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Summary case - St. Bernold’s Hospital: Building on Compassionate Human Care
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This document is a summery of the case of the St. Bernold's Hospital.
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St. Bernold’s hospital: buildingon compassionate Human Care
Introduction
Director Mayra Westman of the St. Bernold’s Hospital in Apeldoorn reviews the 2021 annual
report. They had been hit hard by Covid-19 and they took over the St. Eustachius Hospital in
Zwolle in 2019. The explosive workload had taken a roll on employees at all levels, with
absenteeism higher than ever, mainly due to illness and fatigue. The hospital had been
forced to hire extra staff to be able to cope and it had received less income from outpatient
visits. Although they ended the year positive with 4.5 million euro’s. However, the
hospital badly needed to regain its footing in elective care and stabilize its financial standing
after 2 difficult years.
Healthcare and Dutch Hospital sector
The Dutch government spend more than 100 billion on health in 2020 and approximately
one million people were employed in this sector. The Dutch hospital market had become
increasingly concentrated; more than 135 hospitals have merged. Successive government
policies seeking to increase hospital quality and efficiency had brought about this structural
change. There is also negative critique; causing a policy shift towards incentivizing
competition (health insurers and municipalities increased).
Hospitals organize their work in centres focused on specific pt groups and offering
multidisciplinary care to comorbidity-pt. Insurance financing those groups and the life
expectancy is high. There was predicted a rise in both the demand for costs of care
demographic changes, aging and chronic disease. Also, technological innovation and digital
health implementations were considered essential for healthcare providers in near future.
St. Bernold’s Hospital in Apeldoorn
It is named after a medieval bishop and reformist (Christian identity); a medium-sized
hospital that offered pt-centered care. Values attention and compassion, competency and
professionalism, responsibility and receptivity.
Westman became the chair of the board in 2016. There was a dire need of strong and clear
leadership carry on different programs, cutting costs, reducing positions and implementing
software. Digitization was a far-sighted decision, mostly based on the future. She sees
working in a hospital as an internal motivation in addition to earning a living. The end of
2017, the hospital had a 4.2mil loss due to the time-consuming introduction of EPD’s
which lead to less care, increasing waiting times and lower production. In 2018 Westman
choose to propelling production and increasing volume (fulfill the hospitals growth
aspiration and studied the market for new opportunities).
, The hospital had troubles when it merged with the Emmed Hospital in 1990 created
financial problems for years. Over the years it didn’t improve they where bankrupted,
outflow of staff and losing emergency departments.
Expanding with purpose
In 2019 they took over the St. Eustachius the combined hospitals now offered clinical
services, primary care, acute care, chronic care and medical and surgical specialties. The
board is three-member executive, led by Westman. An independent seven-member
supervisory board oversaw the board of directors, which was responsible for the hospital’s
decision-making processes and organizational structure.
The two hospitals were structurally different and geographically apart.
St. Bernold = average older people, chronic diseases (obesity), constantly focus on retaining
its staff and reducing turnover, despite the difficulty of the different departments.
St. Eustacius = less densely populated, younger, less incidence of chronic disease, less
specialized workforce to choose from challenge of improving working conditions to
attract outside employees.
St. Bernold
Was built to meet structural, logistical and functional purposes, organized in centres
according to pt conditions and care type.
Professionals worked closely together, benefitting from each other’s experience
multidisciplinary care.
o This structure provided room for employee input and innovation and
encouraged collaboration between specialists.
o Dual management system = which both managers and doctors were aware of
and held responsibility for the hospitals finances and strategy.
St. Eustacius
Organised in clusters of speciality units, with strong, structured teams but it had
acute workforce problems such as high turnover and burnout rates increased
The roles of managers and doctors had been traditionally divided
o Managers focusing on the structure and finance
o Doctors in charge of medical teams
The new system of centre-based work (implemented by Westman) led to change in
this team culture (this used to be positive)
o Teams should be more loosely defined; having multidisciplinary mix of
professionals.
Westman looked for solutions and training for those who struggled
mentally with the new working model, blurred team boundaries and
shared domains
Westman was aware of the challenge in the critical disciplines.
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