Commitment or Control: Patient Safety Management in Dutch Hospitals

Little is known about how to effectively manage healthcare professionals to optimise patient safety. HR-management broadly distinguishes two management approaches that guide employee behaviours: control- and commitment-based management. This qualitative multiple case study aims to explore whether these management approaches are relevant for patient safety management in Dutch hospitals. Whereas the HR-literature describes that organisations focus either on control- or commitment-based management, our results demonstrate that hospitals use a combination of both management approaches. Some hospitals focus more on control-based management, whereas other hospitals emphasise elements of commitment-based management. Once hospitals emphasise commitment-based management, they do not completely abandon control; however, the balance shifts from managerial towards professional control. In addition, the results identified that the combination of management approaches varies within hospitals (e.g., depending on differences in the departments, management positions or job categories), as well as over time (e.g., depending on crisis situations and circumstances that distract hospital’s attention from patient safety).