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Book ‘Fit healthcare’ released: author Femke Keijzer’s ‘how,’ ‘what,’ and ‘why’

In the 16 years that I have been active in the field of healthcare, it increasingly struck me that performance management is not that obvious in this sector. A question I regularly encountered was: Why would you get started with it? I found this so astonishing that I decided to perform research – together with Paulina Snijders, former financial director at the Erasmus MC. We incorporated our findings and recommendations in our book Fit healthcare: the step towards healthy control. In this blog, I’d like to tell you more about it.

Development: why write a book on performance management in healthcare?

Where is the urgency? This was the first question that arose. My hypothesis: it is socially responsible to improve performance management. But usually, this doesn’t rank in the top 3 reasons. Common motives include financial improvement and entrepreneurship (directors or teams with an ambition to improve). Understandable, but also a pity. Because in my opinion, the social issue shouldbe a primary motivation.

Furthermore, a lot is involved in implementing performance management and going through with it. Oftentimes, for example, it is accompanied by a culture change. In practice, going from ambition to realization isn’t always that easy.

Moreover, few has been written on this subject in the past 10 years, while there is a great need for it.

The decision to write our own book about it was quickly made. After all, there are still plenty of opportunities to improve performance management in healthcare, and I would like to contribute my bit.

Approach: from interviews to healthy business operations

In the fall of 2017, I conducted a range of interviews using a structured questionnaire. I talked to directors and supervisory board members, but also to health insurers and scientists. The main question: How do they think hospitals should act?

It turned out that many didn’t know exactly how a hospital manages performances and what impact performance management has. So if you ‘press a button,’ such as productivity, it is often unclear where it leads. What I noticed was that people really live in a bubble. Not only health insurers, but also medical specialists sometimes operate in enitrely different worlds. This is incredibly complex for directors.

The Erasmus MC, where I worked on a major process in the field of performance management, played an important role in the development of the book. Former financial director Paulina Snijders provided more case histories. Together, we succeeded in putting the case into words. In addition, we established a theoretical framework for managing healthcare performance as well as for healthy business operations.

Intended outcomes: how will you benefit from the book?

On the one hand, I hope that you will recognize the problems you encounter as an administrator or decision-maker in healthcare. In that case, you can use the recommendations on points you need to tackle. Also, you should realize that it doesn’t have to be complicated: often, it’s a matter of cold feet. The business case is always positive. On the other hand, I would like to say: be astonished and take the message to your organization. I aim to start a debate, so we will jointly get a sense of social responsibility. This can create the space required to act collectively and take the next step towards good, affordable healthcare.

Finally, I hope to provide insight into the interconnection between existing bubbles, the status quo, and the steps to be taken. The book contains a model that provides guidance. When you use this, you will see that performance management really doesn’t have to be that complicated.

Author: who am I and what is my vision?

As an expert in the field of (the transformation of) financial management in healthcare, I consult on complex issues in the areas of funding, control, and performances. I help implement and realize structural changes. With over 16 years of consulting experience within healthcare, I can definitely call myself a sector insider.

After months of intensive work on the book, I can draw one firm conclusion: it is high time for all hospitals, health insurers, and regulators to start working on this subject concretely, and there is no one best-fitting solution that will work for all hospitals. To write the book, I entered into a dialogue with several people. I would like to continue along this line, especially now that the book has been written. Here’s why this is important to me. When I started writing, I’d arrived at a point in my life where it was crucial to me that I could really make a difference as a consultant. I believe that I owe it to the sector to share my knowledge and experience. And hopefully, I will stimulate everyone sufficiently to actively strive for more healthy business operations and performance management.

In my eyes, this message is only logical. What is your vision? Read the book and form your own judgment!

For more information contact: Femke Keijzer,


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