Quality of work assessment included in new business tool

A business tool to calculate the effectiveness of healthcare innovations has been developed in the Netherlands. The calculator is designed to help managers work out whether a new product is a good investment. The tool shows the potential impact of an innovation when both quantitative and qualitative parameters are taken into account. It gives managers the chance to rate aspects of quality of work and employee satisfaction, both before and after implementation of the innovation.

Making a business case

It is vital for business managers in the healthcare sector to be able to accurately assess whether a new product or innovation is going to prove a success. A new business tool has been developed in the Netherlands that can help them decide if a new product, or method to improve services for healthcare and well-being, is worth the investment of time and money.

If a detailed business case is put together, all important variables can be considered by managers in a structured way. This can increase insights into the possible effects of the innovation and suggest ways for further improvements.

How the new business tool works

With this new tool managers can create an integrated business case step-by-step for innovations in long-term care. The tool makes it possible for healthcare providers and advisers to assess the impact of an innovation in its early stages, and so support a decision about whether or not to make an investment. It can also help to convince stakeholders of the effectiveness, or otherwise, of a product or service.

The assessment can clarify what the investment will offer in productivity, quality of care and services, income or costs, quality of work and work satisfaction.

The business case created with the help of the tool can serve a number of purposes:

  • to convince others within an organisation or from collaborating organisations of the worth of an idea;
  • to give an overview of the changes the innovation will bring in quality of work, time and income share;
  • to convince the stakeholders, such as health insurers, of the benefits of the innovation.

What is a business case?

A business case compares the costs/efforts and benefits/effects of an innovation and demonstrates the changes involved. In other words, a business case systematically displays the advantages and disadvantages of an innovation.

Figure 1 shows the steps towards producing an integrated business case. The column on the far left shows the variables taken into account. There is a column for the current situation (before), a column for the situation after the innovation (after), and a column to record any difference.

Steps towards producing an integral business case


Quality of work

One of the variables included in the tool is quality of work. This is something that might be affected by different types of innovation in the healthcare sector. For example, a change in working methods might be needed, a new service might involve making technical innovations, or a change in the type of care delivered might be necessary.

The quality of work variable includes a checklist on a range of topics based on the themes from a study on the quality of labour in the social economy. The study, Quality of work in the social economy (in Dutch, 418 KB PDF), was carried out by Flemish business support group VOSEC between 2002 and 2004. The checklist includes:

  • work content, which involves a person knowing what to do, having enough time, information, knowledge and skills to do the job, as well as finding the work enjoyable, challenging, varied and client-oriented;
  • working conditions which are safe and healthy, the ability to work uninterrupted, and in well-managed conditions;
  • work relations which include having well-defined responsibilities and authorisations, the ability to influence the work situation, and being given feedback about tasks;
  • terms of employment, which include being rewarded and offered employee benefits, being given rest periods, adequate back-up when people are absent, and having a good work-life.
  • future possibilities, which suggest an innovative culture in an organisation, as well as the potential for development and sustainability.

Using the tool

Using the tool to make the business case involves three steps.

Before assessing the variables, it is necessary to mark the boundaries of the innovation, identify the actors involved and determine the main work processes affected by the innovation. A quick feasibility assessment is part of the preparation.

The assessment of the initial situation is then carried out. This will include calculating the time spent by all the care workers involved (for example the doctor and the nurse), giving a rating from 0 to 10. Also calculated is the quality of care and resulting quality of life for the patient and patient/client satisfaction. A calculation is made on the required investment and the costs for daily care and services, indicating the influence on income by indicating which activities are covered by healthcare insurance. Then a description is drawn up of the prevention-related effects the innovation can have, and a rating is made of the quality of work and employee satisfaction on a scale of 0 to 10.

The final step is to assess the situation after implementation in a similar way. This can be a virtual assessment, made before the innovation has been implemented, or an effect measurement when the new situation has been monitored for some time. After completing this final step, an overview of the most important details and calculations of the business case will appear in the summary.

The web tool is available free of charge at www.businesscase-longtermcare.com. A short instruction video explains its purpose and online help text is available.


Manshoven, J. And Pauwels, F. (2004), Handleiding Kwaliteit van de arbeid in de sociale economie [Quality of manual labour in the social economy], VOSEC, Brussels, available at kwaliteitvandearbeid.vosec.be

Rijken, E. and Schoone, M. (2013), Ontwikkeling en eerste ervaringen business case tool voor de langdurende zorg [A development and initial experience business case tool for long-term care], TNO Arbeid, Hoofdorp.

Marian Schoone-Harmsen and Evelien Rijken, TNO

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