A brainstorming session with the CEO of a digital health startup this week highlighted a frustration familiar to anyone who’s tried to make innovation happen in the slow-moving world of health systems.

Meeting with a system executive team to discuss a new approach to virtual care delivery, he described the cross-enterprise collaboration required, and said, “You could see everyone looking around the table to see what everyone else thought, before anyone was willing to react.” 

No surprise, as complex bureaucracies don’t reward risk-taking by leaders; often, innovation is slowly suffocated by internal politics and turf-protecting behavior.

That’s why we often repeat advice from one of the most progressive, successful system CEOs we’ve worked with: “You’ve got to eliminate the vetoes if you want to get stuff done. I don’t let people leave the room until we’ve managed to set aside all the reflexive objections and arrive at a resolution. 

I expect leaders to be solution-driven, not objection-driven.” For all the times we’ve been asked how to build a successful “innovation infrastructure,” it strikes us often the answer lies in leadership, not org charts.