In the healthcare sector, medical discoveries, demographic pressures and new models of care are rapidly changing the environment in which services must be delivered. Leaders and managers are increasingly having to operate in multi-organizational systems with responsibilities across whole pathways of care and patients who demand not just treatments but integrated support to live longer, independent lives.

These changes are prompting a fundamental shift in the types of managers and leaders that healthcare organizations say they need.^{1 2} Terms like ‘distributed leadership’, ‘systems thinking’ and ‘sense making’ are increasingly being used, but this is rarely associated with a corresponding shift in the way that such roles are developed or incentivized. Instead, many modern healthcare managers and leaders are left to fend for themselves in this new environment, using out of date tools to tackle systemic challenges far more complex than those seen a decade ago.

At the same time, the platforms by which development is done are themselves undergoing a revolution. The fundamentals of peer learning and challenge through trusted relationships remain, but can now be supplemented by new opportunities. These include micro-learning that can be condensed into a nurse’s eight-minute break, or multi-media simulations that require staff to interactively solve problems for themselves. The management course isn’t dead, but is undergoing a rebirth.

The goal of this study is to explore what some of the best and most innovative healthcare organizations are doing to adapt to this new world, and what really works to improve the quality of managers and leaders. The report showcases six rules that leading organizations and professionals have told us drive successful approaches to leadership and management development, each with a case study of how this has worked in practice. To begin, we ask the important question of what value management and leadership development can really demonstrate, and what evidence exists for a return on investment.

The findings of this study were generated through triangulation of three parallel research methods:

• A systematic review of the academic literature on management and leadership development to identify the strength of evidence for payback.
  1049 articles were initially reviewed, of which 32 looked in detail at the question of return on investment from healthcare management development, the key messages from which are summarized in the following report.
• Expert insights from people with significant expertise running multiple or large scale management and leadership development programs in healthcare. This included interviews with 22 organizational leaders and KPMG development professionals. A half day workshop was also held with 12 faculty members from the Harvard TH Chan School of Public Health and two large tertiary/quaternary healthcare providers.
• A global search for innovative and successful case studies of management and leadership development in the health industry. A two-way selection process was followed: to contact organizations that were regarded as industry-leading and ask about their development programs, and a ‘bottom up’ process whereby experts were asked to identify organizations whose approaches they saw as ‘world leading’.

Data and lessons from the three streams were analyzed through a thematic synthesis process, with key conclusions summarized in the following report.