Cliëntenregistratie in de jeugdhulp: tussen droom en werkelijkheid

During the last decades various societal evolutions have led to an increased demand for accountability in social work, and youth care more specifically. With the creation of numerous ICT, electronic client records were regularly seen as a means to comply with this growing demand. Through electronic client records social workers could be supported in practice, relevant information could be gathered for policy and data could be collected on which scientific research could be based. However, in spite of the high expectations, there is often a discrepancy between the goals put forth and the realization of those goals in practice. With this dissertation, we examined which factors determine if electronic client records in youth care are a support for practice, policy and scientific research. First, it is clear that the Flemish government regards highly the possibilities of technology and data to realize various policy objectives. But although she created numerous systems during the last years that should substantiate the big reform process towards an integrated youth care, until this day there seems to be a lack of data about youth care. Based on our research we conclude that the government takes too little into account the numerous preconditions that determine the success or failure of a registration project: the discretion of public officials, path dependency, an insufficiently high data quality, and a limited focus on the possibilities that the exchange of data could offer policy. Until this day the policy goal of client records, the realization of public accountability, is therefore only limitedly realized. Second, the way social workers use their discretion during the registration process depends of the interaction of the characteristics of the system, the social setting in which the system is used and their attitude towards this system. The specific frames of reference of social workers and the difficult embedding of client records in practice leads to social workers and services completing the registration process in different ways, which has a negative effect on the data quality. Therefore it is difficult to use registration data to realize public accountability, an explicit goal of client records. Third, numerous conditions linked to the specific setting determine in which degree and how registration data can be gathered and analyzed within the scope of scientific research: a lack of meta-data about the systems, their content and the data quality, the long-lasting and time-intensive process to acquire a juridical authorization to link and analyze registration data, the difficult communication between the involved stakeholders, the ICT-characteristics, the difficulty to create a stable system in a constantly changing context, and the limitations of registration data to interpret them correctly and unambiguously. We pose that the success or failure of client records is determined by a complex whole of factors that are in interaction with each other and that influence one another constantly. Therefore client records should be considered as a continuous harmonization process, whereby these determinants are permanently taken into account.status: publishe