In December 2022, Dr. Tomislav ("Tom") Mihaljevic, CEO and President of Cleveland Clinic, was reflecting on the last few years at the hospital, marked both by unprecedented challenges and remarkable achievements. Cleveland Clinic had recently been ranked the world's second-best hospital. Dr. Mihaljevic was especially proud of the special recognition given to Cleveland Clinic's COVID-19 pandemic response and attributed this to the hospital's 77,000 "caregivers" (defined as all clinical and nonclinical personnel at the hospital). Despite ongoing challenges, from an anticipated operating loss in 2023 to extreme burnout for caregivers across the hospital enterprise, Dr. Mihaljevic was contemplating ambitious Objective Key Results (OKRs) for 2023, particularly for caregivers. Dr. Mihaljevic and his executive leadership team grappled with the latest pressing issues in their weekly team meeting. They had missed their caregivers targets two years in a row, but Dr. Mihaljevic still thought it was best to set stretch goals for 2023. As they thought about the need to attract and retain caregivers, they recognized how imperative it was to accelerate their digital journey. The executive team was now considering how to achieve this by leveraging technology and data to improve patient and caregiver experiences. It was not clear what 2023 would bring for the hospital, but Dr. Mihaljevic remained optimistic about the year ahead and delivering on Cleveland Clinic's four care priorities: patients, caregivers, organization, and community.

In the summer of 2023, Eduard ("Eddie") Croitoru, Vice President (VP) of ICL Group ("ICL") Corporate Initiatives, was reflecting on ICL's internal ideation program, the Business Innovation for Growth (BIG) Accelerator. When Raviv Zoller became the CEO of ICL in 2018, he recruited Croitoru, then his Chief of Staff, to help embed a culture of innovation throughout the company. He tasked Croitoru with addressing employee engagement and innovation challenges, which led to the creation of BIG. BIG enhanced ideation of employees (called "BIG Agents"), accelerated execution of ideas, and improved collaboration within the organization. Under Croitoru's leadership, BIG had evolved into a process where ICL employees from around the world contributed ideas, many of which would go on to be realized and funded as projects by senior management. Croitoru spent three years refining the program, expanding its reach from 3,500 to all 12,500 ICL employees in four new languages. To push the program forward, he anticipated two challenges ahead-continuing to scale BIG company-wide while combining technology with the human infrastructure needed to optimize the program's success, and fostering more breakthrough, "extra-corerestrial" (beyond the core business) ideas within BIG.

In August 2023, Raviv Zoller, CEO of ICL Group, discussed his upcoming business trip to St. Louis with Eduard Croitoru, VP of ICL Corporate Initiatives, to commemorate the construction of ICL's new $400 million advanced manufacturing facility. In preparation for the facility's launch, Zoller reflected on the transformation of an employee idea into a new and exciting business line for ICL-lithium iron phosphate (LFP) battery manufacturing. When he first became CEO of ICL in 2018, he initiated a cultural transformation and tasked Croitoru, his then-Chief of Staff, with launching a company-wide innovation program, the "Business Innovation for Growth" (BIG) Accelerator. BIG became a crucial part of ICL's internal innovation foundation. Simultaneously, Zoller focused on cultivating external innovation partnerships by building an ICL ecosystem, launching the company's agri-food tech startup hub (ICL Planet Startup Hub), collaborating with Israeli and non-Israeli startups, and exploring possibilities in emerging innovation domains. Zoller hoped that the corporate theme for 2023, "Year of Partnerships," would continue to inspire his colleagues to do the hard work of ecosystem-building for the "art of the possible," in years to come, even in the face of tough economic times.

It was December 10, 2020, and Ed Bastian, the Chief Executive Officer (CEO) of Delta Air Lines (Delta), had just finished a meeting with Joanne Smith, Executive Vice President and Chief People Officer, and Keyra Lynn Johnson, the Chief Diversity and Inclusion Officer. The objective of this meeting was to review Delta's first public communication about Bastian's decision to join the OneTen coalition, where he and 36 other CEOs committed to recruiting, hiring, training, and advancing 1 million Black Americans over the next ten years into family-sustaining jobs. For months, Bastian had been in continual dialogue with his colleagues about how to respond to the disproportionate impact of the COVID-19 pandemic on Black and Brown people and an increase in racially motivated violence, including the murder of George Floyd. Bastian had committed Delta to being the "Atlanta City Lead" of OneTen. Although Delta had been "bulldozed by the pandemic," he had signed onto OneTen with no hesitation. Smith and Johnson had raised many questions when first learning of OneTen, but they too had agreed that the initiative was consistent with Delta's own anti-discriminatory action plan. He agreed with his colleagues that Delta's approach to OneTen be strategic and sustainable. He recalled his response at the time: "I [don't] know what this will turn into," but "we have got to start somewhere."

In January 2023, Delta Air Lines (Delta) Chief Executive Officer (CEO) Ed Bastian and his team had just launched the third iteration of an internal skills-first apprenticeship program, designed to move frontline employees into "merit" positions in four job categories. The move to implement an apprenticeship program further advanced Delta's commitment to OneTen's "skills-first" strategy for Black talent. The DE&I and Talent teams launched the pilot program in March 2022 and the second iteration in July 2022. The program grew with each iteration, but the post-mortem of the third program revealed that Delta did not yet have the "bandwidth" to grow the program, and the program would require more leadership development and support for the managers and mentors of the apprentices. The team recognized that they had to figure out how to scale the program with some speed, but knew that change management would take a couple of years. Despite the challenges ahead, the skills-first apprenticeship program had only affirmed for Bastian that Delta was headed in the right direction, as they were better as a company when frontline employees graduated into different skills and opportunities and brought their knowledge of the business into corporate functions of the company. What, if anything, could they do to scale the program faster without sacrificing quality?

In February 2023, Delta Air Lines (Delta) Chief Executive Officer (CEO) Ed Bastian, celebrated the airline's OneTen partnership in a room full of Atlanta's prominent business leaders, educators, and public servants in Atlanta, at a OneTen/Delta Launch Event. To support their commitment to OneTen's strategy, Delta had designed and launched a skills-first apprenticeship program, and its IT department graduated its first cohort of the "Next Gen Academy," a skills-first IT development program. Delta had also been building relationships with key stakeholders, including talent developers and non-profit initiatives, to create a local OneTen talent ecosystem. However, Delta remained the only Atlanta company signed up with OneTen. As Atlanta's "OneTen City Lead," Bastian hoped that the OneTen launch event would encourage other companies to help build out a robust ecosystem for Black talent.

In 2018, Ana Owczarzak was appointed to lead Google Ads' new innovation and accelerator team - the Sales Acceleration and Innovation Labs (SAIL). The purpose of SAIL was to offer testing and incubation services for individuals within Google Ads who were developing new advertising products, services, and go-to-market strategies. When Ana began her new position, she inherited two programs that had been initiated in the core business but had stalled. After researching previous innovation endeavors within Google Ads, Ana and her team started establishing a team culture, procedures, methodology, and metrics to carry out rigorous and disciplined sales innovation across their globally dispersed team. Over the following two years, the SAIL team encountered and overcame numerous challenges related to vetting ideas, managing communication with internal and external stakeholders, adapting experiments with agility, and graduating programs into the core business. In 2020, SAIL received a $1 million budget and was expected to initiate two new innovation programs by Q3 2020. The SAIL team was in the process of developing a new idea-intake process when Ana was assigned to a six-month rotation in a new role. Soon after, COVID-19 began to upend economies across the globe, and some team members became concerned about SAIL's future. Prior to transitioning to her new position, Ana was determined that SAIL establish its intake process and had to select one of two proposals to implement.

In 2018, Ana Owczarzak was appointed to lead Google Ads' new innovation and accelerator team - the Sales Acceleration and Innovation Labs (SAIL). The purpose of SAIL was to offer testing and incubation services for individuals within Google Ads who were developing new advertising products, services, and go-to-market strategies. When Ana began her new position, she inherited two programs that had been initiated in the core business but had stalled. After researching previous innovation endeavors within Google Ads, Ana and her team started establishing a team culture, procedures, methodology, and metrics to carry out rigorous and disciplined sales innovation across their globally dispersed team. Over the following two years, the SAIL team encountered and overcame numerous challenges related to vetting ideas, managing communication with internal and external stakeholders, adapting experiments with agility, and graduating programs into the core business. In 2020, SAIL received a $1 million budget and was expected to initiate two new innovation programs by Q3 2020. The SAIL team was in the process of developing a new idea-intake process when Ana was assigned to a six-month rotation in a new role. Soon after, COVID-19 began to upend economies across the globe, and some team members became concerned about SAIL's future. Prior to transitioning to her new position, Ana was determined that SAIL establish its intake process and had to select one of two proposals to implement.

In January 2023, Raja Al Mazrouei became the Managing Director and Acting CEO of Etihad Credit Insurance (ECI) in Dubai, UAE. In her previous role as the Executive Vice President of the DIFC Fintech Hive, she successfully built and led an accelerator program for start-ups in the financial technology (fintech) sector in Dubai. The Fintech Hive has had successful partnerships with established banks like Emirates NBD and accelerated over 200 start-ups in the MENA region. Al Mazrouei and her team embraced recent technologies and evolved their business models to keep up with the global digital space. With Dubai's ambition to be one of the top ten metaverse economies by 2030, Al Mazrouei's last mandate as EVP of Fintech Hive was to strategize on how to deepen their partnerships and remain at the forefront of technology. She decided to focus on the metaverse with her long-standing partner, Emirates NBD. Although some questioned whether the metaverse would create value for those in the financial sector, this project kept Fintech Hive and Emirates NBD on the cutting edge. Together, they created a global accelerator program for metaverse start-ups to enhance customer experience, contributing to the country's agenda. It was clear to Al Mazrouei that building partnerships, like the one established with Emirates NBD, would continue to be critical for success in her new position. She was eager to collaborate with her new team and fulfill the country's ambitions by building the culture and capabilities required to embrace innovation and digital technology across the Dubai government and economy.

norbloc was founded in 2016 in Stockholm, Sweden, by Astyanax Kanakakis and his co-founders, Vitalii Demianets and Sam Saatchi. Kanakakis and Demianets got to work to address a key gap in the industry: Know Your Customer (KYC) data sharing. As the first distributed KYC utility in the world, norbloc focused on platforms that connected financial institutions and governments, allowing the auditable sharing of sensitive information with the consent of the owner. norbloc connected with Emirates NBD in 2017 as one of 12 start-up finalists in the first cohort of the Dubai International Financial Centre (DIFC)'s fintech accelerator, known as Fintech Hive (The Hive). After the formal program ended, Kanakakis and Emirates NBD's leadership joined forces to make a step-change in KYC. In February 2020, after over two years of negotiating legal agreements, conducting pilots, and reviewing the regulatory implications of the platform, Emirates NBD signed a production agreement with norbloc. After announcing a collaboration with UAE banking players to develop a UAE KYC Blockchain Consortium and scaling norbloc's internal operations, Kanakakis reflected on how these opportunities all started with the DIFC Fintech Hive accelerator program.

When Ajaypal (Ajay) Banga became the CEO of Mastercard in 2010, digital technologies were on the rise, and innovation needed to become a strategic imperative at the company. Banga tasked Garry Lyons, who had joined Mastercard through the 2009 acquisition of Orbiscom, with infusing innovation into Mastercard's culture. With a significant incremental investment, and free reign to spend it as he pleased, Lyons created Mastercard Labs-a global innovation lab network that became a catalytic force for change at the company. In 2018, Ken Moore, a former innovation leader at Citigroup, became Mastercard Labs' new leader. By then, Mastercard had made significant progress on its journey of cultural and digital transformation, but the company had to continue to think and act differently in order to compete and thrive in the fast-changing digital world. Moore's task was to evolve Mastercard Labs so that it could continue delivering value to Mastercard.

In late 2021, Mastercard CEO Michael Miebach and Chairman and former CEO Ajaypal "Ajay" Banga considered how Mastercard could best position itself for continued success in the years to come. Since Mastercard's initial public offering in 2006, the company had grown and transformed, driven in part by a core strategy of "Grow-Diversify-Build" and vision of a "World Beyond Cash." During Banga's recent tenure as CEO, Mastercard had invested in creating a strong culture, recruiting top talent, driving innovation, partnering with would-be competitors, and launching new services. Now, with Miebach at the helm as Mastercard's CEO, the payments landscape was experiencing increasing democratization of the banking system, the rise of blockchain and cryptocurrency, and increasing nationalism, among other shifts. Miebach and Banga needed to identify the most pressing threats and opportunities in the ever-evolving payments landscape and determine how to take advantage of them. As they looked ahead, they asked themselves: Was Mastercard well positioned for the next 10 years?

When Ajaypal (Ajay) Banga became the CEO of Mastercard in 2010, he shifted the company's competitive focus from card networks to cash itself. Mastercard's new vision of a "World Beyond Cash" distilled into a three-pronged framework: Grow the core business, Diversify customers and employees, and Build new businesses that reinforce Mastercard's core capabilities. With digital technologies on the rise, Banga knew that innovation would need to become a strategic imperative. Yet, in a 2010 survey, Mastercard's 7,000 employees ranked "innovation" as the 26th most important factor for the future of Mastercard in a list of 27. Banga tasked Garry Lyons, who had joined Mastercard through the 2009 acquisition of Orbiscom, with infusing innovation into Mastercard's culture. With a significant incremental investment, and free reign to spend it as he pleased, Lyons created Mastercard Labs-a global R&D network that became a catalytic force for change at the company. In December 2017, Lyons is stepping down from his role as Chief Innovation Officer and reflecting on the path ahead for Mastercard and its Labs.

When Ajaypal (Ajay) Banga became the CEO of Mastercard in 2010, he shifted the company's competitive focus from card networks to cash itself. Mastercard's new vision of a "World Beyond Cash" distilled into a three-pronged framework: Grow the core business, Diversify customers and employees, and Build new businesses that reinforce Mastercard's core capabilities. With digital technologies on the rise, Banga knew that innovation would need to become a strategic imperative. Yet, in a 2010 survey, Mastercard's 7,000 employees ranked "innovation" as the 26th most important factor for the future of Mastercard in a list of 27. Banga tasked Garry Lyons, who had joined Mastercard through the 2009 acquisition of Orbiscom, with infusing innovation into Mastercard's culture. With a significant incremental investment, and free reign to spend it as he pleased, Lyons created Mastercard Labs-a global R&D network that became a catalytic force for change at the company. In December 2017, Lyons is stepping down from his role as Chief Innovation Officer and reflecting on the path ahead for Mastercard and its Labs.

In 2006, the Cleveland Clinic and Mubadala Investment Company partnered with a bold ambition to deliver world class healthcare in the United Arab Emirates. In 2015, after nearly a decade of planning and construction, Cleveland Clinic Abu Dhabi opened its doors. By 2017, the hospital had proven it could deliver Cleveland Clinic-quality care 7,000 miles away from its main campus. Dr. Rakesh Suri, Chief of Staff at the time, became Cleveland Clinic Abu Dhabi's Chief Executive Officer; his mandate was to grow the hospital into one of the most innovative academic medical centers in the world, while marching toward financial sustainability. As a newer hospital, Cleveland Clinic Abu Dhabi endured its share of growing pains as it worked to cultivate a culture of innovation and take full advantage of its information technology and business intelligence capabilities. By 2019, there were so many innovation initiatives underway that the executive team was considering whether to implement a Priority Index to foster a more coordinated approach to innovation.

As COVID-19 began to take lives, destroy healthcare systems, and shut down economies across the globe, Dr. Rakesh Suri, Chief Executive Officer of Cleveland Clinic Abu Dhabi, and his executive team adapted their leadership to instill the new levels of agility and innovation required for the hospital to meet the demands of the pandemic. Collaboration across their local ecosystem and the broader Cleveland Clinic enterprise was paramount. In the midst of the pandemic, Dr. Suri confronted his toughest leadership challenge yet-having to lead the hospital from travel-related quarantine. Cleveland Clinic Abu Dhabi's business plan, staffing plan, supply procurement, budget, and key performance indicators (KPIs) had gone out the window. In addition, the U.A.E. government had restricted all travel to and from the U.A.E., so Cleveland Clinic Abu Dhabi had become the only center in the country for a range of emergency procedures. The executive team was now considering how to reformulate their performance scorecards to reflect how the hospital's mix of services would have to evolve as a result of the pandemic and its aftermath. Dr. Suri was due to discuss the new metrics with his team upon his return to the hospital from quarantine.

In 2006, the Cleveland Clinic and Mubadala Investment Company partnered with a bold ambition to deliver world class healthcare in the United Arab Emirates. In 2015, after nearly a decade of planning and construction, Cleveland Clinic Abu Dhabi opened its doors. By 2017, the hospital had proven it could deliver Cleveland Clinic-quality care 7,000 miles away from its main campus. Dr. Rakesh Suri, Chief of Staff at the time, became Cleveland Clinic Abu Dhabi's Chief Executive Officer; his mandate was to grow the hospital into one of the most innovative academic medical centers in the world, while marching toward financial sustainability. As a newer hospital, Cleveland Clinic Abu Dhabi endured its share of growing pains as it worked to cultivate a culture of innovation and take full advantage of its information technology and business intelligence capabilities. By 2019, there were so many innovation initiatives underway that the executive team was considering whether to implement a Priority Index to foster a more coordinated approach to innovation.

In 2016, Nicole M. Jones was hired to lead The Hangar, Delta Air Lines' new innovation center in Atlanta, Georgia. Delta's leadership had intended for The Hangar to catalyze a new approach to innovation at the company. After conducting three months of research on existing corporate innovation lab and accelerator models, Jones learned that most fail to scale impact across the core business. Drawing on her learnings, she established the values, strategy, and methodology for The Hangar to ensure just the opposite. Over the next three years, Jones and The Hangar's diverse team of design thinkers, technologists, and strategists brought together partners from Delta's core business and Atlanta's start-up and academic communities to execute a number of breakthrough innovations. After Delta's debut at the 2020 Consumer Electronics Show, Jones was invited to share her experience of setting up a corporate innovation lab with a consortium of innovation leaders. In preparation, she and her team are conducting a post-mortem of their three-year journey and reflecting on the lessons learned from one of their earliest projects-a Biometric Boarding Pass prototype they executed with CLEAR, a biometrics identity start-up.

Despite their embrace of agile methods, many firms striving to innovate are struggling to produce breakthrough ideas. A key culprit, according to the authors, is an outdated, inefficient approach to decision-making. Today's discovery-driven innovation processes involve an unprecedented number of choices, from which ideas to pursue to countless decisions about how to conduct experiments, what data to collect, and so on. But these choices are often made too slowly and informed by obsolete information and narrow perspectives. To align their decision-making processes with agile approaches, businesses need to include diverse (customer, local, data-informed, and outside) points of view; clarify decision rights; match the cadence of decisions to the pace of learning; and encourage candid conflict in service of a better experience for the end customer. Only then will all that rapid experimentation pay off. The article suggests best practices for these interventions, drawing on the story of the transformation at Pfizer's Global Clinical Supply, which would go on to play a critical role supporting the rapid development of the pharma giant's Covid vaccine.

This case is the third installment in a series about the 10-year cultural and digital transformation of Pfizer's Global Clinical Supply organization. In 2011, Michael Ku became Pfizer's Vice President of Global Clinical Supply (GCS) after the company had undergone three large-scale mergers and acquisitions. Ku and his new leadership team set out to build a proactive, end-to-end, digital and physical clinical supply chain. It took three years to get the cultural foundation in place, another three to overhaul GCS's legacy systems and develop its digital capabilities, and another three to instill a culture of innovation. By 2020, GCS had made significant progress toward becoming the agile, innovative organization necessary to support Pfizer's new strategy to focus exclusively on developing innovative medicines and vaccines. GCS was just beginning to pilot a new 24-hour, 5 day a week workforce model with a new team in Manila when COVID-19 struck. The organization found itself on the front lines having to supply Pfizer's vaccine candidate and investigational antiviral studies, while also ensuring continuity of clinical supply to hundreds of other trials across the globe. Because of the 10 years GCS had spent on their cultural and digital transformation, they were ready to rise to the challenge and help Pfizer deliver a COVID-19 vaccine in record time. In August 2021, Ku and his leadership team are preparing to make a number of major changes to GCS in preparation for a new era of scale, agility, and innovation.