The quality of care is determined for a large part by the quality of the care professionals and the way they are organized. This does not just mean that there have to be enough care professionals to deal with health care demand, but also that they have had adequate training, that they can be approached easily and that they coordinate with each other properly. In this research domain the developments within and between professional groups and health care facilities are examined. The content of the work and its safety is also studied, by looking at improvement projects within care organizations for instance.
Policy makers, care professionals and managers in the health care sector strive for a better organized supply of care, and better quality and safety. The context includes the greater effects of the market in health care and the demands from insurers and patients, but also incidents highlighting that quality and safety can’t always be guaranteed. Because of various policy measures the supply within care organizations has clearly changed over the last few years. To hospitals, the introduction of Diagnosis and Treatment Combinations (DTCs), the use of performance indicators for accountability, and the interest in patient safety all matter. In acute care the out-of-hours GP centres have come into play, radically changing both cooperation and communication between the out-of-hours centres, hospital accident & emergency wards and ambulance services especially. Beside this, various (funding) incentives are causing a shift in the organization and supply of professional carers. The expansion of the so-called B sector of negotiable hospital tariffs and changes to reimbursement according to the Health Insurance Act can be considered here. The boundaries between health care providers, but also between care facilities, are becoming blurred, meaning the question of who can best provide care and in what manner is being reconsidered. In other sectors a lot of work is also being done on providing insight into the quality of care, by means of performance indicators and practice accreditations. New areas within quality policy are patient safety and the approachability of care, for instance in terms of accessibility and waiting lists.
Health care is constantly changing, necessarily so. Nivel research fits into this by doing research into innovations and implementations, aiming to assess implementation strategies, how organization influences innovations and the role professionals and patients play.
Research into the fine-tuning of supply and demand, based on the flow into and out of education and professions as well as developments in policy and content, constitute an important part of the research domain. More and more the focus is on the correlation among professions and possible substitution between them. This goes for GPs and practice nurses, but also for medical specialists and specialized nurses. Apart from this research is being done into the quality and organization of health care at both a national and local or neighbourhood level, for instance within primary care. The Demand Supply Analysis Monitor (VAAM) will be expanded further. Furthermore, work will be done within the obstetric professional group on a large-scale quality study focusing on primary care midwives, the Deliver-study (Primary Care Midwifery Data). It is being carried out on the initiative of the Midwifery Academy Amsterdam and in cooperation with EMGO+, the Dutch Institute for Health and Care Research, and Nivel.
There is also an increasing amount of attention for the transfer moments within professions, between professions and between health care facilities, both in acute and in long-term care.