Investigating Hospital Supervision: A Case Study of Regulatory Inspectors’ Roles as Potential Co-creators of Resilience

�yri, Sina Furnes; Braut, Geir Sverre; Macrae, Carl; Wiig, Siri

Abstract

Objectives: The aim of this study was to explore if, and in what ways, there has been changes in the supervisory approach towards Norwegian hospitals, due to implementation of a new management and quality improvement Regulation. Moreover, we aimed to understand how inspectors’ work promote or hamper resilience potentials of adaptive capacity and learning in hospitals.

Methods: The study design is a case study of implementation and impact of the Regulation. We conducted- and analyzed three focus groups and two individual interviews with regulatory inspectors, recruited from three County Governor-offices who are responsible for implementation and supervision of the Regulation in Norwegian regions.

Results: Data analysis resulted in five themes. Informants described no substantial change in their approach due to the Regulation. Regardless, data pointed to a development in their practices and expectations. Although the Norwegian Board of Health Supervision, at the national level, occasionally provides guidance, supervision is adapted to specific contexts and inspectors balance trade-offs. Informants expressed concern about the impact of supervision on hospital performance. Benefits and disadvantage with positive feedback from inspectors were debated. Inspectors could nurture learning by improving their follow-up and add more hospital self-assessment.

Conclusions: A non-detailed regulatory framework such as the Regulation provides hospitals with room to maneuver, and self-assessment might reduce resource demands. The impact of supervision is scarce with an unfulfilled potential to learn from supervision. The Government could contribute to a shift in focus by instructing the County Governors to actively reflect on and communicate positive experiences from- and smart adaptations in hospital practice

Citation

Øyri, S. F., Braut, G. . S., Macrae, C., & Wiig, S. (2021). Investigating Hospital Supervision: A Case Study of Regulatory Inspectors’ Roles as Potential Co-creators of Resilience. Journal of Patient Safety, 17(2), 122-130. https://doi.org/10.1097/PTS.0000000000000814

• Journal Article Type: Article
• Acceptance Date: Oct 12, 2020
• Online Publication Date: Mar 1, 2021
• Publication Date: Mar 1, 2021
• Deposit Date: Nov 30, 2020
• Publicly Available Date: Mar 2, 2022
• Journal: Journal of Patient Safety
• Print ISSN: 1549-8417
• Publisher: Lippincott, Williams & Wilkins
• Peer Reviewed: Peer Reviewed
• Volume: 17
• Issue: 2
• Pages: 122-130
• DOI: https://doi.org/10.1097/PTS.0000000000000814
• Public URL: https://nottingham-repository.worktribe.com/output/5091837
• Publisher URL: https://journals.lww.com/journalpatientsafety/Fulltext/2021/03000/Investigating_Hospital_Supervision__A_Case_Study.9.aspx