This thesis examines how internal supervision in Dutch healthcare gains meaning in interaction with healthcare practice. Current internal supervision is strongly influenced by New Public Management, in which performance is represented through indicators and reports. Internal supervision based on such incomplete representations can have far-reaching, unintended consequences for healthcare practice and does not do justice to the complex reality of healthcare practices. This thesis shifts the focus from functionality to relationality and approaches internal supervision from a practice-theoretical perspective. Empiricism and theory are brought into dialogue by means of “thinking with” Schatzki's site ontology. The case organisation does not serve as an illustration or proof, but as a space for thinking through internal supervision as relationally embedded in a whole set of practices and material arrangements. Responsibility and accountability thus take on a different meaning. Accountability is no longer understood instrumentally, but as relational and intertwined with internal supervision and care practices. In this perspective, accountability creates conditions for “response-ability”: the ability to act ethically and responsibly in concrete situations. Scientifically, this thesis contributes to the development of a practice-theoretical understanding of internal supervision. Practically, it invites critical reflection on supervisory practices and a rethinking of internal supervision in relation to care practice.
Ans Verstraeten (1971) studied health sciences and completed an Executive Master's in Public and Non-Profit Management. She conducted doctoral research at Radboud University into an alternative understanding of internal supervision that focuses on the intertwining of internal supervision and healthcare practices. Her career includes various management positions in both profit and non-profit organisations, with a focus on governance, business operations and information management. She is currently director of the Dutch Association of Supervisors in Healthcare & Welfare. She is also chair of Stichting Varende Recreatie, which organises adapted sail.