Leading When Everyone Above You Is New

There is a particular kind of quiet that settles over an organization after a leadership change. The new CEO is meeting people. The new team above you is still learning names. Nobody has said anything is wrong, and yet everyone is paying a little more attention than usual.

Now imagine that change happens more than once in a short span. A new CEO, then a new chief operating officer, then a new head of your function. The people who knew your work, who trusted your judgment and who understood why you made the calls you made are gone. You are still here, doing the same job, for people who are meeting you for the first time.

That is the situation a growing number of healthcare leaders are in right now.

Turnover at the top is accelerating

Challenger, Gray & Christmas reported 116 hospital CEO exits through September 2026, up 22% from 95 in the same period last year. Becker's, tracking new appointments, described 2026 turnover as running hotter than 2025.

A CEO change rarely stays a single change. New chiefs bring in leaders they trust, reorganize reporting lines and reset priorities. For the senior leaders one level down, the people who actually run the hospitals, departments and service lines, the result can feel like starting a new job without having changed employers.

Their teams feel it too. Qualtrics' 2026 research found that 72% of employees had experienced significant organizational change in the past year. Engagement among people who went through a leadership change was 67%, well below the 78% among those whose main change was new technology. People adjust to new tools faster than they adjust to new bosses.

What gets lost in the handoff

The hardest part is not the new strategy. It is the loss of context. A new executive team sees results and org charts. It does not see the years of judgment behind them: why a program was built a certain way, which tradeoffs were already tried and which relationships keep a fragile unit running.

Without that context, capable leaders can be misread. Their caution looks like resistance. Their questions look like disloyalty. Meanwhile, their own teams are watching closely to see whether the leader they rely on still has standing, and whether it is safe to keep raising problems.

It is easy, in that position, to go quiet and wait to see how things settle. It is also the wrong move.

How to lead through it

Be the one who explains the history, briefly and without defending it. New executives need context, and most will welcome it if it arrives as useful information rather than nostalgia. Tell them what was tried, what worked and what you would do differently now.

Ask what they are trying to accomplish before you show what you have built. Understanding their priorities first lets you connect your work to them in their own terms. It also signals that you are there to help them succeed, not to protect territory.

Keep your team steady on purpose. Your people are reading you for signals. Tell them what you know, what you don't and what will not change for them this month. Qualtrics found intent to stay was 73% where employers listened more often, against 47% where listening fell away. During a transition, you are the listening.

Hold on to what you stand for. A new team may change many things. It cannot change the reasons you lead the way you do. Leaders who are clear about their own values come through transitions with their credibility intact, even when the specifics shift around them.

Treat it as a chance to reintroduce yourself. A new leadership team does not know your past mistakes either. That is an opening to show who you are now.

I wrote recently that your people can't follow a leader who can't see them. In a transition, that runs in both directions: new executives need to see the leaders below them, and those leaders need to make themselves seen. And as I described in The Strategy Is Announced in the Boardroom. It's Lived on the Night Shift., the leaders in the middle are the ones who turn a new direction into something the front line can live.

The steadiest leader in the room

When everyone above you is new, you may be the person who holds the most knowledge about how the organization really works. That is not a weakness to hide. It is the reason the transition can succeed.

The leaders who do well in these moments are not the ones who wait for the new team to understand them. They are the ones who help the new team understand the organization, and keep their own people steady while it happens.

Want to explore these ideas further? Learn more about my work on leadership, identity and conviction at www.theglennllopis.com.