1. Create a real team around enterprise priorities
A common reason investment fail to translate into lasting results is that leadership teams operate less like a team and more like a collection of well-intentioned portfolio leaders. Each leader focuses on their own area, while the enterprise goal quietly gets squeezed between competing priorities.
Canadian Blood Services (CBS) offers a real-life example.
The organization was faced with rising hospital demand for red cells, global pressures in demand for plasma-derived therapies, shifting donor behaviours and demographics that made recruitment more challenging, and infrastructure that needed expansion and modernization. CBS recognized it had to grow and diversify its donor base by creating more opportunities for Canadians to donate, while addressing complex supply chain challenges and the requirement to meet changing product needs driven by shifts in clinical practice.
The executive team quickly realized this couldn’t be handed off to one function. Donor base growth and diversification, collections capacity, digital modernization, infrastructure renewal and innovation all had to be treated as shared enterprise priorities. The team needed to move beyond portfolio updates and work together to define the problem, co-create solutions and execute against what mattered most.
The lesson is clear: strong leadership teams take collective ownership of enterprise outcomes. That’s essential for the effective stewardship of public funding.
It sounds like an obvious precondition for success. In practice, it takes deliberate effort, honest conversations and a few important building blocks.
2. Establish a compelling purpose that guides tradeoffs
Health care organizations have more worthwhile investment opportunities than they have resources to support them. That means leadership teams need a clear purpose that helps them make tough choices without getting pulled in 10 different directions.
At Canadian Blood Services, the executive management team articulated its role as defining, prioritizing and resourcing the transformation agenda while modelling a One-CBS mindset. This gave leaders a shared lens for difficult tradeoffs: which choices would most directly help CBS move from incremental improvement to the level of donor growth required to deliver on its commitments to patients?
Organizations with a clear, shared purpose are usually better able to focus resources on a smaller number of priorities and make a meaningful dent. Without that clarity, resources can be spread so thinly that even good ideas struggle to gain traction.
In periods of financial constraint, purpose becomes one of the most useful tools leaders have for making disciplined decisions — and for resisting the temptation to try to do everything at once.
3. Bring the right people into investment decisions
Health care transformation is rarely tidy. Significant investments usually affect clinical care, workforce experience, operations, patient outcomes and financial sustainability all at the same time.
For CBS, growing the donor base required the full executive team’s attention because the challenge cut across strategy, operations, people and culture, digital capability, communications, stakeholder management and physical infrastructure. Bringing the right people into the work meant framing donor growth beyond a marketing or collections issue and treating it as an enterprise priority requiring coordinated action across the whole system.
Leadership teams that bring these perspectives in early tend to spot implementation risks sooner, strengthen adoption and improve return on investment. Teams that leave key voices out often discover the problem later — usually in the form of resistance, delays, cost overruns or benefits that never fully materialize.
In other words, the quality of investment decisions depends a great deal on who is in the room when those decisions are made.
4. Strengthen strategic decision-making
Many leadership teams don’t spend enough time reviewing performance against their strategic choices. Instead, precious executive time can get swallowed by operational reporting, status updates and the ever-expanding meeting agenda.
At CBS, new structures were created for the executive management team to spend more time on the hard questions to determine whether investments translated into meaningful impact. The team worked to clarify its must-win battles, define decision principles and create forums where leaders could grapple together with resource tradeoffs across donor growth, plasma and blood collection capacity, digital transformation, innovation and infrastructure renewal.
High-performing teams design structures that help them make enterprise decisions. They clarify governance, decision rights, escalation paths and meeting rhythms so leaders can spend more time on the issues that truly move outcomes.
In our experience, organizations often unlock significant value not by adding yet another investment, but by improving the way investment decisions are made in the first place.
5. Create the conditions for success
Even the most talented leadership teams can struggle when the surrounding systems are working against them.
CBS also recognized that diversifying and growing the donor-base depended on favourable internal and external conditions. Internally, leaders needed a One-CBS mindset, common measures, clear accountabilities and governance mechanisms that reinforced enterprise priorities rather than functional silos. Externally, they needed to maintain confidence with physicians, hospitals and patients by showing that additional investment was being translated into visible progress, disciplined execution and a more resilient blood system.
Supportive contexts include governance structures, information systems, incentives, performance measures and resource allocation processes. When these elements are aligned with strategic objectives, investments are more likely to achieve their intended impact.
Health care leaders should regularly ask: are our systems accelerating transformation or holding it back?
6. Invest in team coaching and continuous learning
In today’s health care environment, adaptability may be the leadership superpower that matters most.
For CBS, team coaching and continuous learning were central to the work. The executive team used interviews, team effectiveness diagnostics, leadership coaching and facilitated workshops to build trust, surface areas of alignment and misalignment, and strengthen the team’s capacity to make enterprise-level decisions.
This helped the team reflect not only on what needed to be done to attract more donors, but on how they needed to work together differently to deliver at the pace and level of impact funders and the health care system demanded.
Team coaching creates structured opportunities for this kind of reflection and learning. Instead of treating implementation challenges as individual failures, teams look at how they work together — and what they need to adjust to perform better.
Organizations that learn faster often get more value from their investments because they identify issues earlier, adapt more quickly and keep improving execution as conditions change.
