Rachel Woods: Every single leader that navigated their teams through COVID-19, especially the acute moments of the pandemic, they know it was all about disequilibrium. It was all about confronting problems. But your take on leadership is that it's not about specific moments in time. In fact, I think you don't even like the word "crisis" anymore. You use "complexity." What's the difference between crisis and complexity?

Matt Cornner: Well, and it's not that I don't use the word "crisis," but crisis and complexity are different. COVID-19 provided for most of us a really strong firsthand, real-world example of crisis, and global crisis at that. It is said that innovation and creativity comes at the intersection of purpose and constraint. Another way of saying that is, necessity is the mother of invention.

At the intersection of purpose and constraint, we get creative. Crisis provides both crystal clear purpose and very clear constraints, and ushers forward extraordinary moments of creativity and innovation. And we saw this in spades during the COVID crisis. All of a sudden our five-year plan for digital health was accelerated to five weeks.

Woods: Or five days.

Cornner: Yeah, extraordinary innovation and creativity. When crisis starts to recede, purpose is less clear, and constraints are less clear. And we all have this deep desire for a return to stasis. And so the minute it looks like, "Wow, we can breathe again, or we can let up from that," we try to. And as a result, organizations find it more difficult to get innovative or creative during times of relative calm.

Now it's still complex, which is to say our world is moving, changing, uncertain. We use the acronym VUCA, volatile, uncertain, complex, ambiguous. The world can be that and is that without being in crisis, that's harder, because we're lulled into this illusion that normalcy is possible, stasis is possible. "Can we just get back to that? We've had enough change, can we just stop please?" And so all of those expectations that are put upon leaders for, "Give me direction, give me certainty, give me security," those all come flooding back, and leaders inevitably in moments of complexity where crisis isn't nearly as clear, they become very disappointing to followers.

Woods: And to your point, complexity is the reality that we, frankly, always have to deal with in healthcare. I don't think there's ever going to be a time in which we are not living in complexity in this industry.

Cornner: That's right. And in particular the part of complexity that we overlook most frequently is around human complexity. We want to solve the technical details like you wouldn't believe, and then there are the human beings who are reacting to both the outside-in change as well as the change that we're authoring ourselves.

Adele Scielzo: It's interesting when you talk about purpose, because there are different kinds of purposes. There is the purpose of our organization, so what is our reason for being? What is the value that we really provide to the marketplace that is helping to transform the industry that we work in? And then there's also my personal purpose as leader of the organization, and what is my role in helping to make sure that we are making good on our organizational purpose. And I constantly was trying to remind myself and hold myself accountable for taking both sets or both definitions of purpose into account literally on a daily basis when I was deciding how I was going to spend my time, what and how to communicate, who to interact with and so on and so forth.

Patricia Lewis: So as the Chief People Officer for UnitedHealth Group at the time of the George Floyd murder, my purpose was to, one, address the concerns of the employees of our company who were understandably shaken by these events. They were very local, happening in Minnesota where we are headquartered, and they were looking for the company to express how the company felt about what was happening around them. And we had to provide a way for our people to be heard.

So as the Chief People Officer, it was my responsibility to address the concerns of our workforce in a very visible way, which is not something that we were accustomed to doing at the time, and particularly around the issues as they were unfolding very quickly in the public eye. It was a teaching moment for our company. Because we were just beginning our diversity journey, it was important for me as a leader to leverage this moment to help the organization understand the journey that we had to go on. This was an incident that affected the workforce and demanded that we as a company address these issues within our own environments.

Listen, this work is ongoing. We have not arrived just because we were able to visibly respond. We did support the family, we supported the community, we did a lot in that environment and time, but we had so much more work to do, and we still have so much more work to do.

What did I learn through this as a leader? I would say it stretched me beyond anything that I'd ever experienced in my 35+ years of leadership. We all were affected by the pandemic from a health perspective, and on the Floyd murder, this was painful for me as a Black American who has three sons. And this type of thing could happen to any one of our children. I think this was a moment of vulnerability for me as a leader, sharing my own personal stories and helping people to understand why this was so profound for me As a black woman with three young African American sons.

It takes courage to step up and be very visible and present during these challenging times. I had the courage to be vulnerable and to share my own personal experience that I believe helped people understand how painful this was for African American people and other people in this country. And so that moment of courage and vulnerability, even though sometimes you want to shy away from those things, you need to take those opportunities because they can be super impactful and they can leave a lasting impression on people. And I believe leadership is all about courage, and courage specifically in times of uncertainty, and when you face adversity, it's critical as a leader.

Woods: We've said several times that comfort is not the goal, that we actually expressly want to create discomfort amid our teams. But how does that square with leader's desire, especially I think the frontline kind of manager's desire, to create a sense of safety for their teams? I feel like safety and comfort might be different things in the context that we're talking about.

Cornner: Well, and I think you just hit on something really important. We tend to conflate comfort and safety, and they are not the same thing at all. In fact, we do not change unless we're a little uncomfortable. I don't know about you, but I haven't seen fit to make any kind of meaningful change unless I'm a little uncomfortable and typically it is some point of discomfort.

I am out of alignment with goals, or with purpose, or there's something that's not working here, some sense of misalignment that's a little bit grating on me, on us that needs to be addressed. We want for there to be a sense of safety, to the extent that I have confidence, I can show up and speak my mind regardless of my role, my position, my race, my gender, I can share of myself and everything that I am thinking about, every experience that I've had. If there's place for that, then we will all be better off, because at that point, we're able to really draw on collective creativity, rather than simply the narrow ideas of a few at the top.

Woods: And frankly, one of the pieces of safety that we want to create is feeling safe enough to fail, to experiment and get it wrong. Because experimentation is the opposite of comfort. The phrase that comes to mind is something that I used to say in my army days, which is complacency kills. That is a situation in which you are actually going to encounter danger. I hope that our leaders in healthcare aren't necessarily encountering danger, but complacency is a dangerous place to be when it comes to being an organization.

Cornner: Well, ultimately what we want is for everybody in the organization to be exercising leadership in the sense that we're all walking around with a deep sense of purpose and we are noticing, we are maintaining even a sense of vigilance around the ways in which we are or are not aligned with purpose.

In those moments, hanging a lantern on a misalignment between action and aspiration doesn't always make you the most popular person, but to create an organization where naming the gap between aspiration and reality is not only acceptable or tolerated but actually caused for celebration, we are purposefully leaning into the discomfort of misalignment so that we can address it. To be able to celebrate that as part of our culture requires strong safety, and a tolerance for discomfort in service and purpose.

Scielzo: We have really tried to engage people in experimentation through a couple of different ways. We've done some of the basics such as look at KPIs and review grids, and MBOs, and what we hold people accountable for, and have done some simple things like put experimentation on every single person's review grid in the entire organization to signal the importance of it.

On rolling our goals, we've also tried to provide a framework for leaders to help them put experimentation into context. And we have three big overarching goals for the organization this year, for example. The first is to learn, the second is to iterate, and the third is to grow. And really in each of those, we are hoping that people will be reminded of and embrace the concept of experimentation.

And then the other thing that we have done, which I think in some ways may be more powerful and it may have been more effective than even those two things is we really early on in our strategy transformation work started to engage and embrace a lot of agile concepts. And so we have ground rules that we talk about at the beginning of any project, any meeting, that are meant to really reinforce a lot of the learning, the experimentation, the iteration, and include things like early, ugly, and often, to encourage staff to bring ideas in their infancy to the table for dialogue and debate.

One, the earlier you bring the idea and the more you workshop it, the more perspectives that you have, the more diversity of thought and inclusion that you're able to represent. It also ensures that the folks who are generating the ideas don't become overly wedded to them before we get too far down the road.

Another one of my favorite agile concepts which we've really embraced is this notion of tough on ideas but easy on people, to really get at the value of discord and disagreement for the sake of making things better, not for the sake of tearing down people.

Margaret-Mary Wilson: It's also important to make the teams that I work with feel safe enough to fail, and safe enough to take risks. And I think I have drawn on that out of my personal journey, which as I reflect, has actually been grounded in a series of failures.

As someone whose career has spanned countries, and who had to move from Africa, to the U.K., to the U.S., in seeking out career advancement, each time I had to make that move, I felt a sense of failure, of not being able to succeed in the country where I was and having to reach out to another country in order to advance.

What I did learn from that though is that each of those points of failure were actually pivotal moments in my career and propelled me even further than I would have had I not failed and taken that risk. And so my philosophy, which I encourage for myself and share with my teens, is that failure is an integral part of success.

The advice that I would give to my younger self to prepare my younger self to navigate challenges ahead, are to remember to humanize, to humanize herself and to humanize others. Humanization drives our empathy, the ability to see things through the lens of another or the other. Vulnerability, the ability to recognize that I don't hold all the answers, and more importantly no one expects me to. So there must be a humility in recognizing my gaps and knowing where to reach out to fill those gaps.

The third is just as I lean into authenticity, humanization also allows us to respect the authenticity of others, and to understand them, seek to understand their nuances, their characteristics, their attributes. And therefore, as we work with people and teams, we're able to draw out the best of them because we understand their strengths.

The final lesson I would give to my younger self is, build broad shoulders. One of my favorite quotes is, "The reason that I have seen further is because I was able to stand on the shoulders of others." And that is an integral part of the leadership journey, because it's all in vain if we have not, as a leader, succeeded in paving the way for others.

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