Successfully approaching organizational change — whether it involves new technology, policies or workflows — is a key responsibility for hospital and health system CEOs, especially in 2026 as they navigate a convergence of financial strain, workforce pressure and emerging tools like artificial intelligence.

Leaders say some of their most important lessons about change management have come the hard way — learning that readiness matters more than timelines, that trust is built over time and that values don’t automatically scale. These lessons continue to shape how they lead through change today.

Becker’s asked four CEOs to respond to the following question:

Looking back at the biggest change you’ve led as CEO, what lesson about change management did you learn the hard way — and how does that lesson show up in how you lead change today?

Editor’s note: Responses have been lightly edited for clarity and length.

Angela Ammons Handley. CEO of Clinch Memorial Hospital (Homerville, Ga.): Looking back, the hardest lesson I learned about change management is that meaningful change never happens on my timeline, it happens on the organization’s readiness. Early in my tenure, I believed that if I could clearly see what needed to change and articulate it well enough, momentum would follow quickly. What I learned the hard way is that as a leader, you often see the problem long before others are emotionally or professionally ready to confront it. Change requires patience, repetition and trust built over time, not just a good plan.

I also learned that not everyone who starts the journey with you will be there at the end, and that doesn’t always mean failure. Some people grow with the organization; others reach a point where the change being asked of them no longer aligns with where they are. Accepting that reality without bitterness or avoidance was a critical leadership lesson for me.

Today, that experience shapes how I lead change. I spend more time listening before acting, setting clear expectations early, and giving people space to adapt, while still holding firm to the direction we’re going. I’ve learned that sustainable change is less about speed and more about consistency, transparency and earning trust one decision at a time.

Colin McHugh. President and CEO of Southern New Hampshire Health (Nashua): Having spent more than 30 years in healthcare I’ve been through a number of changes that have shaped my priorities and goals. One of the biggest lessons I’ve learned is that to successfully navigate change, whatever it may be, you need to have strong, innovative and people-focused leadership at every level of a healthcare system.

Over the last four years we have bolstered our team here at Southern New Hampshire Health, the nonprofit health system based in Nashua, N.H., with some of the very best leaders in the industry. This has allowed us to refocus our approach, expand access, enhance patient care, recruit and retain staff, and streamline our business operations. We have done all of this while making the community aware of how we can best serve their needs. Since 2022, we have reshaped our executive leadership team with new faces and elevated others who we recognized as making vital contributions to our organization. Combined, these leaders have more than 200 years of experience in healthcare and know how to best bring our health system into the future.

Change is always a challenge, but the most successful way to navigate that change is to put a team in place that is trustworthy, and worthy of the responsibility they hold. We are proud to have that team at Southern New Hampshire Health.

David Verinder. President and CEO of Sarasota (Fla.) Memorial Health Care System: I spent the early part of my career as CFO before moving into a CEO role, so I tend to look at change from both sides of the ledger.

Numbers and margins matter. But after 30 years in healthcare leadership, I have learned that it’s an organization’s culture and values, which don’t show up on the balance sheet, that really count.

For the past 20 years, I have had the privilege of leading Sarasota Memorial Health System, a trusted, century-old public institution, through decades of transformational change. During my tenure, SMH has grown from a respected, but financially strapped local hospital to a $2.5-billion-a-year multi-hospital health system. As our regional footprint expanded, so did our staff, from roughly 5,000 employees to nearly 11,000 today.

The hard part wasn’t the growth itself — it was making sure we didn’t lose who we were along the way. One thing I learned quickly is that an organization’s culture does not scale automatically. You can’t just write it down and expect it to stick.

As we got bigger, there was a real risk of drifting away from the community-first mission that defined us. Retention and succession planning became essential. Longtime employees with institutional knowledge and values provide stability and help mentor and develop new leaders. That’s why we made a point of staffing new facilities with experienced leaders and employees from our existing campuses — people who have lived the culture and can model expectations, person to person, behavior to behavior, decision to decision, and maintain the critical balance of mission and margin.

Because in the end, our goal is not simply to get bigger — but to grow without losing the values that make Sarasota Memorial worth expanding in the first place.

Meagan Weber. CEO of Scotland County Hospital (Memphis, Mo.): Looking back, the biggest change I’ve led was a cultural shift, moving our organization from quietly working around problems to openly bringing them to the table and solving them together.

Early on, I underestimated how personal change feels to people, especially in a hospital setting where physicians and staff take enormous pride in their autonomy and clinical judgment. I thought if the vision was clear and the data made sense, people would naturally get on board. What I learned the hard way is that change doesn’t fail because of strategy, it fails because people don’t feel heard, safe or involved early enough.

The key lesson for me was that you can’t just roll out change, you have to build it with people. I invite dissent early, normalize raising concerns and make it clear that surfacing problems is not a threat, it’s an expectation and a sign of professionalism.

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