Zilveren Kruis: “A powerful methodology has sparked change from within. What we aim to achieve externally, we demonstrate internally.”

Case Story Zilveren Kruis: Tiemen Meijer, Manager of Elderly Care Procurement, and Liesbeth Zwanepol, Senior Long-Term Care Procurement Manager at Zilveren Kruis, in conversation with Annelies van der Ham and Maike Hulsbos from Turner Strategy = Execution about the strategic assignment.

The current healthcare policy has become unsustainable. With a growing number of clients and an increasing shortage of healthcare personnel, the accessibility of care is under pressure. Both developments will intensify in the coming years. This requires us to take a different approach to healthcare to ensure it remains appropriate, accessible, and affordable for all. Zilveren Kruis is working across eleven regions to develop future-proof elderly care. Together with Turner, Zilveren Kruis developed a methodology to create a balanced change portfolio: a powerful tool that enables Zilveren Kruis to move forward.

Zilveren Kruis: 'This process leads to more accessible and improved care for the customer.'

Zilveren Kruis strives for a more uniform approach across all healthcare regions and a more effective use of resources.
A phased approach, with room to learn and refine together, led to a well-functioning methodology to optimize the project portfolio.
Not only did it create a clear story, but also visualizing the situation resulted in a turnaround.
This led to different management discussions on strategy and a critical review of our execution of change projects.
The methodology contributes to a more targeted allocation of resources, specifically aimed at the transition needed for sustainable elderly care.

1. What was the challenge for hich Turner was brought in? And what made it so complex?

Liesbeth Zwanepol: “In previous years, we had already invested in dialogues between buyers and care providers about future-proof elderly care. The long-term goals were clear in the various regions. However, we lacked the ability to assess whether the interventions and programs we started were adequately contributing to the objectives. There were valuable projects in the regions, but little cross-pollination or learning from each other. While we saw that what worked in one region could also be useful in others, we sought a way to ensure we all had the same perspective on the transition as a whole. How can we, together with our providers, strengthen the care offering and learn from each other?”

Tiemen Meijer continues: “We were dissatisfied with the results achieved, and we heard the same feedback from the healthcare field. When I started here, I realized a professionalization was needed. How can we develop a method where all eleven regions make more uniform choices about which resources are invested in which projects, ultimately leading to a more effective allocation of resources? Where we are heading requires new competencies from people. The development in elderly care parallels the development of the people in my teams.”

Through the ‘Regiobeelden’ publication, Zilveren Kruis came into contact with Turner. Tiemen: “After a few exploratory conversations, we started working together.”

2. What triggered the breakthrough, whether in terms of content, change management, or project management?

Liesbeth: “Not everyone was eager to embrace this or understood why we needed and wanted to do this. That’s why we chose a pragmatic, phased approach: we started with three of the eleven regional offices and then selected a fourth. One of those regions is where I work as a buyer.”

Turner’s Annelies van der Ham: “We told those four regions: ‘We’re not here to evaluate you, only to take stock of the projects underway.’ It can be daunting for regions to have their projects scrutinized, so we emphasized that we were creating a comprehensive overview without judgment.”

Tiemen Meijer (Zilveren Kruis): "The goal is to have more control in the regions, and that's exactly what the methodology we've developed can be used for."

Tiemen: “We explained that the first four regions would help get the ball rolling, and later in the year, we would expand this to all regions. The first four shared their experiences with the others during a thematic meeting. The key message was that we need to take steps towards professionalization. What we aim to achieve externally, we must first demonstrate internally, and you need tools for that. Turner’s work in making this visually clear was incredibly helpful.”

Maike Hulsbos explains how they approached this: “We evaluated the change portfolio on several factors. By analyzing the entire project portfolio based on the number of projects and the budget, we quickly gained insights. Does the project contribute to our goals? And how significant is the impact? Does the project’s duration and risk align with the type of change project? Additionally, we assessed whether there was sufficient coherence in the overall package. How are the projects distributed between short-term and long-term efforts? You need short-term wins to build momentum for solving more complex issues in the long term. Are projects stuck in the research phase, or is there sufficient focus on execution? Achieving the right balance in the type of change projects leads to better solutions and a sustainable approach. With the visualizations, we made the strategy execution transparent.”

Tiemen: “After the thematic meeting, many people had an ‘aha’ moment. It shifted from ‘Do we have to do this?’ to ‘Oh, this is how it works!’ People began to see: ‘This confirms my perception,’ or ‘I didn’t realize so much budget was going there.’ So, the inventory became a learning experience, ultimately leading to a methodology.”

3. How was the execution established?

Liesbeth: “Collaborative learning was a critical success factor for me. Continuously emphasizing: this is not the final project portfolio, we are learning and refining it together. This created room to develop an optimal methodology for analyzing and optimizing the project portfolio: What are truly projects? What needs to be embedded in the organization? Where should we focus?”

Maike emphasizes: “It was a process of progressive insight. We looked openly at what worked and what didn’t, ensuring that ongoing and future interventions in the regions could optimally contribute to the overall goal.”

Tiemen: “The aim is to have more control in the regions, something care providers also request from us. This starts with insight, and that’s exactly what the methodology we’ve developed provides. It’s essential to emphasize that the methodology is not the goal but a means, and it’s all about more direction in the regions. No one is against that.”

Liesbeth: “Telling our story about direction and how to approach it is important. But visualizing it also greatly contributes to understanding why we’re doing this and whether the projects we fund through the healthcare office are contributing to the objectives. This was not only an eye-opener internally but also for our leaders. The analysis showed that we are often heavily focused on planning and extensively researching everything. But those plans must lead somewhere. This perspective allows for different management discussions in the regions, which is both useful and necessary.”

4. What was the biggest dilemma, and how was it handled?

A key learning point for Tiemen and Liesbeth was recognizing that each region has its own dynamic. Not only were there differences in understanding the ongoing projects, but for some care providers, evaluating project portfolios felt like something being done ‘to them’ rather than ‘with them.’ However, once the region was involved, the methodology raised critical, often valid, questions.

“The beauty was that this critical stance led regional parties to start asking questions about the portfolio’s content and think constructively. That was exactly the goal. Then you’re having the right discussion. Making choices isn’t always easy, but it’s essential.”

On the other hand, some regions experienced a smoother process. “When the collaboration between Zilveren Kruis and care providers is already strong, and there’s mutual trust, you have a joint methodology to create a clear view of the portfolio. A transition starts with building relationships, and then you can implement actions that have an impact.”

Ultimately, the portfolio methodology led to better management discussions across all regions, with more unity in the language used.

5. What are the benefits for the various stakeholders?

Liesbeth: “This approach results in a much-improved project portfolio and engages regional colleagues in better discussions, ultimately leading to more accessible care for customers.”

In addition to a well-functioning portfolio methodology, its creation was a valuable learning process that Zilveren Kruis can leverage for the future. Tiemen: “It remains a process of learning together. We don’t live in a perfectly controllable plan world, and sometimes outcomes differ from expectations. You often learn the most from things that don’t go as planned, and that’s okay.”

Liesbeth concludes: “I believe there’s a lot we can do to keep healthcare accessible without compromising on quality. The method we’re using is effective, and with it, we can move forward.”

Maike Hulsbos, Tiemen Meijer, Annelies van der Ham and Liesbeth Zwanepol

Tiemen Meijer en Liesbeth Zwanepol from Zilveren Kruis

Annelies van der Ham and Maike Hulsbos from Turner

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