What if New Work

meets a Hospital?

Meine Station

At the Aschaffenburg-Alzenau Hospital, the first self-organized general surgical clinic station operates with The Loop Approach® and poses the question: What if the focus in hospitals returned to putting people first?

Effective Collaboration

New Leadership

Workplace Mental Health

Just saving the world real quick?

For years, a cornerstone of our society, the healthcare system, has been corroding in plain view of the public. While politics, trade unions, and employers' associations wrestle with solutions, more and more people are leaving their jobs due to miserable working conditions. Additionally, young individuals today are unlikely to start in this field in the first place. The paradoxical aspect: For many, a career in nursing would actually be a dream job. Because where else is there potentially so much self-efficacy as in the power to heal?

However, in order to feel effective, healthcare workers need a system that prioritizes the needs of all involved, whether patients or staff. This premise is nearly unattainable in the current situation. Reason enough for the team at Meine Station to roll up their sleeves and simply get started.

A pilot project rooted in the Loop Academy

Meine Station is a pilot project at the Aschaffenburg-Alzenau Hospital ('KAB') and a product of our Loop Academy.

In spring 2022, Hubertus Schmitz-Winnenthal, Chief Surgeon of Surgical Clinic I at the Aschaffenburg-Alzenau Hospital, and Nadja Nardini, independent consultant, met during their Loop Approach Fellow training and together considered what it takes to make a real impact in the German healthcare system. The result was the first surgical clinic ward operating on 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 their pro bono fund."

The patient at the

center of attention.

With a kickstart into the race

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

One month later, the first press release was issued to launch the application phase, where interested parties could apply to participate in the project. The response was remarkable. With 70 applicants, the organizing team – now enriched by TheDive trainer and consultant Felix – conducted three so-called team-finding workshops in August and September 2022. Here, applicants gained insights into self-organizational work methods and got to know each other.

Those who realized they truly wanted to work on a self-organized ward were invited to the subsequent team integration workshop. In October 2022, applicants formed project groups such as 'Roster', 'Supply Chain', and 'Processes', defined a common vision, and developed initial collaboration concepts. Subsequently, the training phase for self-organized cooperation began with the remaining 25 participants, using the three modules of the Loop Approach."

A hospital embraces the Loop Approach

The Loop Approach is a transformation framework developed by TheDive, designed to support teams and organizations on their journey towards self-organization. Instead of a 'one size fits all' approach, the Loop Approach is tailored to the needs of individual teams. Rather than focusing on a predefined outcome, the Loop emphasizes the process of transformation. Through three consecutive workshops, teams learn tools and methods of self-organized collaboration and develop a customized operating system that suits their needs. Initially popular in the corporate world, the Loop Approach is now also being utilized in sectors such as administration, education, and healthcare.

In a short period from November 2022 to January 2023, the new team at My Ward completed the three Loop modules - Clarity, Results, and Evolution. To conclude, operational procedures were trained on the ward for two weeks, supplies were ordered, and professional topics were discussed. The 'Ward and Team Building' phase concluded with the third Loop module. Regular patient care operations commenced on February 1st."

Great outcome

The ward team decides autonomously how many patients it can admit and care for. This is a crucial element to prevent team overload and ensure the best possible care for the patients.

How does "Meine Station" operate?

"Meine Station" operates based on the principles of self-organization since February 1st. Emerging from the project teams of workshops, roles and circles have been established. 32 pioneers—how the staff are referred to—no longer work within their traditional job profiles but instead fulfill various tasks based on roles. Psychologists, physiotherapists, and ward secretaries, for example, assume crucial roles in the interdisciplinary treatment process.

Roles related to patient care are assigned at the beginning of each shift. Additionally, there are roles that are permanently filled by team members. For instance, the new self-organized scheduling is coordinated and supported by such roles that are permanently filled through elections within the team. Another example is the role of 'Communication Support', which assists in handling media inquiries, among other tasks. With these and other roles, topics are now brought into the team that are not typically part of the nursing staff's responsibilities and are often new for the employees; for example, recruiting, training, or communication & PR.

The purpose of the ward team guides the orientation for the new treatment pathway, which emphasizes the autonomy of the patients.

The traditional bedside visit has become the exception. Instead, patients and doctors meet in the examination and consultation room. Here, medical diagnostics and treatment planning merge with empathetic conversations. This setting is more intimate, the interaction more personal, and the focus is on the patient being treated.

It's evident that the "Meine Station" team takes its purpose seriously. Patients receive individual training before their hospital stay to learn how to move optimally after surgery and what to focus on for the best possible recovery. Meals are not taken in patient rooms as usual. In the bistro designed by the ward team, patients eat together, fostering a new sense of community and enabling heartwarming interactions. The goal is always to empower patients' autonomy and maturity, facilitate encounters on an equal footing, and provide the best possible support for their recovery.

While many of these changes were initially initiated by the organizing team, improvement suggestions now regularly come from the ward team itself. Similar to other Loop organizations, this process is tension-based. On the ward, tensions are also addressed through sync meetings to translate them into next steps and tasks, and structural changes are decided upon in governance meetings.

Nadja Nardini | Consultant and co-founder we.health.care.

"The most impactful question was 'What do you need?' Even pioneers took this into their personal lives, to the 'dismay' of some affected individuals. Tension-based work sounds simple, but for our authority-dependent and problem-oriented society, it's a real challenge. 'What do you need?' helps to remember to move from big problems to small steps towards solutions. This gradually helps to relax."

The introspection

Even though "Meine Station" is relatively new, it can already be said: Nothing about this project is standard practice, and that has been the case since day one. While Loop training typically involves existing teams, in Aschaffenburg it served as a kind of "pre-training" before the ward was put into operation.

Nationwide attention

The considerable attention the project receives nationwide underscores the significant demand for solutions to attract and retain healthcare staff. Even Bavaria's State Minister of Health and Care, Klaus Holetschek, visited the ward at the end of August, awarded the team with the Barbara Stamm Medal, and expressed appreciation:

'Klinikum Aschaffenburg-Alzenau has prepared for the future with the pilot project 'My Ward' and positioned itself excellently. It offers great opportunities to make real progress in the job satisfaction of nurses. Thanks to its forward-thinking ideas, the project has a ripple effect far beyond Aschaffenburg. I wish continued success in the project's implementation and hope for many imitators!'"

A bold path without any obstacles?

From the perspective of our consultant, Loop process facilitator, and project architect Felix, the station members have faced unique challenges up to now:

Some station members have relocated from their homes and familiar environments to participate in the pilot station. Some have left their previous employers or returned to professions they had previously moved on from. They have embraced a group of around 25 unfamiliar colleagues to independently establish a general and visceral surgical station according to new standards—from treatment pathways to patient bistro.

In addition to these challenges, they are also learning the concept of self-organization. This approach contrasts sharply with the hierarchical environment they have experienced for years and decades in hospitals. They are taking on new leadership roles and responsibilities within the team, requiring them to build new competencies.

Moreover, suddenly, video conferences, digital communication tools, and knowledge management systems are central to their work. They also occasionally face clashes between their expectations for station innovations and the patience required by an extensive process of change. The project is further conducted under significant media attention and scrutiny from their colleagues in the hospital. All of this occurs while their first priority remains the optimal care of sometimes critically ill patients.

Felix Herter | Consultant & Loop Facilitator

"When Nadja and Hubertus first presented their initial ideas for setting up the ward, I admit I was skeptical. There was an empty ward without any operational team, no existing team, and then the Loop process was intended as a precursor training before the team even started working together on shifts. These were unique conditions for everyone involved - for us in the organizing team and for each individual in the future ward team. I have great respect for all involved in how they have faced these challenges."

Write Felix

Staying committed pays off

The feedback from patients and staff is extremely positive. Some improvements are even measurable. The average length of stay at My Ward is unusually short, not because patients are discharged quickly, but because they genuinely seem to recover faster compared to other wards. This aspect requires further evaluation.

Initial successes are also reflected within the team. Disappointment and fatigue from traditional ward operations are being transformed into a motivating new vision at My Ward, sparking enthusiasm for innovation. People who had previously left the nursing field are returning to patient care.

For Hubertus and Nadja, this dynamic is already a huge success. Because for them, it's precisely about ensuring that doctors and nurses feel again that what they do is one of the most important jobs there is.

In Numbers