Organizational Design
Complex academic and service organizations often grant considerable autonomy to department and local leaders. At the same time, they must coordinate activity across multiple functions and sometimes large distances.
My Approach to Critical Issues
I work with leaders to design and enact horizontal and vertical leadership structures that balance effective control and coordination with respect for traditions and commitments related to professional independence, clinical judgment and academic freedom.
Some of the critical issues on which I work with leaders are:
Improving cross-functional coordination
Many leaders struggle to navigate a thicket of committees and task forces meant to coordinate work across functions and/or sites of service. In large organizations, the proliferation of these groups can create confusion for leaders who are looking to make decisions and absorb an outsize share of leadership time. I work with leaders to clarify the responsibilities of critical cross-functional groups, teams and committees to enable effective coordination and oversight of organizational activities.
Clarifying decision processes and responsibilities
Lack of clarity about responsibilities and decision processes and authority is a common cause of tension between and within teams, and can lead to delays and rework. I work with leaders to clarify the processes by which decisions will be made as well as the authority of key stakeholders in those decisions. Some of the specific questions I pay attention to are:
Clarifying what must be done by the senior leader and what work can and should be delegated to others
Exploring what work is best done by individuals and what needs to come to a team
Navigating the distinction between the work of the board and the work of the executive team.
Effectively dividing responsibilities among team members that reflects the distinctive responsibilities and needs of key functions, the skills and interests of leaders, and the strategic needs of the organization.
Establishing effective meeting norms and systems
When meetings are inefficient, leaders come to see them as getting in the way of doing “real work.” Yet, given the need for coordination and collaboration, meetings are an essential way in which leaders and teams get work done. I work with leaders to design meeting systems and develop meeting norms that enable them to effectively and efficiently do the work that must be done together.
Project Summary
Improving upon organic leadership structure for a large medical center
A large medical center had organically evolved a collection of committees and meetings to coordinate cross-functional work. As the organization grew, leaders found that decision processes became unclear or overly onerous.
We redesigned the way in which top leaders worked together, and established a set of leadership bodies authorized to address important organizational decisions.
Client Testimonial
"Elizabeth is an exceptionally gifted listener and thought partner. Her talent for asking thoughtful, probing questions helped us uncover new insights and consider ideas from different angles."
Client
The leaders I work with navigate more complexity than most.
Healthcare Organizations
Healthcare organizations, particularly academic healthcare organizations, are among the most complex organizations there are.
Higher Education
Universities, colleges and research institutes manage the tension between the need to sustain a safe community conducive to inquiry and learning, while remaining open to the surrounding community and the world.
Nonprofit Institutions
Nonprofit organizations navigate the same challenges as other businesses, but also face distinct tensions that stem from their mission-driven nature.
Services

I offer distinct consulting and coaching services, but I find the greatest value often lies in making connections between them.
To ensure we are focused on the most impactful intervention, every engagement starts with an exploration of your specific goals and challenges, and a review of relevant data. I can then design a targeted scope and process with real value for you, often combining aspects of multiple services, such as:
Strategy Development
A strategic plan is, at its most basic, the answer to two questions: “What is success?” and “How will we get there?”
Organizational Design
Complex academic and service organizations often grant considerable autonomy to department and local leaders. At the same time, they must coordinate activity across multiple functions and sometimes large distances.
Change Management
Getting the most from your teams and colleagues in a rapidly changing environment is hard, particularly when teams are challenged just to keep up with daily demands.
Executive Coaching
Executive coaching is an opportunity to address the organizational and business issues most on your mind, while also exploring and cultivating your leadership identity and voice.
Team Development
Effective teamwork can amplify the impact of talented individual leaders and team members.