I recently had the opportunity to present at the American Hospital Association’s 2026 Leadership Summit. The theme of this year’s gathering was (Re)Designing Care Delivery and Operating Models for the Future. The event brought together hundreds of healthcare executives to explore innovative solutions for value-based care, capacity management, and a sustainable workforce.

The theme of “(Re)Designing Care Delivery” reminded me of our approach over the past few years of “Rewiring”…not just change for change’s sake, but thoughtful change based upon the presence or absence of desired outcomes.

My presentation was called “Leading from the Intersection of Change and Trust.” I wanted to create a conversation not around the actual change efforts, but the elements that can fuel change or, conversely, stall change when they are lacking.

I began by illustrating three elements necessary to lead change: Anticipating, Effecting, and Communicating.

For the Anticipating conversation I used a quote that many attribute to hockey great Wayne Gretzky: “I skate to where the puck is going to be, not where it has been.” (In fact, Wayne never took credit for the quote…it came from his father, Walt, as a way of coaching his young son.) Often, it’s a great exercise to simply ask our leaders to consider the question, “Where is our puck going to be?” It frees us up to have conversations that aren’t the age-old three- or five-year strategic planning sessions that we’ve grown used to. It tests our ability (and appetite) to see around the corner.

Effecting change should always include the ability to give our leaders the skills, tools, and knowledge they need to be successful. As fast as our industry is changing/advancing, we feel the time has come to take a much more precise approach to leader development. We call it Precision Leader Development™, and it means supporting each leader as an “N of 1” versus taking a one-size-fits-all approach. We’ve seen organizations accelerate change initiatives by making this kind of investment.

Finally, we know that Communicating change effectively is the link to building trust, especially when the emphasis is on clarity. Trust is shown time and time again to be fueled by clarity:

1. Clarity of goals
2. Clarity in communication
3. Clarity of actions

I paused to allow the leaders in the room to ask, “When it comes to these three versions of clarity, where are we best and where do we have opportunities?”

I then borrowed an excerpt from Genfluence: How to Lead a Multigenerational Workforce, the new book I coauthored with Dr. Katherine Meese. We zeroed in on a piece of the eight-step Control + Alt + Lead framework, designed to help leaders reboot how they influence, coach, and inspire multigenerational teams. The step we focused on is “See every interaction as a trust-building opportunity.” When we think of leading either small- or large-scale change initiatives, perhaps we should allow for a shift in how we see trust: from what it is to how it accumulates or gets depleted. The reality is you never really “have” trust…you’re either earning it or spending it.

We wrapped up our conversation by agreeing there are common challenges to trust during change:

• Fear of the unknown (What’s ours?)
• Lack of clarity about the change process (Where can we be clearer?)
• Past experiences with poorly managed changes can erode trust (What can we learn from our own history?)

I was blessed to have senior leaders as well as early careerists in the room. Their level of interaction made the time fly. It was evident that they were willing participants in this challenge to re-design healthcare in a transformative way. I left confident that our industry is in great hands.