CTI helps healthcare leaders improve the clinical performance of their organizations. Specializing in five foundational elements required for success:

  1. Healthcare Leadership
  2. Healthcare Strategy
  3. Culture
  4. Innovation
  5. Performance

We partner with our clients to achieve clinical transformational change.

CTI Leadership has special expertise in clinical staff performance, aligning and engaging physicians, nurses, and others, to optimize the quality of care and minimize risk. Our leadership program engagements are entirely customized to suit the unique mission, culture and challenges of each client organization, resulting in significant, sustainable, and measurable improvements.

5 Pillars of Transformational Change | Leadership Training Program

“CTI is the fourth consultant group we’ve had evaluate our 300-bed hospital in the last 10 years but the first to sustain a comprehensive re-structure of our medical staff. I’ve been impressed with their insight, patience and commitment.”

Dr. David GrantChief of Staff, UP Marquette

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The world of medicine continues to change at a rapid pace. What remains constant, however, is the need for transformational healthcare leadership. Shifting market dynamics requires strong leadership and a new set of skills aimed at facilitating serious change and true organizational transformation. Our healthcare leadership programs create:

  • Cultural Transformation
  • Optimal Productivity & Capacity
  • Quality Improvement and Process Excellence
  • Performance Improvement

It is in this greater organizational context that we work with leaders and enable them to:

Lead Self: by increasing self-awareness, self-regulation, and self-motivation

Lead with Strategy: by identifying and leveraging unconventional strategies

Lead People: by navigating teams and organizations through periods of growth and decline

Lead for Results: by maximizing decision-making, performance, and growth


















  • Physician Leadership Development
  • Executives Leadership Development (CXO)
  • Executive Coaching
  • Physician Coaching
  • Development and Coaching
  • Dyad Leadership Design and Execution
  • New Leader Onboarding
  • Leadership Retreats
  • Team Building Programs
  • 360º Leadership Assessments
  • Talent Assessments
  • Succession Planning


Strategy often makes the difference between success and failure. CTI focuses on helping clients articulate a healthcare strategy map, guiding and empowering an organization to focus on the critically important aspects of business, while eliminating time spent on the non-urgent, less important aspects of their operation.

While healthcare strategy planning is considered an annual event by many organizations, CTI focuses on strategic thinking as an ongoing process of translating vision into reality. Using our unique Terrain Based Strategy™ (TBS) planning system, we enable individuals, teams, and organizations to explore extraordinary opportunities by creating dynamic, responsive healthcare strategies that align environmental trends with organizational goals. Our planning system targets growth, competitive market positioning, brand discovery, and healthcare strategy alignment and implementation.

CTI encourages leaders to explore ancient and modern thinking on strategic leadership and apply the best principles and practices to their organization. We help you develop strategies at each level of the organization continuum:

  • Individual Strategy
  • Team Strategy
  • Department/Function Strategy
  • Service Line Strategy
  • Division Strategy
  • Organizational Strategy


  • Strategic Planning, Alignment and Execution
  • Change Management
  • Market/Terrain Competitive Assessments
  • Strategic Planning for Medical Staff
  • Board of Trustees
  • Departments and Teams
  • Strategy Alignment and Accountability –
    Line of Sight
  • Population Health – Clinically Integrated Network Optimization

View our Healthcare Strategy Session Results


Physician turnover has accelerated alarmingly in recent years, costing hospital systems and group practices millions of dollars in recruitment expenses and lost revenue.


The average cost to replace just one physician, in fact, is $1.2 million. Average annual turnover is 6.8 percent — with turnover rates particularly high for physicians in the second to third year, averaging between 12 and 21 percent, depending on practice size.

Two commonly cited reasons for high turnover rates are poor cultural fit and insufficient onboarding processes. Did you know that extended onboarding correlates to higher physician retention rates in early years, while a culture that emphasizes physician leadership affects overall job satisfaction and effectiveness?

So much is happening beneath the surface in any healthcare system that affects physician satisfaction and retention, and we ignore these elements at our peril. On the “trust iceberg” (below), note how many of the “below the line” elements are enormously impactful compared to the more obvious, “above the line” issues that often take up our time and attention:



  • Performance Standards Development (Compacts)
  • Physician Engagement
  • Employee Engagement
  • Quality and Safety Ownership
  • Customer-Centric Culture
  • Resilience and Burnout Prevention
  • Coping with Continuous Change
  • Creating a Safe and Reliable Culture
  • Peer-to-Peer Communication
  • Having the Difficult Conversations
  • Physician Leadership in Creating a High Reliability Organization


We believe in “doing different things, and doing them differently”. We value an entrepreneurial culture and encourage our team to continually innovate in our practice and in curriculum development. We are continuously adopting best-practices and sharing them with our client-partners when appropriate. We also adopt proven best practices from other industries and apply them to our client-partner’s specific situation, providing the most appropriate and cost-effective results possible.

We believe the following challenges hinder innovation:

  • Fear of failure
  • Lack of an innovation culture
  • Lack of trust
  • History – Learned Helplessness
  • Definition – equating innovation with invention or with technology
  • Lack of creative people
  • Lack of risk taking
  • Lack of play
  • Right Brain versus Left Brain use
  • Lack of a leadership focus and strategy
  • Lack of importance
  • Lack of an innovation process

We can help you overcome these challenges and develop a more innovative healthcare culture.  We work with companies and entrepreneurs to bridge the gap between innovation strategy and execution, and accelerate the transformation of ideas into results.


  • Assessments
  • How to Create and Sustain a Culture of Innovation
  • Design Thinking Training
  • Innovation Strategy Development
    • Helping organizations define their innovation vision and develop the detailed strategies that will get them there.  Our goal is to help you develop a market-centric, discovery driven innovation process centered on finding new ways of creating value for you and your customers.
  • Innovation Workshops, Retreats and Bootcamps
    • Workshops, Retreats and Bootcamps are customized to the unique challenges and goals of the participants. These programs are designed to launch innovation initiatives and cultural transformation in your organization. We use keynote speakers and interactive, collaborative exercises to foster creativity and engagement in the learning process.
  • Innovation Institutes and Academies
    • The goal of our Institutes and Academies is to teach leaders and employees how to innovate using a structured process and culture. These customized programs include regularly scheduled onsite workshops, coaching, group projects, and group learning.
  • Innovation Coaching

Examples of Innovation Solutions:

University of South Florida Neuroscience Collaborative

The USF NSC is an ambitious program designed to accelerate progress in USF neuroscience research by promoting new campus-wide collaborations among USF faculty, as well as with partners outside the University.

Innovation Hub powered by the University of South Florida

The Innovation Hub, powered by the University of South Florida and the Center for Transformation and Innovation, is a gateway into the university’s innovation and research assets and capabilities.  It is an online portal designed to help navigate the USF ecosystem and locate the resources that can help solve the challenges encountered along the innovation life cycle, from the research and discovery of new and innovative ideas, to the commercialization and diffusion of the innovation into the marketplace.  The goal is to connect the innovation resources at USF with the internal and external stakeholders that need them, encourage collaboration between USF and its stakeholders, and facilitate innovation globally.

Asset Mapping of a Major Research University Using Innovation Hub Modeling

The article evaluates the support for innovation, and the technology transfer and commercialization strengths, weaknesses, and gaps at the University of South Florida.


“CTI is the fourth consultant group we’ve had evaluate our 300-bed hospital in the last 10 years but the first to sustain a comprehensive re-structure of our medical staff. I’ve been impressed with their insight, patience and commitment.” – Dr. David Grant, Chief of Staff, UP Marquette

Any healthcare organization is only as good as its medical staff. The best physicians will provide the best care and every hospital has in place a medical staff organization whose job it is to ensure that the quality of care is as good as it can be.

They do this through recruitment, peer review, credentialing, and privileging – a seemingly rigorous process to regularly evaluate performance, which is vital for sustaining quality of care in any healthcare organization. However, the structure and processes of most medical staff organizations were designed for the healthcare system of yesterday and no longer fulfill their essential mission.

At last count, 67 percent of physicians were employed and 33 percent independent. More young physicians and more women physicians are employed, while more older men physicians remain independent. Older men also tend to dominate positions on the medical executive committee (MEC) and as department chairs, which can cause some generational and gender issues. Competing practices are often represented on medical staffs, which presents conflicts of interest. And because more care is being delivered in outpatient settings, direct observation must give way to indirect evidence to assess peers and quality of care.

This all leads to more and greater challenges beyond the formal evaluation of physicians for credentialing and privileging. It leads to a host of problems that increase risk and undermine the quality of care itself.

Medical Staff Leadership Challenges

To address these challenges and ensure quality of care requires redesigning for medical staff optimization, which can be accomplished in five steps:

  1. Assess Terrain: A full and unbiased evaluation of current medical staff, especially those in leadership roles, including their skills and suitability to their positions, as well as a review of current policies and processes, followed by an assessment of how well the current structure supports the organization’s objectives.
  2. Develop Strategy: Work with key stakeholders to create a transformation strategy that will align the structure and functions of the organized medical staff to the mission of the hospital or health system.
  3. Engage and Align: Communicate strategy and reasons behind it to the medical staff and secure their agreement and cooperation. Provide support (i.e. coaching, training) for staff members to ensure they are adequately prepared for new structure and processes.
  4. Transform: Implement changes in accordance with pre-determined timeline, accounting for dependencies and taking time to ensure one phase is satisfactorily complete before moving to the next.
  5. Sustain: Medical staff structure and governance became irrelevant to its purpose over time, partly because it was not designed to be nimble and partly because there was no mechanism in place to monitor and sustain its effectiveness. New members must be formally onboarded to ensure their suitability to the organization and to their roles as leaders who anticipate change. Quality measures must be monitored continuously and processes regularly reviewed. Otherwise, the newly optimized medical staff will quickly fall behind the rate of change in healthcare.

High Performance Transformation Process



  • Medical Staff Training
  • Physician Recruitment Process Redesign
  • Bylaws and Governance Review and Revision
    • Quality and Safety Ownership
    • Role of Physician Leaders
    • Performance and Quality Indicators
    • Legal Landmines
    • Effective Corrective Action
  • MEC and Medical Staff Leadership Assessments
  • Medical Staff Optimization
    • MEC and Medical Staff Assessments
    • MEC Strategic Planning and Alignment to Board/Organization
    • New Department or Division Chief Onboarding


  • Hassle Factor Index
  • Scribe’s Strategy and Execution
  • Financial Audits and Operational Consulting
  • Lean Process Improvement for Quality, Safety and Patient Satisfaction

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