Over de rode loper: bestuurswisselingen in Nederlandse ziekenhuizen

Abstract

In my practice as an organizational consultant for hospitals, I advocated smooth and shingle board changes, where new directors could walk in 'on the red carpet'. But in practice, this often turned out to be the opposite. This motivated me to conduct this PhD research, with the central question: How do board changes in Dutch hospitals work? Change of management is not an event but the outcome of a process I mapped and a analyzed all the board changes in Dutch hospitals over the past thirteen years. I did case study-research in one hospital and talked to focus groups. Based on my research, I draw the following conclusions: 1. Board changes are stress tests for hospitals This will show whether the supervisory board, with the board and other parties such as the medical staff board, the employee representation council and the managers, are able to understand each other's perspectives and jointly determine which board the hospital needs. 2. A good process increases the chance of a good outcome (but is not a guarantee). Board changes are not manageable, although if certain conditions are met, the chance that it will end well is greater. After all, a change of the board is not an event but the outcome of a process. 3. Continuity and discontinuity are both legitimate goals of board changes. In a hospital, a lot continues even if there is discontinuity in the board. So taking the time for a change of the board as a valuable transition period is useful. 4. Board changes also have a symbolic meaning. Just as the board does not have a purely functional role, board changes are not more than just replacing one board member with another. The story that comes with board changes can reinforce the symbolic value of management. The downside is ‘personalizing’ board changes: ‘With X is the hospital is in good hands again.’ 5. The parties, the supervisory board in particular, learn little from board changes. Supervisory boards have too little control over the process and usually do not evaluate board changes, with the result that negative patterns repeat themselves and the positive ones are insufficiently anchored. Importance of the board as a team The metaphor of the red carpet unfortunately and fortunately turns out to be wrong. 'Unfortunately' because the suggestion that a good farewell to a board member paves the way for her successor is not the reality. 'Fortunately' because the research shows that a smooth process is not always desirable. It is therefore often a wise choice to use a change of the board as a valuable transition phase and not to immediately lay out the red carpet for a successor.. Moreover, my research shows the importance of the board as a team, and I call on to stay away from the emphasis on the individual board member who, as a 'strong leader', has to save the organization.