The 90-Day Test: How I Stabilize Organizations in Crisis

When I walk into an organization in crisis, the first thing I hear is urgency. "We need results. We need them now. People are leaving. The board is watching. Fix it."

I understand that urgency. I've felt it under congressional oversight. I've felt it when the Office of Inspector General was in the building. I've felt it when patient safety was at stake and the national media was calling. But here's what I've learned across 25 years of leading organizations through their worst moments: the leader who rushes to fix before understanding what's actually broken will make everything worse.

"Missteps made during the crucial first three months in a new role can jeopardize your success."

Michael D. Watkins — The First 90 Days (Harvard Business School Press, 2003)

Watkins is right. But what he describes for leadership transitions, I apply to crisis stabilization. The first 90 days aren't about proving you have answers. They're about earning the right to lead — and that starts with listening.

Phase One: Listen and Assess

The single most important thing a leader can do in the first 30 days is shut up and pay attention. I don't mean reviewing dashboards from the C-suite. I mean walking every floor of every building. Sitting in the break rooms. Talking to the night shift. Hearing what the people closest to the work actually experience every day.

When I took over as CEO of a 3,000-person healthcare system, I inherited an organization with significant cultural and operational challenges. The workforce was demoralized. Turnover was high. The relationship between leadership and staff had eroded to the point where people stopped raising problems — because they'd stopped believing anyone would listen. I've seen the identical pattern in private-sector hospitals, in military commands, and in corporate environments. The industry changes. The dysfunction doesn't.

My first 30 days looked nothing like what the board expected. I didn't restructure. I didn't announce a new strategic plan. I walked every floor of every building — my hospital, not the C-suite conference room. I sat with housekeeping staff and surgeons alike. I asked two questions: What's working? What's broken? And then I listened. This approach isn't unique to healthcare. I've deployed the same method in private-sector turnarounds and military environments. The principle is universal: you cannot lead what you do not understand, and you cannot understand from behind a desk.

This isn't soft leadership. This is intelligence gathering. John Kotter, who developed the most widely used change management framework in business, emphasized that the first step in leading change is creating a sense of urgency — but urgency grounded in reality, not in panic. He wrote that organizations must "create a sense of urgency around the need for change" (Leading Change, 1996). What most leaders miss is that you can't create real urgency until you understand the real problems. And you can't understand the real problems from the executive suite.

I applied this same discipline in the private sector when I took over underperforming hospitals. The instinct from corporate leadership was to restructure immediately. Instead, I spent the first 30 days understanding why the facilities were underperforming — and what I found was rarely what the reports suggested. The problems weren't in the org chart. They were in the daily operating rhythm, in how decisions got made, and in what leadership had stopped paying attention to. Had I acted on the corporate narrative instead of the ground truth, I would have fixed the wrong things.

Phase Two: Act and Align

By day 31, you should know three things: the real problems (not the reported ones), who your key people are (the informal leaders, not just the org chart), and where the first visible win lives.

"Secure some early wins to leverage your energy and expand the potential scope of your subsequent actions."

Michael D. Watkins — The First 90 Days (2003)

What I've found is that the right early win does something far more powerful than build credibility. It changes what people believe is possible.

At my healthcare system, the first visible win was in employee engagement. We didn't announce a program. We fixed specific things that frontline staff had been asking about for years — things that leadership had dismissed as minor. Scheduling flexibility. Equipment that actually worked. Responsiveness to concerns. Each fix was small in cost but enormous in signal: we're listening, and we're acting. In the private sector, I've applied the same principle to operational turnarounds — find the quick win that the workforce already identified, deliver it, and watch the culture begin to shift.

This phase is also where alignment becomes critical. You cannot stabilize an organization if your leadership team is pulling in different directions. I sit down with every senior leader individually during this phase. I want to understand their priorities, their concerns, and their willingness to do the hard work ahead. Not everyone makes it through this conversation. That's not a failure — it's clarity.

Amy Edmondson, the Harvard Business School professor who pioneered the concept of psychological safety, found that high-performing teams share one critical characteristic: the belief that the team is safe for interpersonal risk-taking. In her landmark research, she demonstrated that "team psychological safety" directly predicts learning behavior and team performance (Administrative Science Quarterly, 1999). In practical terms, that means your people need to feel safe enough to tell you the truth — especially the truth that's uncomfortable. If they don't, you're leading blind.

During this phase, I build that safety deliberately. I share what I've learned in the first 30 days openly with the entire organization. I name the problems publicly. I acknowledge where leadership failed. And I make clear that the path forward is a shared one. This transparency is uncomfortable for some leaders. It's non-negotiable for me.

Phase Three: Hard-Wire and Sustain

The third phase is where most turnarounds die. The initial energy fades. The first wins create a false sense of completion. Leadership attention drifts to the next crisis. And the organization slides back to where it was — or worse, because now the workforce has been disappointed again.

I don't let that happen. Days 61–90 are about embedding changes into the operating rhythm of the organization so deeply that they survive without me. This is what I call "hard-wiring" — building the changes into governance, into reporting structures, into daily operations, into the culture itself.

"Anchor Change in the Culture."

John Kotter — Step 8 of the 8-Step Change Model, Leading Change (1996)

Kotter places this step last for a reason. He writes that organizations must "consolidate gains and implement more change" before anchoring, because premature declarations of victory are one of the most common reasons change efforts fail.

I've seen this play out in real time. In the private sector, the temptation to declare victory after early operational improvements was enormous. The numbers looked better. Corporate was pleased. But I knew the improvements were still fragile — dependent on my presence and attention, not yet embedded in the operating system of the facility. So we kept building: standardizing rounding, embedding accountability metrics into daily huddles, training charge nurses to own the operating cadence. One facility eventually earned a national "Excellence" designation — not because of a single intervention, but because we refused to stop before the changes were self-sustaining.

At that same healthcare system, hard-wiring meant transforming how we measured success. We moved from lagging indicators — turnover numbers after the fact — to leading indicators that showed us the health of the culture in real time. Employee satisfaction surveys became living documents, not annual paperwork. Rounding became a leadership standard, not a suggestion. And accountability became a two-way street: leadership was accountable to staff, not just the other way around. I've since deployed the same measurement framework in private-sector and faith-based organizations. The metrics change. The discipline of measurement doesn't.

The result? The organization went from last-quintile to first-quintile in workforce retention nationally. Not through a single intervention. Through 90 days of discipline that turned into years of sustained performance.

Why 90 Days Matters

There's nothing magical about the number 90. What's meaningful is the discipline it imposes. Thirty days to listen. Thirty days to act. Thirty days to lock it in. This cadence forces a leader to resist the two most dangerous impulses in a crisis: acting before understanding, and declaring victory before the work is done.

Russell Reynolds Associates, one of the premier executive search firms in the world, recently cautioned that "the 'First 100 Days' rhetoric misses what truly matters" — because early wins alone don't secure long-term success. They're right. But in my experience, without a disciplined first 90 days, there is no long-term to talk about. The 90-day framework builds the foundation. What you build on it determines the legacy.

The Practitioner's Commitment

I don't advise from the sideline. When I enter an organization, I lead. I take the seat. I own the decisions. And I hold myself to the same 90-day standard I'm describing here — because the workforce will watch what I do long before they believe what I say.

That's the C3PT approach: Communication first, then Collaboration to break silos, Culture as the operating priority, Perseverance to sustain the work through resistance and fatigue, and Trust as the foundation for all of it. In 90 days, you can't fix everything. But you can change what people believe — and when you change belief, you change behavior. When you change behavior, you change results.

Every turnaround I've led started with the same decision: stop talking and start listening. The answers are always in the building. The leader's job is to be humble enough to hear them and disciplined enough to act on them.