ABSTRACT
Up until the 1990s there was an almost mythical preoccupation in management thought with the individual characteristics of leaders, with leadership being regarded as a quality of the person that was acquired or that one was born with. This view fi nally gave way to a more de-individualized concept of leadership as a system, ‘distributed’ between different layers and different parts and people within the organization: in other words, the notion of distributed,1 multi-layered2 and strategically collective3 leadership.4,5
This case study of the Reinier de Graaf Groep (RdGG) hospital system in the Netherlands seeks to show that a preoccupation with an individual or a small group of leaders (usually at the top) may have led practitioners and researchers alike to overlook – or underestimate – the importance of multi-level systems-based leadership in quality improvement programs within healthcare organizations.
