New Leadership Approaches for Health System Transformation in a Time of Rapid Change.

Bonesteel, Rachel; Rawal, Purva; Tabb, Kevin; Opatrny, Lucie; McBride, Tilithia; Hirsch, Matthias; Brockman, Larissa; Zimlichman, Eyal et al. · NEJM Catal Innov Care Deliv · 2026

other · Level V

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Abstract

Health care leaders across the world face a time of dynamic change, with rapid innovation, a diverse workforce, and many other challenges that affect long-standing leadership strategies. In this article, the authors outline new leadership competencies, tactics, and strategies to navigate these challenges and support emerging leaders. These competencies were identified through a landscape analysis of current leadership challenges, a survey of more than 100 hospital Chief Executive Officers (CEOs) in seven countries, a scan of curriculum vitae of CEOs at 250 hospitals, and a combination of individual semistructured interviews and work group meetings with Future of Health members to identify case examples. Through these analyses and conversations, the authors identified communication, shared responsibility in leadership teams, and strategic agility as key competencies for emerging leaders for navigating rapid change. The competencies and specific strategies and tactics to advance these efforts are meant to serve as a tool kit for leaders as they engage their workforce and implement new initiatives. The case studies also highlight implementation challenges and strategies to navigate through them. The authors' landscape analysis includes a snapshot of international programs and curricula leveraging these competencies to train emerging leaders.

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