Leadership in Rapid Change Environments: Filtering to Maintain Momentum
- carolmastrofini
- Apr 7
- 8 min read
One of my coaching clients, Dr. Kim, is a physician in a leadership role at a university hospital. Her experience reflects a broader challenge many leaders are facing today.
Leadership in rapid change environments where attention is constantly pulled toward new priorities, emerging information, and shifting expectations. In these environments, the challenge isn’t simply making decisions. It’s determining what deserves attention in the first place and maintaining enough focus for progress to continue.
She describes her lived reality this way:
Everything is a Priority for Leadership in a Rapid Change Environment
“We are working on so many different goals right now that it can feel overwhelming, and they are all important. Both to the hospital and, more importantly, to our patients.
That’s always where it starts for me. What matters for our patients. What improves care, access, and outcomes.
At the same time, I’m responsible for how those decisions affect the hospital. How we sustain the work, grow, and support the people doing it.
We are under pressure to move quickly on AI-enabled tools, and there is no doubt they can support physicians and improve outcomes. At the same time, we are expanding access to care through telehealth—for many patients, this isn’t about convenience, it determines whether care happens at all.
We are also working to increase research funding, not just to support the institution, but to advance treatment and attract the talent that keeps the hospital moving forward. And while we are pushing into all of that, we are also trying to hold on to what already exists. Faculty retention is an ongoing challenge, and every departure affects patient care, training, and team stability.
And I’m expected to move all of this forward at once.
None of it is optional.”
I ask her where her attention is being pulled right now.
She doesn’t hesitate.
When Priorities Begin to Compete
“There’s a new conversation happening about launching a clinic focused on chronic kidney disease, and it’s not a bad idea, that’s what makes it hard. The need is real, and I can make the case for it in terms of access, outcomes, and long-term impact.
But that’s where the tension starts.
I thought the leadership team had a shared understanding of what we were working toward this year. What matters. Where we’re focusing. What we’re trying to move forward. It felt clear enough to act, and now I’m not so sure.
Am I missing something important—for the hospital or for our patients? And if I don’t move this forward, what does that say about me as a leader? Does it look like I’m hesitating, or not seeing something I should be seeing?”
I ask her how they normally work through decisions like this.
She pauses before answering.
“We don’t really talk about it that way. We talk about what is important for our patient population and for the hospital, what needs attention, what we’re trying to move forward. It’s more ongoing than defined.
And it works—until something new comes in that could matter just as much.”
When Everything Becomes a Variable
What once functioned as a stable assumption now behaves more like a variable—something that has to be questioned, recalculated, and tested in real time.
“Another challenge is how quickly things are changing, especially with AI-enabled tools.
We’ll start a conversation about how something might fit, where it could support our teams, what it could improve, and before we’ve fully worked that through, something new comes out—a new capability, a new tool, a new expectation.
So it’s not just one conversation. It’s a constant stream.”
I ask her how she decides whether something new actually needs to move forward—or remain a conversation.
She exhales slightly.
“That’s part of what’s hard, because some of these things could make a real difference. They’re not easy to dismiss, but it’s not always clear how far to take them.
We’re constantly asking whether something shifts what we’re already doing, whether it should change what we’re focusing on, or whether it’s something we acknowledge and come back to later. And while we’re trying to sort that out, everything else is still moving.
It’s not just evaluating the tool, it’s deciding how much attention it deserves without a clear way to make that determination. And it feels like we’re doing that over and over again.”
She sits with that for a moment before continuing.
“This actually reminds me of another situation—with grants.
We’ve had a clear focus on expanding research funding—growing what we bring in and building programs around it. That was something we were moving toward intentionally.
And then the administration cuts federal funding.
So it’s not just a shift. It’s something we were building on that's being pulled back. And even if some of that funding comes back, it’s not necessarily the same. There are conditions and expectations that may not align with how our university operates. It becomes more complicated, it's not just whether the funding is there, but what comes with it.
That changes how we think about everything connected to it, because we’ve already started building around those assumptions. Now we’re asking whether we keep pushing toward that goal the same way, adjust how we approach it, or step back from parts of it entirely.
And none of those are small decisions.”
She continues.
“Telehealth is similar, but in a different way.
We’ve expanded access, invested in it, and built around it. Patients rely on it, and it’s been a clear part of where we were going. But with changes in reimbursement, it’s not that it stops, it changes how we think about growing it.
What made sense before doesn’t land the same way now, so we’re looking at something we’ve already committed to and asking whether it still holds in the same way, or whether we need to rethink how we move it forward.”
I ask her how decisions like that are worked through, when something that was already part of the plan shifts.
She pauses longer this time.
“That’s where it gets harder to navigate, because we’re not starting from scratch. We’ve already committed time, resources, and people, and now we’re trying to adjust while still moving forward.
It’s not always clear how those decisions get made, or how quickly they need to be made, and you’re trying to respond to what’s changing while still being accountable for what we said we were going to do.
And those don’t always line up.”
When Rapid Change Begins to Take a Toll
I let the moment sit before asking:
“As you’re talking through all of this… what does it feel like to try to move things forward?”
Dr Kim answered.
“It’s the constant change. Not just that things are changing, but that you can’t stay with something long enough to actually move it forward.
We start to move forward thinking we have enough clarity to act, and then something shifts. What should have become progress turns back into reconsideration, and time that could have gone into execution is spent reopening what we thought was settled.
You start with a clear sense of what you’re trying to accomplish. You understand what matters, what the goals are and over time that becomes harder to hold onto because the goals keep shifting, or at least it feels like they are. Some days it’s not even clear what the goal is anymore, or what it will be tomorrow. And that’s what wears on you over time."
What This Points To
The pattern she is describing isn’t coming from a lack of effort or commitment. Every decision she described is grounded in care for patients and the future of the hospital.
And it isn’t unique to her role or her organization.
What has changed in our workplaces is something more fundamental.
What used to function as dependable assumptions no longer holds in the same way.
Conditions that once provided stability—funding expectations, reimbursement models, even how emerging tools would be evaluated, now behave more like variables. They shift, reappear in different forms, or disappear altogether.
This is the environment leaders are operating in. Over time, the impact of that shift becomes visible.
A shared understanding of what matters starts to loosen.
What deserves attention becomes harder to determine.
And decisions that once held long enough to build on begin to reopen.
When that happens, the burden doesn’t disappear, it shifts. It shifts into repeating conversations, revisiting decisions that were already made, and redirecting energy away from execution and toward re-evaluation.
Work continues. Effort continues. But forward movement becomes harder to sustain in a way that holds.
Over time, this creates what I describe as Ambient Effort™—the additional, often invisible energy required to stay effective when conditions keep shifting and decisions don’t hold long enough to build on.
In environments like this, progress depends on something more than effort alone.
It requires structure.
A clear way to hold direction—so that not everything reopens when something new appears. A way to filter incoming information—so that every new idea doesn’t carry equal weight. And a way to make decisions that can hold long enough to support forward movement.
This is the role of the Change Stability Model™.
Not as something layered on top of the work, but as a way of stabilizing it so that leaders can continue to move forward, even as the conditions around them continue to change.
Leadership in environments like this is not just about responding to change, it’s about filtering what deserves attention so momentum can continue.
If this Feels Familiar
As you think about your own work right now… what is pulling your attention?
And once you decide something matters—does it hold long enough to build on?
For many people, the answer isn’t simple.
It isn’t just one priority, one decision, or one clear path forward. It’s a combination of things—some already in motion, some newly emerging, and some shifting under you.
When you’re in a situation like this, the instinct is often to work harder, move faster, and stay on top of everything—revisiting decisions until they feel settled.
But that approach has limits.
What this requires isn’t more effort.
It requires stepping back long enough to see what is shaping the work itself—what is drawing attention, what is changing, and what is allowed to hold.
Because in environments like this, the challenge isn’t simply the pace of change. It’s maintaining the ability to move forward within it.
If your leadership team is spending more time revisiting decisions than building on them, it may not be a capacity issue.
It may be structural.
In environments where change is constant, progress depends on more than effort. It requires a clear way to hold direction, filter what matters, and make decisions that can sustain forward movement.
Our organizational work is designed to help teams build that structure so that progress can continue, even as conditions shift.
If this is something your organization is experiencing, I’d welcome a conversation. Schedule a free 30-minute consultation here.
Related Insights
The Ambient Effort™ Series
Understanding the hidden energy required to remain effective in workplaces shaped by constant transition.
The Change Stability Model™
Exploring how organizations maintain coordination and clarity when disruption accelerates.
