Seit Jahren korrodiert mit dem Gesundheitssystem ein Grundpfeiler unserer Gesellschaft unter den Augen der Öffentlichkeit. Während Politik, Gewerkschaften und Arbeitgeber*innenverbände um Lösungen ringen, verlassen immer mehr Menschen aufgrund miserabler Arbeitsbedingungen ihren Job. Wer jetzt gerade jung ist, fängt zudem mit großer Wahrscheinlichkeit gar nicht erst dort an. Das Bizarre: Für viele wäre ein Job in der Pflege eigentlich ein Traumberuf. Denn wo sonst liegt potenziell so viel Selbstwirksamkeit wie in der Kraft zu heilen?

Doch um sich wirksam zu fühlen, benötigen Pflegekräfte ein System, das die Bedürfnisse aller Beteiligten, sei es Patient*innen oder Personal, in den Mittelpunkt stellt. Eine Prämisse, die in der derzeitigen Situation quasi unerfüllbar ist. Grund genug für das Team von Meine Station, die Ärmel hochzukrempeln und einfach mal loszulegen.

My Station is a pilot project at Klinikum Aschaffenburg-Alzenau (“KAB”) and a growth of our Loop Academy.

In spring 2022, Hubertus Schmitz-Winnenthal, Chief Physician of the Surgical Clinic I at Klinikum Aschaffenburg-Alzenau, and Nadja Nardini, independent consultant, met during their Loop Approach Fellow training and discussed what it would take to truly move things forward in the German healthcare system. The result was the first surgical ward operating according to the principles of self-organization. Our Diver and consultant Felix Herter is one of the project architects alongside Nadja and Hubertus and part of the core organizational team. TheDive supports the project with expertise and resources from the pro-bono fund.

Together with Nadja, Hubertus quickly developed a rough concept in May 2022 for building a surgical ward using the Loop Approach, TheDive’s transformation framework.

One month later, the first press release was published to kick off the application phase, allowing interested parties to apply for participation in the project. The response was remarkable. With 70 applicants, the organizational team—now strengthened by TheDive trainer and consultant Felix—held three so-called team-finding workshops, which took place in August and September 2022. There, the applicants gained shared insights into the ways of working in self-organization and got to know each other.

Those who realized that they truly wanted to work on a self-organized ward were invited to the subsequent team-consolidation workshop. There, in October 2022, the applicants formed project groups such as “Duty Roster,” “Supply Chain,” and “Processes,” defined a shared vision, and developed initial concepts for collaboration. After that, the training phase for self-organized collaboration began with the three modules of the Loop Approach, with the remaining 25 participants.

The Loop Approach is a transformation framework developed by TheDive that supports teams and organizations on their journey toward self-organization. Instead of a “one size fits all” approach, the Loop Approach adapts to the needs of each individual team. Rather than a predetermined, blueprint outcome, the Loop puts the transformation process at the center. In the process, a team learns tools and methods for self-organized collaboration in three consecutive workshops and develops an operating system for collaboration that fits them. Originally popular in the corporate world, the Loop Approach is now also being used in public administration, schools, and healthcare.

The new team at Meine Station completed the three Loop modules—Clarity, Results, and Evolution—in a short period of time from November 2022 to January 2023. To conclude, the ward spent two weeks training on workflows, ordering supplies, and discussing professional topics. With the third Loop module, the “ward and team building” phase was completed. On February 1, regular patient care operations began.

Roles that relate to patient care are assigned at the beginning of each shift. In addition, there are roles that are taken on permanently by team members. For example, the new self-organized duty roster is coordinated and supported through such permanently filled, elected roles within the team. Another example is the role of “Communications Support,” which helps, among other things, with handling media inquiries. Through this and other roles, topics that are not part of the typical responsibilities of nursing staff are now being brought into the team—many of which are new for the employees, such as recruiting, training, and communications & PR.

The classic bedside ward round has become the exception. Instead, patients and doctors meet in the ward’s consultation and examination room. Here, medical diagnostics and therapy planning merge with compassionate conversation. This setting is more intimate, the contact more personal, and the focus is on the patient being treated.

It becomes clear that the Meine Station team takes its purpose seriously. Patients receive individualized training before their inpatient stay so they know exactly how to move optimally after surgery and what to pay attention to for the best possible recovery. Meals are not eaten in the patient room as usual. In the bistro designed by the ward team, patients take their meals together, creating a new sense of community and enabling heartwarming encounters. The goal is always to strengthen patient autonomy and empowerment, to create encounters on equal footing, and to support recovery as effectively as possible.

While many of these changes were initially initiated by the organizational team, improvement suggestions now regularly come from the ward team itself. As in other Loop organizations, this happens through tension-based work. On the ward, operational tensions are translated into next steps and task packages, among other things, via the Sync-Meeting, and structural changes are decided in the Governance-Meeting.

The high level of attention the project is receiving across Germany also shows that the need for solutions to retain and attract employees in hospitals is significant. The Bavarian State Minister for Health and Care, Klaus Holetschek, visited the ward at the end of August, awarded the team the Barbara Stamm Medal, and shared appreciative words:

The Klinikum Aschaffenburg-Alzenau has prepared itself excellently for the future with the pilot project ‘Meine Station.’ It offers great opportunities to achieve real progress in nursing staff job satisfaction. With its forward-looking ideas, the project has a radiating effect far beyond Aschaffenburg. I wish continued success in implementing the project and many imitators!

From the perspective of our consultant, Loop process facilitator, and project architect Felix, the ward members have faced—and continue to face—some very specific challenges:

Some team members changed their place of residence and their familiar surroundings to participate in the pilot ward. Some left their previous employers, while others returned to former professions they had previously left behind. Then they committed to a group of roughly 25 unknown colleagues to independently build a general and visceral surgery ward according to new standards—starting with the treatment pathway and extending all the way to the patient bistro.

On top of these challenges, they are also learning the concept of self-organization. In both mindset and approach, it stands in stark contrast to what they have experienced over years and decades in the ultra-hierarchical hospital environment. They also take on new leadership responsibilities and roles within the team, for which they must first develop competencies.

Additionally, video conferences and digital communication and knowledge management tools suddenly play a central role in their work. There is also an ongoing clash between their own expectations for the innovations on the ward and the patience required for a comprehensive change process. The project is also taking place under significant media attention and is being closely watched by the critical eyes of their colleagues in the hospital. All of this happens while, as a first priority, they must provide the best possible care to sometimes seriously ill patients.

Feedback from patients and staff is extremely positive. Some improvements are even measurable. The average length of stay on Meine Station is unusually short—not because patients are discharged quickly, but because it appears they actually recover faster than on other wards. This is something that still needs to be evaluated further.

Early successes are also reflected within the team. The disappointment and fatigue associated with the traditional way of running a ward have been transformed into creative energy through a motivating new vision at Meine Station. People who had previously left the nursing field are returning to the bedside.

For Hubertus and Nadja, this momentum is already a huge success. Because that is exactly what matters to them: that doctors and nurses feel again that what they do is one of the most important jobs there is.

70

Applicants for the pilot project

approx. 40

Medical professionals

approx. 32

Pioneers on the ward since the start of operations, with numbers still rising

10

Leaders looped

25

Doctors looped

1

Awarded the Barbara Stamm Medal by the Bavarian State Ministry for Health and Care (08/2023)

1st Place

in the Corporate Health Management (BGM) Sponsorship Award from DAK-Gesundheit (10/2022)

2nd Place

in the New Work SE New Work Award 2023 in the “Better Work” category (06/2023)

Articles
Ansteckungsgefahr! in brand eins magazine

Ärztinnen und Ärzte in Führung – New Work in der Medizin einfach machen in Ärztestellen – The Job Market of the German Medical Journal

Television
“Meine Station” – Klinikum Aschaffenburg-Alzenau with a unique pilot project on TV Main-Franken

Richtig streiten - wie funktioniert Gewaltfreie Kommunikation on hr-Fernsehen

Podcasts
Nadja Nardini & Frederik Fleischmann von The Dive: Mit dem "Loop Approach" Organisationen von innen transformieren in the New Work Chat Podcast

Schaffe, Schaffe, Abschaffe - Können wir uns weniger Arbeit leisten in the hr2 Der Tag Podcast