Executive Leadership Development (ELD) programs in US Healthcare Systems What factors have determined the need for evaluation and evolution of Executive Leadership Development (ELD) programs in US Healthcare Systems? Evaluation and Evolution of ELD Programs ? The effectiveness of this program was evaluated based on succession planning, employee job satisfaction, patient satisfaction and quality improvement. ? Only five responding program used return of investment (ROI) as the evaluation metric. ? Executive support and engagement, relationship between leadership development and strategic priority, strong leadership program and organization value for development were four critical success factors.