Reinvigorate Your Health Care System: Build Meta-Leadership into Your Practices and Thinking

Hospital administrator conducts staff meeting

As the pandemic recedes, proactive health care leaders see a moment of opportunity. The past three years presented a host of unprecedented challenges. Now is the time to re-position their people, their system, and their leadership. How can you emerge from these three years into a renewed posture of leadership strength?

“The pandemic response tested the health system like never before. Looking forward, the challenge for leaders is to reimagine and rebuild that system to be ready for its next challenges. Achieving this goal requires intentional leadership efforts to foster social cohesion and build critical capabilities,” explained Leonard Marcus, PhD, program co-director of Leading in Health Systems: Activating Transformational Change, an executive leadership program offered by Harvard T.H. Chan School of Public Health.

“What I’m hearing from leaders is that they remain overwhelmed by the daily transactions of their jobs. What they long for is the time to step back to think about transformation in the face of rapidly changing conditions,” added Eric McNulty, program co-director of Leading in Health Systems.

Marcus and McNulty are co-authors of Renegotiating Health Care: Resolving Conflict to Build Collaboration, Second Edition as well as You’re It: Crisis, Change, and How to Lead When It Matters Most.

Helping Health Care Leaders Build New Strengths

Leading in Health Systems offers participants the original and time-tested Meta-Leadership framework for rebuilding and reinvigorating their leadership thinking and practices. Marcus and McNulty, along with their colleagues at Harvard University, developed Meta-Leadership thinking and practices to guide organizations in building enterprise-wide connectivity of effort. It has been used in the field for two decades.

“Many of the factors in health care are changing faster than they historically have—and that’s why they are so confounding. It’s hard to keep up and align the organization. Leaders need a new mindset that embraces complexity and ambiguity. That’s quite different from traditional linear thinking. The Meta-leadership framework we use in this course helps leaders grasp this new mindset,” McNulty said.

Addressing Current Challenges in Health Care Leadership

One topic the program covers is the change in social cohesion that many organizations have been experiencing since the pandemic struck. Marcus stressed that rebuilding trust-based relationships is fundamental in addressing this issue. “The extreme operational contingencies and contentious political experience of COVID-19 frayed this essential trust. It left health care professionals feeling isolated, beleaguered and frustrated. For many, it was the first response where they were designated as the ‘bad’ actor. The result was self-doubt, trauma, and distress,” Marcus said.

Undoing this damage and rebuilding social cohesion takes more than logistical and tactical fixes, according to Marcus. “It requires leaders to assess and understand their pandemic experiences, to reaffirm their commitment to common purpose, and to refresh the ways of interacting and engaging so they can genuinely lead together,” he added. “The Meta-Leadership model was designed to guide these very processes.”

Applying Lessons Learned

Alongside rebuilding social cohesion, leaders must also learn how to apply the lessons learned over the past few years, to include the turbulence of the COVID-19 response. The curriculum provides a valuable framework to guide participants in understanding their experiences and leveraging them effectively.

“Social, technological, and other changes require adapting, and in some cases reimagining, how health care systems work with the workforce and community. How can you leverage the strengths of the system while overcoming its limitations? There are both challenges and opportunities,” noted Marcus.

Finding a New Way to Lead

One imperative, according to McNulty, is to reclaim the word ‘leading’ and what it means to you. “Too often, ‘leadership’ and ‘leading’ are used as an umbrella for a wide range of executive activities from vision setting to culture building to strategy and finance. Leading is really about the human factors in a health system—the people, their relationships, and the conditions in which they interact,” he said.

“Leaders know that people are the purpose of health care and the irreplaceable heartbeat of care delivery. Leaders seek out the most talented people—from surgeons to the custodial staff; nurture them; and create the environment where they can reach their full potential. Our job in this course is to help participants to learn how to better succeed in that mission,” McNulty added.

Leonard Marcus and Eric McNulty co-direct Leading in Health Systems: Activating Transformational Change, an on-campus executive leadership program for health care professionals.

Harvard T.H. Chan School of Public Health offers Leading in Health Systems: Activating Transformational Change, an on campus program designed to empower health care professionals through meta-leadership.




Marcus, Leonard, PhD, program co-director, Leading in Health Systems: Activating Transformational Change, zoom interview, April 12, 2023.

Leading in Health Systems

McNulty, Eric, program co-director, Leading in Health Systems: Activating Transformational Change, zoom interview, April 12, 2023.

Leading in Health Systems