Rapport Patiëntveiligheid, de rol van de bestuurder - Veilige zorg ...

ing networks, writing reports) so the professionals’ time is put to the best ofuse, which is focusing on the content. All six strategies work together tocreate the possibility for processes to do their work.Conclusion – the empirical data supports the theoryThe empirical data showed that the board of the UMC Utrecht led patientsafety improvements effectively. Again, it must be stressed that an actualeffect on safety cannot be proven. However, proxy measures (e.g. incidentreporting, amount of implemented recommendations) strongly suggest apositive effect on patient safety. It is very likely that the strategies used by theboard have led to this effect. For a large part these strategies fit the hypothesisbased on the theory. The board led patient safety improvements:- taking the four traits of the patient safety problem (visibility, ambiguity,diversity and side-effects of professionalism) into account;- considering the specific difficulties inherent to leading professionals andprofessional organizations;- using a process management style (openness, safety, momentum, ratio)adding two extra strategies (appeal and support);- resulting in a cycle of continuous learning.The board did not only use process management strategies, but also otherstrategies like command and control. However, this was always done to startor improve the processes or to embed the results of the processes in theorganization. The role of the board was fourfold:- create the right conditions for process to start;- guard the continuation of the processes;- judge the outcome of the processes;- give standing to the outcomes and embed them in the organization.Recommendation – process managementThis research suggests that boards can effectively lead patient safety improvementsthrough process management. To make it possible for theprocesses to lead to acceptable and trustworthy outcomes, the board shouldensure:- Openness: everybody should be able to provide input;- Safety: each participant’s core values must be protected;- Momentum: adequate pressure for the process to keep its momentum;Patiëntveiligheid, de rol van de bestuurder 387