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Werkgroepen Governance & Strategy HCM/ZoMa
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- Erasmus Universiteit Rotterdam (EUR)
Alle werkgroep antwoorden voor het vak Governance & Strategy van de master Zorgmanagement/Healthcare Management
[Meer zien]Voorbeeld 2 van de 14 pagina's
Voorbeeld 2 van de 14 pagina's
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Voorbeeld van de inhoud
Governance and StrategyWorkgroup 1: Unravelling the concept of governance
1. How is governance defined and described in the articles of Peters (2001), Rhodes (2007),
Scholten (2018) and Riley (2006)?
Peters
Multi-level governance refers to negotiated, non-hierarchical exchanges between institutions
at the transnational, national, regional and local levels. Taken one step further, the definition
could be slightly expanded to denote relationships between governance processes at these
different levels. Thus, multi-level governance refers not just to negotiated relationships
between institutions at different institutional levels but to a vertical ‘layering’ of governance
processes at these different levels.
The important point here is that although we tend to think of these institutional levels as
vertically ordered, institutional relationships do not have to operate through intermediary
levels but can take place directly between, say, the transnational and regional levels, thus
bypassing the state level.
To some extent, multi-level governance seems to emerge as the combined result of
decentralization, the ‘hollowing out’ of the state, a shift from an interventionist towards an
‘enabling state’, budgetary cutbacks and a growing degree of institutional self-assertion and
professionalism at the subnational level.
Rhodes
Governance is a new process of governing/the new method by which society is governed/a
changed condition or ordered rule.
- Interdependence between organizations, governance is broader than government,
covering non-state actors. Changing the boundaries of the state meant the boundaries
between public, private and voluntary sectors became shifting and opaque.
- Continuing interaction between network members, caused by the need to exchange
resources and negotiate shared purposes.
- Game-like interactions rooted in trust and regulated by rules of the game negotiated and
agreed by network participants.
- A significant degree of autonomy from the state. Networks are not accountable to the
state: they are self-organizing. Although the state does not occupy a privileged, sovereign
position, it can indirectly and imperfectly steer networks.
In sum, governance refers to governing with and through networks = network governance.
Scholten
Hospital governance is defined as a set of processes and tools related to decision making in
steering the totality of institutional activity, influencing most major aspects of organizational
behavior and recognizing the complex relationships between multiple stakeholders. Complex
because of two intermingling dynamics; internal and external.
Riley
Governance is the power to direct conduct, with the concept of mentality, or how governing
is thought about and approached. It concerns not only with tactic or practices of
government, but also with practices of the self that shape and mold the individual through
directing choices, desired aspirations and needs. All the different professional groups can use
governance.
, Impact of surgeons on how the clinical environment functioned It’s governance and
control but governance does not have to be performed by surgeons or other high officers. It
can also be performed by nurses or assistants. It is not bound by hierarchy. Governance is
related to the autonomous capacity of OR nurses to create a dominant image.
2. What is the role of governance in these four articles: what or whom is being ‘steered’ and
how? What does this tell us about what the concept of governance entails?
Peters
Multiple non-hierarchical layers are steering society. The gradual shift from a government
towards a governance perspective reflects the new role of the state which has become
typical of western politics in the past decade or so. We have been witnessing a development
from ‘a command and control’ type of state towards an ‘enabling’ state, a model in which the
state is not proactively governing society but is more concerned with defining objectives and
mustering resources from a wide variety of sources to pursue those goals. Hollowing out of
the state government is now reliant on other stakeholders for their power.
Rhodes
Steering networks: networks are intertwined. Within these networks, organisations steer
each other. They are independent. The state is also part of the network. It indirectly steers
networks.
Hollowing out of the state: the growth of governance reduced the ability of the core
executive to act affectively, making it less reliant on a command operating code and more
reliant on diplomacy. The state is giving more and more responsibility to other actors, which
means they have less strength. This can come in 3 ways: from above, sideways and below.
Shadow of hierarchy: visible but not as obviously present as before. It is still there and
influences the steering of networks (indirectly). The state decentralises but when that goes
wrong and they want their power back, they can always do this. Meta governance: not
always directly supervision but often via other organs.
Scholten
Internal dynamics: interdependencies between autonomous groups
o Four groups: doctors, nurses, managers, supervisors
External dynamics: results from governments’ and stakeholders’ pressure to change
hospital governance
o Laws and regulations
o Governments exercise power to transform hospital structure monolithic
management
Conflict internal ↔ external dynamics
Undefined roles/role ambiguity
o Strong norms are important
o Local context decides which norms are to be held
Riley
Governance is used by professionals to control their own work environment. E.g. the practice
of gatekeeping as a technology of governance. Nurses competed with each other for status
by selectively withholding or divulging information about surgeons; technical preferences for
surgery. Knowing surgeons in terms of time was a form of governance that nurses used to
control not only their own clinical practice, but that of the surgeons.
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