Kam, David de, MA.

Governance and (external) regulation and supervision of the quality and safety of healthcare

Institute of Health Policy & Management (iBMG), Erasmus University Rotterdam, dekam@bmg.eur.nl

Supervisor: Prof. Roland Bal and Dr. Kor Grit

Background

In 2011 I graduated from Comparative Literature at Utrecht University. In 2013 I enrolled in the pre-master program Health Policy & Management at Erasmus University and by the summer of 2015 I received my Master’s degree in Healthcare Management. After obtaining my degree I started working at the Institute of Health Policy & Management (iBMG) as PhD candidate in health care governance.

Summary

My PhD research focuses on the governance and (external) regulation and supervision of the quality and safety of healthcare. Specifically, I am interested in seeing how the governance of the quality of safety comes about through the interactions between (external) regulation and supervision of quality and safety, how healthcare organizations seek to address quality and safety—as well as the regulatory demands they face—and how healthcare professionals ‘do’ quality and safety within these organizations. In a way, the governance of quality and safety can be viewed as an assemblage, wherein (governance of) quality and safety is a temporal arrangement that comes about through the actions and interactions of a variety of actors.

• In the first project as part of my PhD research, we zoom in on the way in which various departments within a hospital frame and register complications. Quality and safety has been framed throughout the years as entailing efforts to avoid something bad from happening. In a way, quality and safety is the absence of medical errors, complications, calamities and other sorts of unwanted outcomes.
• In the second project as part of my PhD research, we explore how significant changes in the organizational and regulatory structure of hospitals potentially affect the quality and safety of care that is provided. In this project we specifically look into mergers of hospitals and a recent change in how medical specialists are employed by hospitals. Moreover, we focus on the way in which the Dutch Healthcare Inspectorate (DHI) seeks to supervise significant changes in the organizational and regulatory structure of hospitals, such as mergers and the redesign of how hospitals employ medical specialists, given the quality and safety risks they associate with these changes.
• In the third project as part of my PhD research, we look into the way care organizations—that care for the elderly and mentally disabled—research and seek to learn from calamities that resulted in the death of a patient. This project started very recently and ties into public debates about the need to be transparent as a healthcare organization, the dictum to learn from ones mistakes and the call for independent research in case of calamities.

Publications

De Kam, D., Wallenburg, I. & R. Bal. Submitted. “Registering complications in pediatric care: the multiplied reality of a non-existing registry.” Science & Technology Studies