Martin Werthmüller: Uster Hospital has been through a financially difficult period. Three years ago, it was about ensuring the hospital’s survival. Today we are in good shape; we have recovered and stabilised financially. For me, that raised a fundamental question: how do I take our management team along into this new phase? The shift away from a «fight for survival» towards shaping and developing the hospital brings entirely different demands. It was important to me not simply to assume internally what the issues might be, but to find out, in a sound and comprehensive way, what drives, supports or holds back our 115 managers in their daily work.

Martin Werthmüller: Absolutely. I prefer to call it a question or the current situation. We didn’t want to go looking for faults. We wanted a comprehensive, honest picture of our day-to-day leadership, obtained as efficiently and visibly as possible.

Martin Werthmüller: In conversation with Andreas Seonbuchner, I realised that he had developed exactly the right tool for this question. In conventional surveys, you usually answer a set number of predefined questions with yes or no, and that’s it. BrainE4 takes a completely different approach: it allows for a genuine, dynamic dialogue. As the Executive Board, we put forward our own hypotheses. Participants could rate them, but above all they could contribute their own theses, arguments and examples, which were in turn mirrored back to other managers. That’s a very good way to design a dialogue like this.

Martin Werthmüller: For the management team, it was of course new and took some getting used to. They were used to filling out a survey once. With BrainE4, the discussion evolves over time. You have to log in several times, reactivate the dialogue and look at new input. That initially required some explanation and motivation, but in the end it paid off brilliantly.

Martin Werthmüller: Of the 115 managers invited, 85 took an active part, a participation rate of almost 74 percent. For a new survey format, that’s a very good result. We reached three quarters of our managers, a clear majority. For me, that makes the results extremely robust.

Martin Werthmüller: It was fascinating to watch how the system developed. Many of our original hypotheses were complemented or replaced by much better, more precise statements from the management team. Managers contributed their own examples and ideas that were much closer to the heart of the matter than my own assumptions beforehand. At the same time, there was live feedback around the hospital.

Martin Werthmüller: For me, there were two decisive moments. I didn’t know how the people we approached would respond to the format. When Andreas Seonbuchner regularly shared the key figures with me, I saw in black and white how participation literally began to multiply. But the real tipping point for me was experiencing it live in the hospital: in the corridors, in meetings and over lunch, I suddenly heard first-hand how managers were discussing the content. That’s when I knew: the dialogue isn’t just happening online, it has become part of everyday life.

Martin Werthmüller: I was impressed by the openness and constructive attitude. People really dared to give critical feedback, too. For example, one statement was that senior management was too far removed from the front line, despite the hospital’s manageable size. At first glance, that may not be pleasant feedback, but it is extremely relevant. When I presented the results, I showed such critical voices verbatim and said: this is an important voice for me as CEO and for us as the Executive Board. It also shows that we have a good culture in which such statements have a place.

Martin Werthmüller: I clustered the results into four core leadership areas: Deciding clearly, communicating reliably, implementing consistently and leading together as a management team. For each area, we presented original quotes with commentary. This transparency was very well received, because participants could recognise themselves directly in the results.

Martin Werthmüller: Employees do come. That shows me there is a real need. And even if the number of participants is still modest, people go out afterwards and tell others about it. It sends a strong signal of approachability.

Martin Werthmüller: Yes. We found that a fair amount of energy was being wasted across our entire project portfolio management because of a lack of clarity around decisions and processes. We formulated two or three very concrete measures here. We are also developing a tailor-made programme, «Leadership Development Uster Hospital 2027», to build a shared understanding of leadership, a core idea that was strongly supported by the BrainE4 dialogue.

Martin Werthmüller: No, that wasn’t the focus. What really mattered to me was making Uster Hospital more effective, enabling us as a management body to decide clearly, communicate reliably, implement consistently and lead together. Those four leadership areas were the benchmark, not the budget.

Martin Werthmüller: As CEO, you have to be willing to let things happen and to tolerate a dynamic that you can no longer fully control. But that is exactly what moves an organisation forward! Anything else just means you hear what you want to hear. When critical issues come to the table, that’s not a risk, but an opportunity to tackle things that may have been neglected in the past.

Martin Werthmüller: For me, it was well worth embarking on this «experiment». The methodology and the support from Andreas Seonbuchner were outstanding. The participation rate shows that this type of dialogue resonated very well with our managers, and I was able to arrive at robust results within a manageable time frame.

Martin Werthmüller: Absolutely. BrainE4 is suited to any question where you want to systematically capture sentiment and ideas. For Uster Hospital, I can well imagine running such processes in future with key external groups too, such as referring physicians or even patients.