Dr. I. (Irene) Grossmann

Profile

Originally a medical doctor and surgeon, Irene Grossmann is now assistant professor dedicated to Safety in Healthcare, at the Delft University of Technology.

Research

My research interests are

  • How culture relates to safety in healthcare (a.o. just culture, psychological safety, learning environment, professional team performance, non-violent communication). Including how to integrate the advantages of a structured environment with the need for professional autonomy.
  • How treatment harm can be reduced by using more inclusive research methods and embracing the diversity and complexity of reality in designing personalized clinical care concepts.
  • Responsibility as a key value in healthcare

She studied Medicine at the University of Amsterdam and graduated as MD cum laude in 2000. She was trained as an oncological and abdominal surgeon and was additionally trained as an Intensive Care specialist.

She did clinical research in the field of colorectal cancer treatment from 2004 till 2017. She received her PhD in 2011 at the Groningen University and worked hereafter on a national trial on follow-up after colorectal cancer treatment (CEAWatch) and further on studies into complications of abdominal surgery.

She worked as an abdominal surgeon in the advanced cancer group at the Aarhus University Hospital in Denmark and as oncological surgeon in the Netherlands. She also did duty as emergency ICU specialist during the COVID pandemic.

In July 2021 she started her tenure track at the Centre for Safety in Healthcare.

Human behavior and behavioral interactions are an important factor in safety, and this is all the more true in healthcare that predominantly relies on human - and team performance. To improve on that, several research steps are needed, such as understanding the how and why of healthcare cultures; appraisal of how psychological safety and just culture can fit to improve; what role organizational structure and work process design have (or can have); and how responsibility is or should best be divided.

A main question is how to create a learning culture. That can be described as a working environment where it is felt as normal to address and solve working situations that lead to potential adverse outcomes. Such a culture requires both adequate input (speaking-up, active monitoring) and response (leadership) and creates a continues improvement cycle managed by healthcare professionals themselves. We took to the challenge to design methodologies (from existing sources in other domains) that fit the healthcare context. Herein we work together with the ErasmusMC, RadboudMC Nijmegen and Catharina Hospital Eindhoven.

Concerning aspects of safety management structures, a seeming antithesis was found in the importance of a well-structured environment and work processes, translated in healthcare into care pathways and protocols, versus the need for professional autonomy for context-dependent complex decision-making. One challenge we take up is designing integrative work process approaches that outline designated space for professional autonomy. The role of training and education methodology, also how this relates to governance, will be part of the research. We believe that such a ‘conscious context system’ adds to the resilience of the healthcare system, in facilitating the best possible outcome in differing circumstances and supporting healthcare professionals.

A different source of potential damage lies in causing unnecessary treatment-harm through unnecessary treatments. This approach lies within the medical domain and relates to the question whether diseases are correctly defined and whether the treatment for a well-defined disease fits the patient. Concerning defining diseases correctly, I refer most to medicalizing syndromes that may mostly or in part be a social or societal issue, such as with depression and ADHD. Concerning the issue of fit between patient and treatment, it is known that there is little evidence on individuals, only on average patients and average disease behavior, that both do not exist. The lack of inclusiveness and representation of all patients (including elderly, women, and functional illiterates) in medical research, causes malalignments between guideline advice and what the actual patient needs. I lead a multidisciplinary, multi-institutional research group that works on patient-centered oncological care; a personalized approach that embraces individual differences, leading to a better fit between patient and treatment and therewith reduces harm.

A personal interest, to conclude with, lies in the domain of responsibility as key value. Questions I am asking are: what does define responsibility? What is its relationship with active thinking? Why, and where, is it relevant in the health system and healthcare?

  • Handboek Colorectaal carcinoom. Hoofdstuk 13 Follow-up. De Tijdstroom 2013. ISBN 9789058981967
  • Health System Management (BSc course in the minor MedTechEntrepreneuship)
  • Health Systems (MSc elective at faculty TPM starting Q1 2022-23)
  • Safety science in the degree program Clinical Technology

Irene Grossmann

Assistant Professor

Department:
Values, Technology and Innovation

Section:
Safety and Security Science

Secretary:
Astrid Pinzger-van Staalduinen

Research interests:
Design for values
Management of responsible innovation

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