Knowledge Bank Workplace Innovation

Best practices and other information about Workplace Innovation and Smart Working

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  • Publication date: 2010
  • Date added: 27 April 2010



Rating: Wilhelmina ziekenhuis Assen, working smarter in a hospital

Wilhelmina ziekenhuis Assen, working smarter in a hospital

2010 – The staff of the Wilhelmina Hospital in Assen (WZA), the Netherlands started a project on ‘Working Smarter’ and found a win-win solution for doctors and nurses. The central question was: how do you work more efficiently in a pleasant way? The support of the management has been very important in this process.

Workplace innovation
The project ‘Working Smarter’ at the Wilhelmina Hospital is a good example of workplace innovation. The nursing staff got more responsibility and voice in how they organize their own work. For doctors, this results in time savings.

The objective of the project was to work more efficiently and smarter. Nurse Jan de Jonge indicates that the project started with the idea: ‘it can be done better’. According to him the WZA is the first hospital in the Netherlands that applied ‘Working Smarter’ in such a way.

The experiment started at one division (A2) of the hospital. First, the Board of Directors and management allowed  the division A2 to spend time and to take space to start and work together with consultancy BMC. The first step was a brainstorming session with ten employees. Half of these were seasoned staff with extensive knowledge and experience, the other five were "greener" and relatively young. So there was both knowledge and a fresh perspective included.
The central question during the brainstorming was: what could be done better? The most important point appeared to be the cooperation between doctors and nurses. This could be improved and it was important hereby that time spending and planning of nurses and doctors  was put  to center stage.
This was the starting point for the nurses. The many visits by the doctors throughout the day, were sometimes seen as disruptions to the work of the nurses. This is solved by planning all the visits of the doctors before half past eight in the morning. The underlying idea is that the nurses have a lot of knowledge, however in many occasions first a formal consultation with the doctor is needed before the care or treatment can be carried out. Therefore, instructional protocols for several situations are developed, so that nurses can take action themselves in case of, for example; chest pain, low blood pressure, or low urine output. These protocols were approved by the doctors. It is also agreed that if multiple instruction protocols apply for a certain patient, the nurse always has to call the specialist to discuss the case.

By the Working Smarter project the efficiency is increased. Nurses are allowed to take action in incidents immediately and don’t have to wait for an expert to come in firstly. In the mid-term the doctors indicated that for them this way of working is also more convenient because they are not disturbed for things that nurses themselves can do very well. In this way the doctors give trust to the nurses.
The executives say that employees become more and more professional and get self-insight into their professional development. The executives are also pleased that through the process, noses are in the same direction and nurses take on more responsibility. The nurses themselves consider it a success; they take the initiative in redesigning their own work. The approach is contagious, often they could not wait until the next Working Smarter meeting!


Jan de Jonge gives a number of tips for successful Working Smarter routes:
- There is a need for a leader who knows the organization well and knows what developments are going on in the organization.
- Plan meeting time outside the department.
- Perseverance is very important to keep the process moving.
- The composition of the group is important; a positive impact and equality is necessary.

The above case description is based on an interview with Jan de Jonge, nurse at the department orthopedics, urology, ear nose and throat and oral surgery.