of customization. The paper proposes that modularity theory should distinguish between the creation of modular offerings in care provision versus their creation in goods production, since the findings are the exact reverse of the state‐of‐the art knowledge in manufacturing modularity.Research limitations/implicationsThe empirical part of this paper is limited to providers of elderly care and services in The Netherlands and is exploratory in nature. However, the newness of care and service modularity justifies the exploratory research approach.Practical implicationsThis paper offers elderly care organizations in‐depth understanding of their complex and multi‐faceted specification process. The insights help both care and service providers to make well‐considered decisions as to what level of client involvement to allow and the type of modularity to apply.Originality/valueThis paper contributes to the emerging literature on service modularity.

Purpose
– To guide organizations toward total quality management (TQM), various models have been developed such as the European Foundation for Quality Management Excellence Model (EFQM Model). The purpose of this paper is to conduct a longitudinal investigation of whether the EFQM Model can serve as a framework for TQM in healthcare.


Design/methodology/approach
– Data on a national representative survey about quality management (QM) in the hospital population in the Netherlands were used to conduct this study. The survey had five measurement points between 1995 and 2011.


Findings
– The results of the study show that applying the EFQM Model in hospitals is related to improvement in organizational performance over time, a feedback loop in which hospitals use their results to further improve their organizational processes is established, and improvement is stronger when all the model's elements are considered simultaneously.


Practical implications
– The results of the study can be applied by quality managers of healthcare institutions to achieve higher quality of care.


Originality/value
– Previous research on the relationship between the EFQM excellence model and TQM neglects two essential characteristics of the TQM philosophy, namely, the holistic perspective on QM and the presumed feedback loop of organizational performance that feeds a cycle of continuous quality improvement. The study provides new insights into the long-term benefits of applying the EFQM Model as a framework for TQM in healthcare.

OBJECTIVE: To prevent wrong surgery, the WHO 'Safe Surgery Checklist' was introduced in 2008. The checklist comprises a time-out procedure (TOP): the final step before the start of the surgical procedure where the patient, surgical procedure and side/site are reviewed by the surgical team. The aim of this study is to evaluate the extent to which hospitals carry out the TOP before anaesthesia in the operating room, whether compliance has changed over time, and to determine factors that are associated with compliance. DESIGN: Evaluation study involving observations. SETTING: Operating rooms of 2 academic, 4 teaching and 12 general Dutch hospitals. PARTICIPANTS: A random selection was made from all adult patients scheduled for elective surgery on the day of the observation, preferably involving different surgeons and different procedures. RESULTS: Mean compliance with the TOP was 71.3%. Large differences between hospitals were observed. No linear trend was found in compliance during the study period. Compliance at general and teaching hospitals was higher than at academic hospitals. Compliance decreased with the age of the patient, general surgery showed lower compliance in comparison with other specialties and compliance was higher when the team was focused on the TOP. CONCLUSIONS: Large differences in compliance with the TOP were observed between participating hospitals which can be attributed at least in part to the type of hospital, surgical specialty and patient characteristics. Hospitals do not comply consistently with national guidelines to prevent wrong surgery and further implementation as well as further research into non-compliance is needed.