Communication with nurses. When it came to communication with the nurses, a common and recurring concept was incomprehension. Here, a highly important factor is the fact that the CAD staff cannot see the severity of the patients in a particular department. They rely solely on the provision of resources and conclude on that basis that the relevant department can or cannot admit patients. Consequently, if there is an available bed in a department, they will take it, as according to the interviewee, they often have no other choice. A second aspect, which does not facilitate communication, is the fact that the interviewee believes that the visions within the hospital do not coincide. The respondent emphasized the fact that both the nurses and secretaries think department-wide and the CAD thinks hospital-wide. Additionally, the CAD also faces the problem of a lack of correct data. Specifically, the late entry of discharges was emphasized here, which can be seen as a failure to communicate a discharge via OAZIS. CAD respondent 1- “I think the difficulty often lies in the fact that we do not always have the right data. In the sense that we can see how many patients come in, but the discharges, we notice from reports that are drawn up, in the morning we do a bed count and we see, I say hospital-wide or for surgery, we see that we have 20 discharges, if you do the same thing at 11 o'clock you notice that there are only 8.” The respondent went on to say that if this was done more correctly, certain unforeseen events leading to misunderstandings could be avoided. The respondent further pointed out that the late notification of discharges, and thus the sudden release of a relatively large number of beds, leads to a convergence of placed patients in the relevant departments. It was referred to as a vicious circle, in which the departments, through their own negligence, work themselves into trouble. Part 2: Challenges Figure 7: Thematic network staff members CAD: challenges During the interview of both the CAD staff members, the current problems were gradually addressed. A first pressing problem was raised by the second CAD staff member, namely the capacity problem in the external environment. As the dotted line in figure 9 indicates, these external problems also contribute to the internal capacity problems. As the second respondent pointed out, on the one hand, they have difficulties discharging patients who need home care. On the other hand, they also have to cope with the external capacity sho...
