There was no playbook. There was tonight.
At the height of the pandemic, I ran the same check every night around eight. One last pass through the dashboards for the hospital I was leading, which included a tertiary-level intensive care unit. The question I was asking was not whether everything was solved. Nothing was solved. The question was narrower and harder. Do we have enough critical care beds to get through tonight, and does the clinical team know exactly what to do if we approach capacity?
We had built for that question in advance. Phased response protocols, level one through level five. Paired nursing models that put ICU nurses alongside colleagues who had never worked critical care. Defined thresholds for when specialist physicians would be mobilized into roles they had not held since residency. When the pressure arrived, nobody improvised, because the architecture existed before the crisis did. If I could answer yes to both questions, I went home. Had dinner. Slept the way you sleep with a newborn in the house, present but with one eye open.
I did not know it at the time, but I was learning the leadership model that an entire generation of executives is now being asked to adopt, five years later, under a different kind of pressure.
What I kept seeing.
Long before the pandemic, I had spent years leading large-scale change inside complex organizations, including running process improvement work with frontline teams since 2008. Those rooms taught me something that has never once failed to repeat. The documented process and the real process are two different things. Every time a team maps how the work actually happens, someone discovers that the organization runs on judgment calls, workarounds, and relationships that appear in no manual and no org chart. The map was a belief. The territory was people.
I also learned why change efforts stall, and it is almost never the plan. Organizations do not adopt change because a slide deck told them to. They adopt it when the people carrying the work can see themselves in what comes next, and they resist it, quietly and rationally, when they cannot. Most stalled initiatives I have been called into were declared technology problems or execution problems. They were adoption problems wearing a disguise.
And I learned to distrust single-future planning. Running a large portfolio teaches you that the decision you make today creates the problem you will be managing in eighteen months. The second and third order effects are where the real cost lives, and almost nobody is paid to look for them. So I trained in the discipline of holding several plausible futures at once, planning against scenarios rather than a single trajectory, and building strategies with declared expiry dates instead of pretending a three-year plan can survive contact with a world that reorganizes itself quarterly.
Put those together and you get the gap I now work in. Most leadership teams are running a toolkit built for problems that hold still, in an environment full of problems that do not. AI has made that gap impossible to ignore, because handing work to a machine forces you to see how the work actually happens. But the gap was there first. AI is just the most honest mirror an organization has ever held up to itself, and what it reveals is usually treasure. Judgment, relationships, and accumulated experience that were creating value the whole time, invisibly.
What working together looks like.
Leaders usually arrive with a presenting problem. A board question about AI that needs a real answer. An investment that produced an invoice and not much else. A team that escalates everything upward. We start there, with the actual decision on your desk, and we work until your team can tell the difference between a problem it can solve and a condition it has to navigate. What you leave with is not a binder. It is a shared language, a small set of things you are holding to, and the ability to keep reading what changes. I am not there to give your organization the answer. I am there until your organization can diagnose and navigate without me.
The background, for context.
I spent my executive career in public healthcare, ultimately responsible for an operational and strategic portfolio of two hundred million dollars and 2,500 people spanning acute, community, and long-term care. I served as system-wide implementation lead for one of the most sensitive policy changes in my country’s recent history, delivered without precedent or playbook. I have facilitated lean and process improvement work with leadership and frontline teams since 2008. I hold a Master of Arts in Leadership and an ICF coaching credential. None of that is the reason to work together. It is the reason the work sounds the way it does.
Moving Forward
If something on this page named what you have been carrying, the next step is simply a conversation, and it starts here.