Leadership Coaching at Academic Medical Center
Case Study
Role: Senior Consultant (Leadership Coach)
Timeline: February 2024 – September 2025 (19 months)
Organization Size: ~50-person marketing department within academic medical center
Team: Coached 8 leaders from manager to director level
Challenge
A leading academic medical center’s marketing department was transitioning to agile ways of working while simultaneously facing significant organizational upheaval. Leaders struggled to maintain effectiveness amid cascading challenges:
Leadership Issues:
- Leaders transitioning from peer to manager roles without clear frameworks
- Managers operating reactively rather than strategically
- Weak delegation practices creating bottlenecks and burnout
- Imposter syndrome and low confidence limiting leadership presence
Organizational Dysfunction:
- Teams not consistently delivering high-value, high-priority work
- Infighting and distrust between team members
- Poor cross-functional alignment and communication
- Organizational reduction in force creating anxiety and uncertainty
Mandate: The AVP of Marketing brought CMG Consulting in to develop leaders who could champion agile practices and effectively lead their teams through transformation and uncertainty.
Approach
Phase 1: Foundation Building (Months 1-6)
Individual Leadership Development
Established coaching relationships with 8 leaders, focusing on self-awareness, leadership identity, and core management practices.
Key Interventions:
- Built confidence addressing imposter syndrome and peer-to-manager transitions
- Strengthened 1:1 meeting structure and effectiveness
- Developed vulnerability-based leadership approaches
- Increased assertiveness and executive presence
Outcomes:
- Leaders gained clarity on leadership identity and role expectations
- Improved delegation while maintaining high standards
- Stronger tools for coaching direct reports through uncertainty
Phase 2: Strategic Leadership (Months 7-13)
Leading Through Complex Change
Coached leaders through a reduction in force and multiple high-stakes organizational changes while maintaining team morale and performance.
Change Management Challenge:
- Organizational layoffs created fear and distrust across teams
- Leaders needed to maintain steadiness while processing their own uncertainty
- Website governance initiative required 9-month change management approach
- Multiple competing priorities (Legacy Integration, PWR, Brand Refresh) demanded clear strategic focus
Implementation:
- Developed people-first communication strategies for difficult announcements
- Built frameworks for strategic planning vs. reactive problem-solving
- Coached leaders to create and communicate clear vision through ambiguity
- Established tools for advocacy and impact reporting
Results: Leaders maintained team stability and performance through significant upheaval, with one director successfully launching a governance initiative that gained senior leadership support.
Phase 3: Organizational Impact (Months 14-19)
Building Capability and Influence
Focused on expanding leaders’ organizational influence while developing their teams’ capabilities.
Key Developments:
- Implemented GROW goals and OKRs to drive team alignment
- Strengthened cross-functional partnerships and communication
- Improved performance documentation and accountability practices
- Developed coaching skills for addressing performance and interpersonal issues
Results: Leaders demonstrated measurable growth in strategic thinking, team development, and organizational influence.
Results
Leadership Capability
- 8 leaders developed from reactive managers to strategic leaders
- Improved delegation practices freeing up 20-30% of leader time
- Enhanced coaching skills for developing direct reports
- Increased confidence and executive presence across leadership team
Team Performance
- Better alignment to high-priority work through OKR implementation
- Reduced infighting through improved communication and role clarity
- Stronger onboarding and role definition processes
- More effective performance management and accountability
Organizational Impact
- Successfully navigated reduction in force with minimal team disruption
- Launched governance initiative with executive support
- Strengthened cross-functional partnerships across university
- Leaders contributing visibly to university-wide problem-solving
Cultural Shift
- Moved from crisis management to strategic planning mindset
- Built vulnerability-based leadership culture
- Increased resilience and emotional intelligence across leadership team
- Established people-first management practices
Constraints and Context
Organizational Turbulence: The coaching occurred during a period of significant uncertainty, including layoffs, reorganization, and merger of marketing with communications. This required constant adaptation of coaching priorities to immediate organizational needs.
Competing Priorities: Leaders managed multiple high-stakes initiatives simultaneously (Legacy Integration, PWR, Brand Refresh, website governance), making sustained focus on development challenging.
Agile Transition: The organization was learning agile practices while leaders were developing their leadership capabilities, requiring coaching on both fronts simultaneously.
Successful Transition: Engagement concluded as planned in September 2025 with leaders operating independently and organization entering sustainment phase.
Key Lessons
Leadership Identity First: Leaders couldn’t effectively adopt agile practices until they developed confidence in their core leadership identity. Addressing imposter syndrome and peer-to-manager transitions was essential groundwork for organizational transformation.
People-First Leadership in Crisis: Leaders who maintained empathy and steadiness during the reduction in force preserved team trust and performance. Vulnerability-based leadership proved more effective than traditional command-and-control approaches during upheaval.
Strategic Clarity Through Chaos: The most effective leaders created and repeatedly communicated clear vision, even when circumstances were uncertain. This practice anchored teams and reduced reactive behavior.
Delegation as Development: Teaching leaders to delegate intentionally both freed their time for strategic work and developed their direct reports’ capabilities. High standards and delegation aren’t mutually exclusive when approached thoughtfully.