Poster Title: Innovative solution to a long-standing problem – How systemic flexibilization can end the constant strain on nursing staff.
Organization or Hospital: KERN Katholische Einrichtungen Ruhrgebiet Nord
Unit: Nursing HR Development
Authors: Steffen Branz
Conference Name: SANA 2026
Presentation Date: May 11, 2026
Project Summary:
The poster I created refers to our project, which began in 2024, to provide lasting and sustainable relief for nursing staff by fundamentally changing the structures of the network and the individual hospitals. We are basing this on the model of systemic flexibilization, which is already standard practice in the Netherlands and could soon become standard practice in German hospitals. As part of my doctoral research, I am providing academic support for the project and will be able to publish concrete results shortly. The main goal of systemic flexibilization is to stabilize the work schedules of all nursing staff and eliminate dependence on on-call shifts, swapping shifts, and external temporary staffing. Furthermore, systemic flexibilization manages with the generally required target staffing levels and does not require additional nursing personnel. The developments in the hospitals of the KERN Catholic Institutions Ruhr Area North demonstrate that the model works just one year after its implementation.
Methods:
• A look at the Netherlands and collaboration with Dutch experts – the originators of systemic flexibilization.
• One year of project work, including preparation, implementation, and rollout of a pool of approximately 220 full-time equivalent (FTE) staff into live operation.
• Participation of over 100 nursing staff to ensure acceptance and practicality in real-world operations.
• Establishment of a separate company licensed for temporary staffing to ensure cross-facility staffing of nursing personnel.
• Academic support for the project as part of Steffen Branz’s doctoral dissertation.
Results:
• In five of the nine participating hospitals, significant reductions in external temporary staffing as well as on-call and shift-swapping services for nurses have already been achieved.
Annual savings of €1.8 million, or €540,000 in VAT and margins.
Examples of the best results:
o Reduction of external temporary staffing by 93% at the Marien-Hospital Marl location compared to the previous year.
o Reduction of on-call and shift-swapping services by 14.5% at the St. Barbara Gladbeck location.
Conclusion:
Implementing systemic flexibility provides lasting relief for nursing staff and simultaneously improves patient care. Employees no longer have to juggle their personal lives and professional lives; instead, the restructuring of working conditions allows them to optimally balance both.
Recommendations:
1. Seek advice, for example, from Frei ist Frei (Noteboom and van der Meulen Management Consulting).
2. Convince management, the nursing directorate, and the works council or employee representatives.
3. Involve staff; form a project group consisting of ward managers, nursing experts, etc., with representatives from all locations.
4. Invest sufficient time in the project and select an experienced, nursing-oriented project manager.
5. Systemic flexibility is particularly beneficial for:
a. tertiary care hospitals
b. hospital networks with multiple locations
c. locations located close to each other
References:
https://dorsten-online.de/kernflex-kern-gmbh-setzt-auf-flexible-arbeitsmodelle-in-der-pflege/
https://www.waz.de/lokales/gelsenkirchen/article408301635/total-flexibel-diese-idee-soll-400-arbeitsplaetze-schaffen.html
https://www.waz.de/lokales/gelsenkirchen/article411152562/revolution-fuer-die-pflege-dieses-modell-veraendert-einfach-alles-fuer-uns.html
https://www.zukunftsstiftung.optadata.de/forschung/statistiken/statistische-jahrbuecher/ Beitrag im Jahrbuch 2026
Contact Person(s):
Steffen Branz, M.Sc.
s.branz@kern.ruhr