PhD defence F.G. (Françoise) Johansen

Below is a brief summary about the dissertation:

If we consider the combination of an ageing population, a declining labor force and rising costs of healthcare, as well as the broader context of climate change, we can ask if the Dutch healthcare system in its current form is, literally, sustainable: can it continue to perform facing such critical challenges? This context has sparked interest in sustainable healthcare and need for a fundamental transformation. This thesis explores a transition movement in Dutch healthcare by highlighting the developing discourse around sustainable healthcare. Several emerging alternatives are studied that introduce new cultures, structures and practices and interact and develop with the incumbent regime. This thesis explores this uncharted territory of transition in healthcare by investigating initiatives and experiments, specifically looking at sustainability programs (Expedition to Sustainable Healthcare), frontrunners who offer alternatives (Neighborhood Care), development of new language and a new paradigm (Positive Health), and the struggle of incumbents charged with everyday delivery of healthcare (Transition Pain). 

By identifying different perspectives and meanings, this thesis contributes to the operationalization of sustainable healthcare. The empirical cases give insight into transition dynamics. The research makes two conceptual contributions: Transition Pain and Healthy Care. Transition Pain signals experienced dissonance by individuals during organizational change when internal culture, structure and practices are not aligned. Healthy Care is proposed as binding concept to bring the different perspectives on sustainable healthcare together, based on a health paradigm. Proposed characteristics of Healthy Care are: human-oriented and inclusive, environmentally adaptive and conscious, and, economically viable and accessible.