5Nov
A checkmark is not proof.
Thursday, November 5 · online with Envida and Profportaal Zorg
What Envida learned about learning together. Envida, Profportaal Zorg and Tulser show what changes when a colleague looks on during real work.
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A checkmark is not proof.
7:42 a.m.Ilse gives Mr. Smeets his insulin.
7:55 a.m.The night shift turns out to have done it already.
Every employee is competent. The team isn’t (yet).
Only a team can deliver safe care.
Simon, giving insulin, checked off. Ella, catheter care, checked off. Lucy, giving insulin, checked off. Mark, giving insulin, checked off. Robin, catheter care, checked off. Incident report 7:55 a.m.: Double dose of insulin, Mr. Smeets.
Team learning
Demonstrably competent, together
- Team learning is built into the work teams already do. Teams don’t need to free up extra time for it.
- An implementation team of your own staff introduces the program.
- Tulser leads at first and then steps back, one step at a time.
For learning advisors and quality nurses.
- De Zorg Leert Samen
Working more safely together. Then on your own.
Tulser helps teams in healthcare organizations work more safely together, as a partner and in everyday work.
- Guidance from Tulser, four sessions of 90 minutes per step
- The peer check and the maintenance kit, built on your own protocols
- The toolkit with templates, check questions and team profiles
- A baseline measurement and two outcome measures, so you can see what it delivers
- Online office hours as an option
- Online coaching available
- Two personal AI assistantsComing soon
Four steps to implement in partnership.
- Up front · 1 to 3 monthsSetting direction
Know where you stand and what your policy is missing.
See the step
- Four sessions led by Tulser
- The scan results, tested together with your organization
- A baseline measurement and an addition to your policy
Faster if your organization moves quickly.
Tulser leads
- Team learning I · 6 monthsThe peer check
A colleague looks on during a real procedure and debriefs it right away.
See the step
- Peer checks in ten teams
- A register per procedure and per team
- Workplace supervisors who look on
Tulser guides
- Team learning II · 6 monthsThe maintenance kit
Teams learn at five fixed moments and hold on to what works.
See the step
- Five fixed moments per team
- Team leaders who keep the rhythm
- Agreements in the quality report
Tulser coaches
- Team and organizational learning III · 6 monthsLasting improvement
Teams solve a recurring problem themselves. Other teams adopt what works.
See the step
- Each team tackles a recurring problem
- Other teams adopt what works
- The organization carries on by itself
Tulser on call
The starter package
7 to 9 months · Setting direction and Team learning I
Start with Setting direction and the peer check in ten teams. Then your implementation team takes over. Tulser stays available in the background whenever needed.
- Everything from Setting direction
- Peer checks in ten teams
- A register per procedure and per team
- The toolkit templates
The follow-on
Team learning II and Team and organizational learning III, 12 months in total, with an annual toolkit membership.
The starter package and the follow-on can be bought separately.
Six months. Four sessions.
Every step of team learning follows the same rhythm. Teams do their everyday work. The implementation team learns. What works, the teams build into their standard way of working. Setting direction, the step up front, takes one to three months.
Month 1Month 2Month 3Month 4Month 5Month 6
Work and learnLearn and implement
WorkReal procedures in the teamsEveryday work is the practice
Learn1Session 12Session 23Session 34Session 4
ReflectionReflection
The toolkitTemplates, questions and overviews for the implementation team
ImplementA new way of workingWhat works, teams build into how they work
The registerWho showed what, per procedure and per team
DecisionDecision
- 90-minute session with a facilitator
- Implementation team reflection, 45 minutes, without a facilitator
- Decision
- Work
Teams do their everyday work. Every high-risk procedure is a chance to practice, at no extra time.
- Learn
The implementation team attends four sessions and reflects twice without a facilitator.
- Implement
Each team records what works and keeps a register.
- Build on what exists
Your own policy, your own protocols and your own meetings. New policy only where there is a gap.
- 0 hours
extra for teams. All team learning methods are built into the work teams already do: the morning huddle, the handover, the high-risk procedure itself, the debrief and the team meeting. That is why it costs teams no extra time.
- ± 2 hours
per month per implementation team member. The Tulser facilitator spends about seven hours per step of team learning.
It’s not about the checkmark. It’s about Mr. Smeets.
About the night shift that hands over, the colleague who looks on and the team that works together a little better every day.
Safety is also a feeling. For the client, for the family and for the nurse who sits quietly in the break room for fifteen minutes at 8:10 a.m.
Why team learning is needed now.
-
98% competent. Still it goes wrong.
The dashboard shows what each employee can do. The error happens in the collaboration.
De niveaufout -
Learning is a shared task.
In building block 4, the Generic Compass of the National Health Care Institute calls learning and development a shared task of professionals, teams, team leaders and executives (Zorginstituut Nederland, 2024).
Generic Compass -
A self-declaration alone is risky.
According to ActiZ (2025, p. 30), relying on the self-declaration as the only safeguard carries risks.
ActiZ -
In other sectors too, regulators look at teams.
From elderly care to aviation, regulators look at how teams work together and learn.
Oversight -
Teamwork goes hand in hand with better performance.
That is the finding of a meta-analysis of 31 studies with 1,390 healthcare teams (Schmutz et al., 2019).
Research
How it works at Envida.
Envida and Tulser work together through Envida Leert. Teams there do peer checks and learn from their own work. ActiZ cites Envida as an example in its guidance Bekwaam is inzetbaar.
The peer checks are “not tests, but embedded in the work process.”
ActiZ, 2025, pp. 31–32
They contribute “visibly to team learning and the quality of care.”
ActiZ, 2025, pp. 31–32
Everyone competent. And yet.
White paper · coming soon
Why a dashboard showing 98% says little about the team. And what does count as proof for the employee, the team and the organization.
The first in a series. More white papers will follow.
Send me the white paper
De niveaufout
Jos Arets · The book · coming soon
Three levels, each with its own proof.
From individual checkmarks to reliable performance.
Why 98% competent says little about the team, and how teams show competence in their work. With the Envida case, from self-declaration to team learning.
Keep me postedDe niveaufout is part of the Value-Based L&D Trilogy. Het juiste niveau and Het niveauverschil are in preparation.
Built on your own protocols.
- Coming soon
The implementation team AI assistant
For the implementation teamPrepares the sessions, finds patterns in the peer check results and helps write the policy and the quality report.
- Coming soon
The AI assistant for healthcare professionals
For teams and team membersSets up a peer check, provides questions for the debrief and answers professional questions based on your own protocols.
What healthcare organizations ask.
We already have a policy.
That is where the program starts. Where there is a gap, the implementation team writes an addition of a few pages together with Tulser.
We don’t have time.
Teams don’t need to free up extra time. Team learning is part of their everyday work. Only the members of the implementation team spend about two hours a month on it.
Isn’t the self-declaration enough?
The self-declaration stays. But people are only moderately good at judging their own abilities (Zell & Krizan, 2014). That is why a colleague looks on, a form ActiZ names as an alternative.
Is the peer check a new test?
No. Nobody can fail, and results never go into a personnel file. It is about looking on and debriefing, not about assessing.
This is too big for us.
You start with one package. After each step you decide whether to continue. And because team learning happens in everyday work, what changes is mainly how teams work, not their schedule.
Does it work?
ActiZ cites Envida as an example. Meta-analyses show that teamwork goes hand in hand with better performance and that teams who debrief perform better afterwards. In the research center Tulser is setting up, the evidence for the approach as a whole is growing.
Does the inspectorate accept this?
The Health and Youth Care Inspectorate (IGJ) does not approve methods. According to the ActiZ guidance, which the IGJ helped shape, the inspectorate looks “not only at the policy as it stands on paper” (ActiZ, 2025, pp. 25–26). As alternatives to the practical test, ActiZ names peer checks, peer review and workplace learning (ActiZ, 2025, p. 32).
Does the whole organization need to join at once?
No. The program starts with ten teams and three high-risk procedures. After that your organization expands at the pace it can handle.
What does it cost?
That depends on the size of your organization and the steps you choose. After the first conversation you receive a quote.
Only a team can deliver safe care.
Tell us where your organization stands. Tulser will show you where best to start.
Plan an introduction