Enhanced care management and clinical leadership

Enhanced Care Management and Clinical LeadershipStrong clinical leadership is a priority for Waitemata DHB and we are committed to enhancing clinician responsibility for the clinical and financial outcomes of our services. We seek to move from clinicians as users of healthcare resources to clinicians as the stewards of those resources. To support this transition, we are investing in building the networks, processes and capability to deliver the tasks of clinical leadership.

Prof Richard BohmerResearch into the characteristics of healthcare organisations that achieve sustained, outstanding performance has demonstrated that transformation in system performance comes substantially from clinically-led care design and delivery. With this in mind we introduced a dedicated clinical leadership programme in 2013. This programme, Enhanced Care Management and Clinical Leadership, is led by Richard Bohmer, a New Zealand trained doctor who is an International Visiting Fellow at the King’s Fund, UK, where he works on issues related to clinical leadership[1].

The programme is based on a new model of care management and equips clinical and managerial leaders with the skills and experience needed to deliver the tasks of clinical management and care re-design. Key components of the enhanced care management model include strengthened leadership development for clinicians; revision of the clinical leader role with defined clinical and managerial responsibilities; paired administrative support for clinical leaders; and operations redesign.

Programme participants work together in clinically-led teams to re-design systems of care for key population subgroups, clinical conditions, and/or work processes.

Strategy model

Enhanced Care Management and Clinical Leadership: Strategy model

Programme Delivery

The programme is being delivered sequentially to cohorts of senior clinical and managerial leaders in the organisation. The third cohort of this programme commenced in May 2015; up to 50 participants are included in each cohort. The programme involves a series of modules covering strategy, operations design, culture and change, and improvement and innovation. The final module in the series is dedicated to system review. Each module is run over 1.5 days at three-monthly intervals. Additional training programmes, such as short courses in financial literacy, further support the learning from these modules.

In addition to modules, the programme involves cohort participants working together in clinically led teams to (re)design systems of care for key population subgroups, clinical conditions, or work processes. This work is based on assignments that are part of the programme course.

The intention is that the care redesign methodology applied by the programme will become the standard operating model for Waitemata DHB.

Clinical Programme Structure

Clinical Programme Structure


  1. Richard Bohmer is a New Zealand-trained doctor and a management academic. He has practiced as a hospital and primary physician and a medical administrator. He was on the faculty of Harvard Business School for 18 years where he established graduate and executive programmes in health care management and co-founded the MD-MBA. He has published extensively in the medical and management literatures and is the author of "Designing Care: Aligning the Nature and Management of Health Care" (HBS Press, 2009). Dr Bohmer is an International Visiting Fellow at the King’s Fund where he works on issues related to clinical leadership. He also works internationally with numerous hospitals and health authorities to help them establish clinical leadership and management models and improve their performance.

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