About

How to deal with disruptive (technological) change? How can professionals adapt effectively to shifting roles and responsibilities? What are effective 21^st Century healthcare workforce skills and knowledge and how should we invest in those? And how should we deal with healthcare’s ancient, hierarchical and unwritten rules that are hard to change? How can we transform our regions into efficient networks of complex adaptive systems, with multi-disciplinary teams working based on a patient-centred culture of continuous improvement? How can we facilitate SUSTAINABLE transformation?

Send in the change management experts? We think not.

Expert opinion indicates that answers are harboured in the soft factors within organizational change, interdisciplinary collaboration and behaviour of people. Moreover, latest research indicate so called ‘socio-technological’ issues a last barricade for healthcare innovation.

And here’s where DIRMI comes in.

Fear for change

Adequate sharing of information comprises use of sophisticated information systems, as well as effective collaboration between people. We also know that about 80% of collaboration is based on communication, which is predominantly influenced by nonverbal communication. And this is where things start to be complex.

Research and experiences unequivocally proof that people often find it hard to speak up or to receive feedback. Also, due to similar underlying emotions (e.g. fear), most people dislike change – in particular the disruptive kind. Research also brought us to the understanding that, bluntly put, significant amounts of people die, due to preventable adverse event caused by human factors. Yes, there is a correlation.

Factors hampering effective communication or change are often strongly related to individual attitudes and behaviour, as well as organizational culture. Concepts like ‘just culture’, ‘safety climate’, ‘patient centred care’, cannot do without a culture of psychological safety and trust. Consequently, establishing such climates is highly beneficial to safety, to innovative ideas and … transformative activities.

Dirmi … what?

Like most important things: it starts small. Transformation starts with the individual. In particularly when things get difficult it is a challenge to speak your mind, be open, provide or receive feedback. To collaborate towards sustainable change. Or vice versa, to effectively listen to others as well as to ourselves. This makes or brakes quality and innovation.

However vague all this might sound: at DIRMI we know of lots of science that shows the significance. It’s the soft part, that is the hard part. We think that creating or maintaining a culture of continuous improvement starts with ‘dirmi’ – Italian for: ‘please tell me’.

Roots & foundation

DIRMI was founded in 2014 and officially launched in 2018, with support of partners, including the University of Twente, the Netherlands.

The DIRMI vision is based on extensive (action) research work and field experience of healthcare transformation experts, in particularly those contributing to Projects featuring on this website.

Part of the DIRMI work is rooted in the PhD projects and prior work of Wouter A. Keijser MD, who is research associate at the Faculty of Behavioural, Management and Social sciences (Chaired by Prof Dr. Celeste Wilderom), University of Twente and healthcare transformation coaching expert at Wacomed BV, Utrecht the Netherlands, and HIM SL, Barcelona, Spain.

DIRMI’s lifecycle

We believe that healthcare transformation will take significant time. However, in some years from now, the way things-are-done in healthcare will have changed. Moreover, we foresee that the ‘way’ people and institutions in and near healthcare will be able to continuously change and adapt. At that time, DIRMI will cease to exist.