heard but not heard. Control requires leadership

In order to achieve more job satisfaction in healthcare, Minister Connie Helder has allocated 500 million euros annually in the future-proof TAZ Labor Market Program. In view of the shortage in the labor market, high absenteeism and large outflow, this is much needed. For job satisfaction and employee retention, proper organization of employee control and leadership should receive more attention.

In scientific studies, the relationship between control, job satisfaction and employee retention has been researched and proven. Just like the relationship between control and patient safety, quality of care and quality improvement in care. But regulation of formal control opportunities alone is not sufficient for this: control takes place in the dynamics between people, and therefore requires (personal) leadership.

vertical control

In the TAZ programme, the minister notes that administrators and supervisors must facilitate and support greater participation by involving health care workers in policy and decision-making. (vertical control). This is now legally guaranteed also in the Quality of Care Complaints and Disputes Act, to which it is added that caregivers must be able to influence the initial process of providing care and policy regarding care in the organization.


However, the question is whether these formal opportunities for participation and influence are sufficient to allow employees to experience the fact that they have an opinion. Research within the Dignity and Pride on-site program shows that managers and administrators of aged care organizations are generally more optimistic about the potential of health care workers to influence organization policy than are caregivers and nurses.

feeling audible

The study analyzed data collected from nearly 4,000 Dutch healthcare professionals working in 180 nursing home sites. Although these numbers also revealed a significant relationship between the chances of control on the one hand and job satisfaction and retention on the other hand, employees made a lot of comments in the disclosures such as: “I wouldn’t know how to influence policy,” or “I’ve never heard of Video assistant referee I don’t think there is one This has also happened in organizations where management and board report that they actively use input and advice from employees and advisory boards So analysis of this data shows that managers and directors simply cannot assume that they are adequately supporting and facilitating employee participation If there are officially enough opportunities to do so, not to mention that employees feel heard.

horizontal control

TAZ also pays attention to horizontal control. It’s about equality and the ability to speak on your team. This is also a good idea because it benefits learning, improvement, and collaboration in teams. Both the scholarly literature and data collected within Dignity and Pride on Site show that good team collaboration and a team culture of learning and improvement correlate with job satisfaction and employee retention as well as better quality of care.

Fewer functional groups

However, hierarchy not only plays a role at the organizational level, but certainly also in care teams. This also deserves attention in the context of control. For example, various studies have shown that employees in lower job groups in particular are less likely to express themselves. For example, because they feel they have a right to speak less than others in the team or because they feel less involved in the organization. Roles such as EVV’ers, distinguished nurses, and nursing professionals are beneficial on the one hand, but on the other hand they can encourage hierarchical relationships in teams. In nursing homes, care aides, assistants, and caregivers are the hands on the bed where there is such a shortage. The question is what, in addition to enough time, do they need to make their voices heard.

Soft border terms

500 million annually for more job satisfaction and control in healthcare is an impressive and important initiative. However, in order to reap the benefits, adequate time and energy must also be invested in the soft preconditions for control. This means good leadership in management, the board of directors, and supervisors for health care workers. But it also requires personal leadership from health care workers themselves, so that health care workers at all levels feel supported to have their voice heard and experience it being heard. In this way, monitoring can actually contribute to increasing job satisfaction and employee retention and improving the quality of care.

Billis van den Berg And the Pauline VermontConsultants Vilans

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