From the Desk of Michael J. Negrete
Articles, frameworks, and tools on leadership, strategy, and organizational performance.
The frameworks, methodologies, and perspectives on this site are original work developed by Michael J. Negrete, PharmD, over decades of practice in healthcare leadership and leadership development. AI tools are used in the writing and editing process — not to generate ideas, but to refine expression. The thinking is mine.
The traits that get someone chosen as a leader and the traits that make someone effective once they're in the role are only loosely related. From Theranos to WeWork to Uber, this article traces why selection systems keep rewarding charisma over competence, and gives both hiring leaders and the leaders being evaluated a concrete way to close the gap.
Read the article →Most communication starts with the message. Strategic communication starts with the outcome, and it isn't finished until you've confirmed you got it. A five-stage cycle, from outcome through assessment, for communication that produces change instead of just activity.
Read the article →Executives don't have time for the full story. SBAR, a framework built for nuclear submarine crews and refined by Kaiser Permanente for healthcare handoffs, gives leaders a structure for communicating clearly under pressure, in the boardroom and everywhere else in the organization.
Read the article →Generic engagement programs produce generic results. The VISN framework — Values, Interests, Strengths, and Needs — gives leaders a practical lens for understanding what actually drives each person on their team. When applied intentionally across hiring, onboarding, performance reviews, and everyday interactions, VISN alignment becomes the operating system for sustained motivation and peak performance.
Read the article →AI has made it easier than ever to build a business. That's not the same thing as making it easier to build a good one. For leaders with real career capital at stake, the question that matters most — should I actually do this? — is one no tool can answer for you. A personal account of three ventures that were directionally right and still didn't deliver, and what that taught me about what rigorous thinking before the leap actually requires.
Read the article →Most managers delegate to get things done. The best leaders delegate to build people. This article introduces the ACCORD framework — a six-step model for the delegation conversation that generates alignment, closes the loop on understanding, and turns commitment into reliable follow-through.
Read the article →Most leadership failures aren't caused by a lack of intelligence, effort, or commitment. They happen because capable leaders keep getting results the old way — even after the role demands something fundamentally different. This article names the five most common self-imposed ceilings and what it takes to break through each one.
Read the article →Most of what's on your calendar is noise. This article shows how to find the signal, your line of sight to the organization's winning proposition, defined through Who, What, and How, and use it to decide what you Do, Defer, Downsize, Delegate, or Delete.
Read the article →Leading a cross-functional team through a high-stakes, twelve-month project is one of the harder things a leader is asked to do. This article names seven failure modes you should expect — the illusion of alignment, functional loyalty, accountability without authority, the quiet dissenter, middle-mile drift, hypothesis protection, and late-stage distortion — and explains how the GRRR and BSHAARP frameworks give you specific, practical responses to each one.
Read the article →Most change efforts stall for one of three reasons: leaders don't clarify the direction, they don't step back to let others deliver, or they cling to a plan instead of learning their way forward. This framework integrates Kotter, Elsbeth Johnson, and Rita McGrath into a single, practical approach for leading change when the future is uncertain.
Read the article →AI should eliminate friction, not add complexity. This workshop guide helps teams systematically identify, test, and share practical AI uses that reduce low-value work — creating space for the judgment, creativity, and relationship-based work that only humans can do well.
Read the article →Most organizations are racing to implement AI everywhere — and producing scattered pilots, fragmented investments, and little measurable value. Rita Gunther McGrath's discovery-driven planning offers a disciplined alternative: a framework that turns uncertainty into structured learning rather than expensive noise.
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