Table 3

Capabilities of senior and emerging leaders

Themes and categoriesSenior leadersEmerging leaders
I. Ground management in medicine.
  It is the [patient] flows and the consequences. That is what one must be able to speak about. If you can’t do that, well, that is why I also think that it is important to have doctors as the top managers. (PS17)*Combine in-depth medical knowledge with organisational development, economics and quality improvement to understand the medical consequences of management decisions.Continually expand knowledge in medicine and management.
II. Engage others.‘Work with the system.’‘Work the system.’
 Relate to stakeholders in the system.
  If you want something to change you have to tell everyone: the government, the Department of Health, the politicians, so that they know that what I want is this. Because if you want to change something you will always have to sell something as well. (PE12)*Mediate conflicting interests by focusing on shared purpose.Negotiate to build support among decision makers.
 Bring together the right people.
  I’m strategic in cuddling up with people with more knowledge in areas I don’t have […] I create a team around myself that can influence others so that if needed, I can say, “I don’t know this very well, but this person does”. This team building is a strength. (PE19)Find strategic allies.Compensate for own limitations through other’s competencies.
 Engage staff in change initiatives.
  They joined me and we planned and followed-up and so forth, so we really shared it all. (PS16)Be present and engage staff in order to identify problems, their root cause, and develop solutions.Ask questions and facilitate discussions to test hypotheses.
 Listen to engage.
  I suppose I think rather quickly and I’ve learned over time not to speak first, but to wait for the others. (PS11)Listen first. Tell stories, inspire, walk the floors to keep people focused on goals.Listen in order to tailor communication approach.
 Develop resonant relationships.
  At the end of the day, it’s actually about impacting the organization in a way that really matters. The only way you can reach that is, of course, by working [with] the organization’s people […] the actual people who are going to be the agents of change. (PE05)Seek to understand what matters to people—empathise, motivate and inspire.Be curious and interested in others, develop good social skills.
III. Catalyse systems by acting on interdependencies.
 Recognise patterns.
  I also think that I have a tactical or strategic sense for possibilities so that I can see things within the system that are not linked today, but I can actually see that if I can connect this person to that person, whether I’m going to be a part of that or not, it might actually lead to something that is interesting. (PE04)Connect ideas, help others to see the big picture.See interdependencies in order to develop a strategic mindset to spot opportunities, set goals, develop action plans, provide structure and grow networks.
 Lead by example by using oneself as a learning tool.
  The only [learning] tool I have is myself, really, so, in that way I sort of learn and then see reactions from people. (PS14)Improve self-awareness by using oneself as a learning tool. Test changes on oneself.‘Walk-the-talk’ as a strategy to convince others.
 IV. Employ a scientific approach to understand problems and measure progress.
  First you take a step back and you see the whole process and then you have to start measuring and see what data you have and if it supports you or not. […] it is not enough to just have a lot of figures and measurements […] you have to draw conclusions from it as well. (PE07)Be curious, ask questions and collect and analyse data to understand problems before jumping into solutions. Measure progress.Maintain a healthy scepticism and think critically. Systematically collect and use data to analyse problems and measure progress.
  • *PS: senior leaders. PE: emerging leaders.