Four Questions to Reinhard Busse

Prof. Dr. med. Reinhard Busse is the head of the Department of Health Care Management at TU Berlin. He is also a faculty member of the Charité, scientific director of the Berlin Centre of Health Economics Research (HECOR), co-director of the European Observatory on Health Systems and Policies and was editor-in-chief of Health Policy (2011-2022). Currently, Prof. Busse is also member of the government commission for modern and needs-based hospital care in Germany. His department has a highly international focus and follows an interdisciplinary approach in its research. ​It has a long tradition in the field of nursing science and was already the German project partner in the RN4CAST project (Nurse Forecasting in Europe 2009-2011). 

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​1. What particularly motivates you in your work in the Magnet4Europe project?
Two reasons: First, the official one – nurses, and workforce in general, are a paramount part of health care and health systems, and definitely worth every bit of effort by us researchers. Secondly, the more private one – I have been enjoying working with Linda for more than a quarter century. We started to collaborate with a project in 5 countries, and our Health Affairs article from back then, “Nurses’ reports of hospital quality of care and working conditions in five countries”, is still a highly cited classic.

2. In your opinion, what have been the greatest achievements in the Magnet4Europe project to date?
That we moved from observational studies such as RN4Cast to an intervention. And a necessary precondition for that is that – unlike in previous projects, where we as scientists “only” studied hospitals, nurses and patients – we now involve the hospitals, and especially their nurses, directly.

3. You are a member of the government commission for modern and needs-based hospital care in Germany, which was established to address necessary reforms for the German hospital sector. How could the Magnet4Europe project help to achieve the intended changes in Germany?
Hospital reform is difficult in any country, but we felt that besides improving patient outcomes as well as keeping expenditure under control, the workforce and their work environment are crucial success factors – we know that from RN4Cast and Magnet4Europe. We designed the reform proposal with that in mind. I am particular proud that we proposed that especially trained nurses such as nurse practitioners could lead the inpatient wards in the smaller hospitals, which we want to transform into “ambulatory-inpatient centers”. We feel that this would give nurses a real choice between working in larger, more specialized hospitals treating more complex patients – or being in charge of the care for less complex patients themselves.

4. The Magnet4Europe project is now in its 4th year. When you think ahead, what does success of the project look like to you personally?
Many people, including politicians, still believe that the workforce problems can be solved by more persons and more pay. Looking at the demographic transition, the first “more” is very unlikely, and looking into the world as it stands, the second one as well. All the more it is crucial to find other solutions how to make working in hospitals, and the health sector in general, more attractive. If we can show that “our” Magnet4Europe hospitals retain or even gain more staff than others, we have proven an important success factor.