Context analysis at HKZ: step-by-step guide for small care organisations

A context analysis at HKZ is a short description of the factors that affect your care. You write down what outside and inside your organisation influences the quality of care, and what you do about it. HKZ schemes are built on ISO 9001, where the context analysis is a fixed requirement. The generic part is explained in the requirements of the standard. The approach below follows that ISO logic. For small organisations this is also the starting point, see HKZ Small Organisations.

What is a context analysis, in plain language?

Imagine a small day-care service. Outside the door, plenty happens: new subsidy rules from the municipality, a shortage of care workers in the region, a new competitor nearby. Inside the door, plenty happens too: a team that changes, an old building without a lift, a director who still does everything themselves.

The context analysis sets these things out in order. Not to fill in a report, but to see which factors actually affect your care. Then you choose what to do about them.

Splitting external and internal factors helps you miss nothing:

External factors: legislation, funding, procurement by care insurers or municipalities, the labour market, referrers, technology.
Internal factors: staff, culture, premises and equipment, systems and the way you work.

Step 1: Gather the factors

Start with a one-hour brainstorm with your team. Write down everything that touches your care, without weighing it. Then divide the points into external and internal.

An example from a fictitious small home care organisation with eight employees:

Type	Factor	Why it matters
External	Shortage of care workers in the region	Fewer people available for the care demand
External	New municipal requirements for Wmo (Dutch Social Support Act) procurement	Reporting and quality requirements change
Internal	Two of the eight team members work part-time	Less handover between duty rosters
Internal	Some records are still on paper	Information is not always available on time

Step 2: Choose what you actually include

Not every factor belongs in your analysis. Choose the factors that affect the quality of care or the achievement of your objectives. This usually leads to five to ten points. More than twenty is a sign that you have gone too broad.

For each factor, ask: does this affect the client, safety or the work of employees? If yes, it stays in.

Step 3: Determine the impact and the response

For each factor, write down two things: what the effect is, and what you do about it. This is the part the auditor wants to see. A factor without a response is only an observation.

Factor	Impact	Response	Owner
Shortage of care workers	Lower staffing on the evening shift	Set up a temporary staffing pool, recruit through the network	Team leader
Records on paper	Handover sometimes goes wrong	Introduce a digital record in the first quarter	Quality officer
New municipal requirements	Extra reporting	Set the format and include it in the policy	Director

A response can also be: “We accept this risk and monitor it.” That is valid, provided you make the decision consciously and record it.

Step 4: Record it and link it to the system

Write the analysis in one or two pages. Add a date and a version. Link the most important points to the rest of your system: the risks you take from the analysis return in your organisation’s risk management, and the actions appear in your improvement plan.

Keep the analysis a living document. Review it every year, for example during the management review. If the context changes, the analysis changes with it.

Example of the format

A short version you can use straight away:


Context analysis home care De Wijk, version 2, 1 March 2027

External factors
- Shortage of care workers in the region. Response: temporary staffing pool, see action 4.
- New municipal reporting requirements. Response: format set by the director.

Internal factors
- Two part-time team members. Response: schedule fixed handover moments.
- Paper records. Response: digitisation in Q2, owner quality.

Reviewed: annually, at the management review.

Common mistakes

A copy from another consultancy. A context analysis that covers “the care sector in general” says nothing about your organisation.
Only external factors. Many organisations forget the internal side, even though the biggest risks often sit there.
No response. A list without a decision is a finding.
Writing it once. An analysis from two years ago no longer reflects the current situation.
Too many points. A list of thirty factors cannot be managed. Choose the most important ones.

Who does this apply to?

The HKZ Small Organisations scheme is for organisations with a maximum of 10 FTE (full-time equivalents), according to Kiwa and HKZ.nl . Check the standard text of that scheme to see whether the context analysis is set up differently there. A larger organisation chooses a different scheme and follows the generic part.

The exact requirements for the context analysis, such as the numbered clause and the mandatory elements, are in the standard text of your scheme. This page gives a method that follows ISO 9001. Use the requirements of your own scheme as the benchmark.

Checklist

Have you named both external and internal factors?
Are the factors limited to what truly affects care or your objectives?
Does every factor have an impact and a response?
Does every response have an owner?
Is the analysis dated, with a version, and is there a review moment?
Do the risks come back in your risk management?

If one of these questions is answered with no, your analysis is not finished yet.