How can healthcare managers navigate the complexity of hospital organizations while simultaneously pursuing quality of care, economic sustainability, and population health outcomes, and staff well-being?

These questions were at the core of APOLLO 2028 Business Game*, an interactive teaching simulation experienced by students of the Master of International Healthcare Management, Economics and Policy (MIHMEP) at SDA Bocconi School of Management.

The simulation is part of APOLLO 2028, a four-year initiative funded by the European Union and involving 12 partners (University of Montpellier; Bocconi University; Kaunas Technology University; Karolinska Institute; Eötvös Loránd University; Trinity College Dublin; Vilnius University; Åbo Akademi University; Centre Hospitalier Universitaire de Montpellier; Centre Hospitalier Universitaire de Nimes; Massachusetts General Hospital) across 8 countries and 2 continents. The project is dedicated to advancing the understanding of healthcare worker and organizational resilience in increasingly complex and demanding health care environments. 

“APOLLO 2028 adopts a comprehensive, multi-level perspective, investigating how resilience is shaped at the individual, team, and organizational levels through an extensive international research effort involving doctors and nurses across participating countries. Beyond its strong research dimension, the project is explicitly action-oriented: insights generated through data collection and modelling are translated into innovative tools, strategies, and interventions aimed at supporting the mental health, well-being, and resilience of health care professionals. Developed in close collaboration with health care workers and organizational leaders, these solutions are designed to foster more resilient, supportive, and sustainable health care organizations” Irene Georgescu, leader of APOLLO 2028 project.

During the simulation, students worked in small teams assuming the role of a hospital department’s management team within the fictional APOLLOland health system. 

“Across three gameplay rounds, participants were required to make strategic decisions related to staffing, care quality, production pressures, and financial constraints, while monitoring performance through indicators aligned with the Quadruple Aim: population health outcomes, patient experience, cost efficiency, and staff well-being”. Carl Savage, PI for Karolinska Institute

Each round was followed by structured debriefing sessions and collective discussions, allowing students to reflect on their strategies, compare outcomes across teams, and identify how different managerial choices affected performance and resilience at multiple system levels. These iterative cycles of decision-making and reflection highlighted the complexity of managing health care organizations, where trade-offs between competing objectives are inevitable and must be continuously balanced.

“This Business Game is a clear example of how the MIHMEP program delivers an integrated learning journey that combines innovative educational tools with a strong emphasis on transferring classroom concepts into practice, through realistic simulations and field-based learning experiences. By engaging with complex and dynamic scenarios, students are constantly encouraged to apply theoretical frameworks to real-world managerial decision-making,” said Andrea Rotolo, Associate Professor of Practice and MIHMEP Program Coordinator.

“Beyond gameplay, the session also included a “behind-the-scenes” perspective on the simulation itself. Students were introduced to the fundamentals of agent-based modelling, gaining insight into how complex organizational and social dynamics can be represented computationally. An introductory discussion on the role of artificial intelligence in managerial decision support further connected the simulation experience to emerging tools in health care management”. László Gulyás, PI for Eötvös Loránd University

A distinctive feature of the APOLLO 2028 Business Game is its collaborative development approach. MIHMEP students participated not only as decision-makers, but also as end-users providing structured feedback on the realism, clarity, usability, and educational effectiveness of the simulation. Their inputs will contribute to refining the tool ahead of further developments in other APOLLO 2028 partner sites.

Elisabetta Trinchero, Associate Professor of Practice and Principal Investigator for SDA Bocconi highlights: “The participation to the APOLLO 2028 Horizon Project reflects the distinctive DNA of SDA Bocconi School of Management: the continuous integration of research, education, and an international vocation to develop innovative, evidence-based content that addresses the evolving challenges of health care systems worldwide.”

*This research project is funded from the European Union's Horizon Europe research and innovation programme under grant agreement: No. 101137144.