The Trust Infrastructure Model: How one CEO proved that rebuilding trust, not just operations, determines whether your organization breaks or bends through crisis
Three CEOs in three years.
Providers leaving faster than you can recruit them.
A hundred sixty employees just trying to survive each day.
If this sounds familiar, you’re not alone. When an organizational crisis is diagnosed, many reach for the typical playbook: restructure departments, implement new systems, cut costs, hire consultants to optimize processes.
Then they wonder why nothing actually gets better.
Here’s what our research shows: 64% of turnaround efforts fail to produce sustained improvement. And after studying over 1,000 employees across industries, we now know why.
You’re trying to fix organizational performance without first rebuilding the trust infrastructure that makes performance possible.
Only 36% of organizations emerge from disruption with stronger trust. But those that do? They’re 6.5× more likely to have clear strategies for what comes next. They retain talent while competitors hemorrhage staff. They maintain reputation while others scramble to explain. And they sustain performance through volatility that breaks everyone else.
The Traditional Turnaround Playbook (And Why It Keeps Failing)
You’ve seen this movie before:
- New executive arrives with a 90-day plan
- Announces changes to “fix what’s broken”
- Focuses on efficiency metrics and cost reduction
- Implements changes quickly to look decisive
- Declares victory based on operational KPIs
This approach treats organizations like machines. Find the broken parts. Replace them. Turn the system back on.
But here’s what we keep learning the hard way: Organizations aren’t machines. They’re human systems held together by trust.
And when that trust is already fractured? Operational fixes alone won’t help. Years of instability, broken promises, and leaders who talked a good game but never followed through have done too much damage.
What you get instead: initiatives that employees resist, “change management” that feels manipulative, compliance without commitment. And six months later, you’re right back where you started.
A Different Blueprint: The Trust Infrastructure Model
After analyzing what separates the 36% who emerge stronger from the 64% who don’t, we’ve identified the pattern:
They build trust as infrastructure first, not as an outcome they hope will emerge later.
Think of it this way: You wouldn’t launch a product without the technical infrastructure to support it. You need servers, security systems, backup protocols. Try to skip that step, and everything crashes the moment real users show up.
Trust works the same way. It’s not the result of good operations. It’s the foundation that makes good operations possible.
Trust infrastructure has three elements that must be in place before you can successfully change operations:
1. Psychological Scaffolding
Your people need to feel safe raising concerns, questioning decisions, and admitting when they don’t know something, without fear that it’ll cost them.
Our research shows this is the most fragile element during crisis. It’s also the most essential. You can’t solve problems you can’t talk about honestly.
How to measure it: Do employees openly disagree with leadership decisions? And when they do, does it lead to better solutions, or do they get punished?
2. Behavioral Consistency
This is where most turnarounds fail. Leaders make promises about “putting people first” or “valuing transparency,” then their first decision sacrifices those values for convenience.
Your employees have heard the speeches before. They’re not listening to your words anymore. They’re watching your behavior, especially when following through is expensive or inconvenient.
How to measure it: Can you point to a financially “risky” decision you made that prioritized your stated values over short-term efficiency? If not, you don’t have behavioral consistency. You have marketing copy.
3. Systemic Listening Capability
This isn’t about engagement surveys that no one believes you’ll act on. It’s about building organizational mechanisms that ensure the people closest to problems actually inform the solutions.
Because here’s the reality: Your frontline staff see what’s really happening. Your managers in the field know which processes are broken. Your providers understand what patients actually need.
Without listening infrastructure, you’re making strategic decisions with half the information you need.
How to measure it: Can you trace recent strategic decisions back to specific employee insights? Do your frontline staff see their input reflected in organizational changes? Or are decisions still happening in conference rooms based on what leaders think they know?
What This Looks Like in Practice
When Tammy Green became CEO of Alaska’s largest community health center in 2015, she walked into exactly the crisis we’ve been describing.
Three CEOs in three years. Providers fleeing. One hundred sixty employees in survival mode. Her board’s message was clear: Fix this. Fast.
🎧 LISTEN: Hear Tammy’s Full Story
Want to hear the complete conversation? Listen to Tammy Green’s episode on Courage to Advance where she shares the specific tactics she used during her listening tour, her decision-making process during COVID, and her advice for mid-level leaders who want to lead differently. [Listen to Episode →]
Here’s what she did that seemed counterintuitive:
She admitted she didn’t know what was broken.
Instead of showing up with a 90-day plan, she spent her first months building trust infrastructure. She met with every provider. Talked with leaders at every level. Hosted town halls to hear directly from staff.
Then she made the move that tested everyone’s trust in her judgment.
She reduced provider working hours and kept their compensation the same.
The business case was solid. Healthcare industry research shows physician turnover can cost organizations up to $1M per provider in recruiting, onboarding, and lost productivity, and she was hemorrhaging staff. But the deeper play was behavioral consistency: proving through a costly decision that the organization actually valued provider wellbeing over productivity.
It took persistence to get board approval. The model launched in January 2020.
Three months later, COVID-19 hit.
While healthcare organizations across the country lost staff by the hundreds, Anchorage Neighborhood Health Center retained its providers. A year into the pandemic, providers were telling Tammy: “If we hadn’t had that model, I don’t think I would have stayed.”
What This Means for Your Organization
Tammy’s approach challenges everything we’re taught about turnaround leadership. You’re supposed to be decisive. Show quick wins. Demonstrate you’re in control.
But our research proves what she discovered:
Organizations with strong trust infrastructure are 6.5× more likely to have clear strategies for navigating future disruptions.
Not because they face fewer challenges. Because trust infrastructure gives them:
- Access to frontline reality that prevents expensive mistakes
- Real commitment instead of performative compliance
- Resilience to absorb setbacks without the culture fracturing
- Capacity to maintain performance when everything feels uncertain
Three Things You Can Do Starting Tomorrow
1. Resist the Pressure for Quick Wins
Your board wants to see results. Your investors want proof you’re in control. Everyone’s pushing you to announce changes fast.
Here’s what we’ve learned: Transformation without trust infrastructure produces compliance, not commitment. And compliance doesn’t survive the first real setback.
Invest your first 3-6 months building psychological scaffolding and listening capability. Yes, it feels slow. But it’s the only way to build change that lasts.
2. Find Your Costly Signal
In organizations with broken trust, people don’t believe your communications anymore. They’ve heard the promises before.
What they’re watching for are costly signals: decisions that sacrifice short-term efficiency to prove your values through action.
Ask yourself: What’s the most financially uncomfortable decision you could make that would demonstrate genuine commitment to what you say you care about?
That’s your trust-building opportunity.
3. Audit Your Listening Systems
This one’s uncomfortable, but here’s your diagnostic:
Can you name three specific employee insights that changed a recent strategic decision?
Not “we gathered input.” Not “we ran a survey.” Can you point to actual frontline insights that shaped actual decisions?
If you can’t, you don’t have listening infrastructure. You have theater. And your people know the difference.
The Difference Between Breaking and Bending
Years after Tammy left ANHC, a physician who’d recently returned asked leadership: “How have you maintained this culture when so many places haven’t?”
Their answer: “We’re still following what Tammy built.”
That’s the difference between operational fixes and trust infrastructure. Operational improvements depend on individual leaders and fade when they leave. Trust infrastructure becomes organizational capability.
For healthcare leaders navigating workforce crises, AI transformation, and escalating patient expectations, the question isn’t whether you’ll face disruption.
The question is: Are you building trust infrastructure that lets your organization bend without breaking?
Ready to Build Trust Infrastructure?
Download the Complete Research
Get the full SparkEffect Trust Study with detailed breakdowns by industry, organization size, and leadership level. [Research link]
Hear Tammy’s Full Story
Listen to the complete Courage to Advance conversation, including the specific tactics Tammy used to build listening capability, her decision-making framework during COVID, and her advice for mid-level leaders who want to build trust infrastructure before they have executive authority. [Podcast link]
Work with SparkEffect
If your organization is facing the kind of crisis Tammy inherited, or you want to build trust infrastructure before crisis hits, we can help. Schedule a conversation to explore how: [Contact link]
About SparkEffect
SparkEffect helps organizations build trust that bends without breaking. Our Trust Performance Index and consulting services give leadership teams the tools to diagnose trust gaps and build the infrastructure required for lasting transformation.
The Courage to Advance podcast features leaders building the organizations they wish existed, proving that business doesn’t have to be dehumanizing.
