Imagine2 EHMA 2024

Clinical leadership: challenges to
achieve continuous improvements
Dr. Relinde de Koeijer, Erasmus University
Erasmus School of Health Policy and Management
5 - 7 June 2024 - Bucharest, Romania
Politehnica University of Bucharest, Bucharest, Romania
#EHMA2024

Clinical leadership program & next steps
• 2015 – present: 127 physicians from 13 Dutch Hospitals participated in a post
academic leadership program (Imagine2).
• Unique characteristics: Long-term partnerships with hospitals, strong executive
involvement and ambitious change initiatives.
• What happens when the program ends?
• Preliminary research: analyzing >50 interviews with participants as well as their
change initiatives. Planned July 2024: focus group with executives of the medical
board of four hospitals.

Some quotes from the interviews
“Stakeholder
management, long-term
vision are becoming an
increasingly important part
of your profession as a
clinician. Also, we need to
grow towards value-based
healthcare, but that turns
out to be very complicated
because financial issues
are involved.”
(Gynaecologist)
“Every day, I see opportunities for
continuous improvement. However, many
local improvements seem to be
disconnected from the broader strategy
and other initiatives. Especially in our
large hospital.” (Geriatrician)
“‘There are so many good examples and
colleagues that are alumni of Imagine2.
Yet we don't find each other naturally.
How do we ensure that we make use of
each other's experience, and we create a
movement of improvement?’ (Chair
Board of Medical Directors)
“I have been working
on an improved
pathway for a very
vulnerable group of
patients. We have
already achieved
several successes. But
there are still many
challenges. It is
sometimes frustrating
to want so much, but to
have so little time to
make it happen.”
(Surgeon)
‘I am full of ideas for
better care.
However, my drive
has become dulled
in recent years.
When I propose an
idea different than
the status quo, too
often I hear ‘no,
that's not possible
because...’. I so
often hit a wall.”
(Nuclear Physician)

Our research ambition
After Imagine2, the
challenge for continuous
improvement really begins.
Often it is the happy few
who, with a lot of
perseverance, manage to
keep making changes.
Because context often don't
change.
Imagine2
Therefore, our research
ambition is to support hospitals
in their endeavors to:
‘fixing the workplace’ rather than
‘fixing the professional’
(Sinskey et al., 2022;
Govindaras et al., 2023).