Children's journeys through organizations: How inspectors evaluate coordination of care

S.I. Rutz*, A.A. de Bont, P.B.M. Robben, S.E. Buitendijk

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review


Inspectorates have been criticized for assessing compliance with the rules rather than outcomes for children. In the Netherlands, inspectorates have developed a ‘journey tool’ to reconstruct children's travels through all the organizations providing care. Using document analysis and semi-structured interviews, we evaluated how inspectors use this tool in practice. We applied an ontological theoretical framework to the coordination of care to analyse 24 journeys through care organizations, including a selection of six journeys in further detail. Our analysis shows that up until now, inspectors used only one form of coordination, the creation of a hierarchy, resulting in one problem definition. However, in complex care practices, children have multiple and often incompatible problems so that one coherent problem definition cannot be made. We show that ‘patchwork’, a form of coordination that allows discrepancies enables inspectors to reflect on complex care practices and evaluate options to improve outcomes for children.
Original languageEnglish
Pages (from-to)608-618
JournalChild & Family Social Work
Issue number4
Publication statusPublished - 2016
Externally publishedYes


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