University of Twente Student Theses

Designating European cancer institutes: 'towards a professional tool for quality improvement': a quality study on the challenges and critical features of a designational system for European cancer institutes with the focus on development and implementation

Hesselink, Gijs (2008) Designating European cancer institutes: 'towards a professional tool for quality improvement': a quality study on the challenges and critical features of a designational system for European cancer institutes with the focus on development and implementation.

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Abstract:	The growing cancer burden and a great unused potential for making advancements in cancer care and research on an international scale, urges policymakers to take extra measures. In view of this need, the ‘Organisation of European Cancer Institutes’ (OECI) pleads for more harmonization between cancer institutes in Europe through common used methods that enable the comparison, evaluation and synchronization of their cancer activities. Subsequent to the introduction of an accreditation project, the most recent proposed initiative is to develop and implement a system in which European cancer institutes can be designated. Although this initiative appears to be very promising at first sight, two major problems currently occur in the development and implementation of the designation system: (1) the challenges and features for developing the right categories, criteria and review-methods are unclear (2) their is insufficient understanding of the social-political context and what consequences it might have for the development and implementation of the designation system. A qualitative research has therefore been performed in order to get a better understanding of the system-technical and social-political aspects in developing and implementing the designation systemand to provide subsequent recommendations. Data has been gathered with the help of a literature review, interviews, observations and many informal conversations. The analysis of data in the field has been supported by theoretical concepts, considerations, relevant aspects of existing examples similar to this designation initiative. Findings from the theoretical and field research indicate that the development and implementation of the designation system are mainly challenged by the complex context. Translating it from theory into practice appears to bear several hazards along the way. From a system-technical point of view these hazards mainly concern the practical applicability of the system, with regard to demographic, legislative, administrative and language differences. Social-politically it is the complex social setting that initially triggers conflicting and strategic behavior and therefore challenges the required acceptance and commitment among stakeholders to the system. These hazards can be related the best to what Bowker and Star (1999) in theory call a ‘divergence between the symbolical and material side’; . The big managerial challenge for the future is therefore to find a balance between the overarching purpose of the system and a ‘satisfying’ basis that is applicable and worthy enough to be loyal to for all parties. From a system-technical point of view, this means that in the development of categories, criteria as well as the review methods a balance have to be found between the level of abstraction and rigidity - for having an effective purpose on a supranational scale- and the level of specifity and flexibility -for anticipating to the daily, complex practice in which cancer institutes have to be designated. A first draft of the designation system based on this thought is presented in the appendix. From a social-political point of view, it requires an extra effort in realizing a more constructive, harmonized setting as well as in clarifying and promoting the system’s added value to reach to required consensus and commitment.
Item Type:	Essay (Master)
Faculty:	BMS: Behavioural, Management and Social Sciences
Subject:	85 business administration, organizational science
Programme:	Health Sciences MSc (66851)
Link to this item:	https://purl.utwente.nl/essays/59170
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