Delivering cash flow results

Client need

A global professional services firm delivering risk advisory and insurance solutions to companies, institutions, and individuals was undergoing a strategic transformation to accelerate growth, increase operational efficiency, and prepare for the future. To succeed, this transformation would require investments to streamline processes and platforms, along with a shift in how people work. To improve operations, the organization had already segmented the business and reduced layers, attempting to drive simplicity, transparency, and distributed decision making across the firm. However, adapting to the new operating model would require systemic change.

The organization’s chief human resources officer (CHRO) engaged BTS to help jumpstart the strategic transformation. BTS collaborated with the organization to create a program that would align the broader leadership team, comprised of everyone below the executive committee, to this transformation. The goals of the program was to help leaders translate the new strategy into something meaningful and actionable at their departmental level, and also to catalyze the broader leadership team’s strategy execution.

BTS created a highly contextualized business simulation, including presentations, facilitated discussions, and focused training, all of which were customized for the organization.

Solution

BTS began the design process by interviewing 18 senior executives across the organization. These senior executives included the CEO, COO, CHRO, and presidents of regional divisions. They were selected to provide a broad representation of and perspective on the organization. The goal of this research was to define two broad topic areas:

The Business – understanding the organization's business model, the markets in which it operates, and the unique challenges and opportunities it faces.

The People and Leadership – understanding the behavioral and mindset shifts the organization wanted to see in its people, leadership, and culture.

Following the interviews with top-level executives, BTS conducted eight additional interviews with mid-level executives. This allowed for insight into specific business units and challenges referenced in the previous set of interviews.

Interview responses were distilled into a list of themes and organized into an “impact map.” The map defined the business impact envisioned by the organization and linked it to the knowledge, skills, behaviors, and mindsets the organization sought to foster.

The organization’s steering committee reviewed the impact map with the goal of gaining alignment on their key challenges, desired behavioral shifts, and key business results.

To achieve these behavioral shifts, the company collaborated with BTS to design a business simulation modeled after the company’s business. The simulation created a risk-free, engaging, and fun way to achieve learning objectives, and was composed of three rounds experienced over a two-day program. Each round had a theme with distinct learning points.

Round one was designed for leaders to learn how to optimize today’s business in service of driving long-term profitable growth. This involved gaining an understanding of the business landscape, as well as familiarity with the decisions and trade-offs that such growth requires. Round Two focused on the client, becoming a strategic advisor to clients, and enhancing leaders’ abilities to execute. Round Three prepared leaders for a future of making long-term investments in order to develop a sustainable competitive advantage.

Leaders were divided into teams of five at the beginning of the program. Each team included participants from a diverse array of functional and geographic sections of the organization. The experience was composed of seven main elements:

1. Pre-Work and Introduction – Participants received a pre-start date reading assignment: a detailed case study featuring a fictitious company in a fictitious market environment. The company and market environment described were very similar to the organization and its environment. BTS facilitators kicked off the program by making a case for change, highlighting shifts in the market environment. Participants then broke off into pairs to reflect on those shifts and discuss what the changes meant for them as leaders. Then, BTS facilitators led a discussion wherein participants shared their reflections with the entire group.
2. Strategy Session – In teams of five, leaders came up with a strategy for how they would lead the simulated company.
3. Running the company - In their teams of five, leaders ran their simulated company by making over fifty critical decisions. Each team had their own designated breakout room where they would debate their decisions and enter them into a live digital-simulation platform. Periodically, teams would receive a “Wobbler,” which was an unexpected event that they had to respond to in real time (usually a competitor action, a client issue, or a talent issue). Their decisions impacted their KPIs and market share for each market and segment. Participants “ran the company” for three rounds, which represented a three-year timeframe.
4. Know-Hows – After each round of running the company, participants came back to the main room for a teach-piece or “know-how,” which were skill or knowledge gaps identified as needing to be addressed. After Round One, the topic was “effective decision-making.” For Round Two, it was “future-proofing.” Round Three’s topic was “feedback culture.”
5. Debriefs — With the entire group present, BTS facilitators reviewed the results for each team, linking the decisions that teams made to their performance. Each of the three rounds had a theme, and facilitators emphasized key takeaways related to these themes. At the end of each debrief, facilitators revealed where teams ranked against each other. Participants also received a report showing their team’s annual financial performance, along with another that summarized the competing teams’ performance.
6. Application Session – During these sessions, participants committed to post-program actions, recording them using an electronic tool. Following the completion of the program, participants received follow-up reminders of their commitments at a scheduled cadence.
7. Reflection Sessions — Solo reflections and team reflections were interspersed throughout the two-day program. During the solo reflections, which followed the know-how sessions and debriefs, participants reflected on what they had learned. After the “running the business” segments, participants reflected on their team dynamics. At the end of each day, BTS facilitated short discussions during which participants would share their reflections with the larger group.

To date, ten cohorts have gone through the program since its launch. Each cohort had 25 participants, all just below the C-suite.

At least ten more cohorts, each with a similar number of participants, plan to attend the program next year.

Results

Overall, the program was a great success. The CEO of the Italy division of the company concluded that the BTS program was “much better than any other session of its kind.” The CHRO and the executive team were enamored, and continued to communicate this in subsequent discussions. The organization also extended the original agreement to roll out even more programs.

In the application session section of the program, participants were asked to choose and commit to post-program actions related to on-the-job behaviors. Most frequently, they committed to actions around making informed decisions, prioritizing growth opportunities, and focusing on client relationships. These actions were aligned with the changes that the organization set out to make:

72% of participants stated or planned to have “tough conversations with colleagues about performance and/or with leaders about the business.”

74% of participants stated or planned to “focus on the broader client relationship and anywhere else you can solve risk for the client and align our value proposition.”

54% of participants stated or planned to “prioritize talent development, grow from within, and recruit externally when appropriate.”

Participant testimonials

“I thought this was the best training I’ve ever done. The learning from our team interactions was very illuminating. I loved the risk storming / pre-mortem methodology.”

“It was very useful for me, very genuine, and corresponded with reality. It was entertaining as well.”

“The simulation exercise was an outstanding learning tool. I would be very disappointed never to experience a similar exercise again AND would recommend that our company regularly use the software to measure learning.”

“The simulator tool was very comprehensive and intuitive. Enjoyed the cadence of mixing up sim time and organizational behavior group sessions in different teams. The feedback session was very useful. Excellent team of facilitators.”

Client need

A leading provider of home health and hospice care in the United States consistently delivers high quality care but strives to be the premiere solution for patients across the country to age in place. To meet this ambitious goal, the organisation identified the need to develop their people, providing them with the leadership and business skills necessary to drive results and continue providing top-of-the-line care.

At the company, often the best physical therapists, nurses, and occupational therapists are selected to lead care centres, shifting roles from a caregiver to a business leader. Care centre leaders report to regional heads and are responsible for managing their care centers’ P&L, holding other caregivers accountable, and growing the business. These major responsibilities can be challenging for many new care centre leaders. While they have excelled as caregivers, their background is not in business.

Solution

To mediate this issue, the organisation engaged with BTS to help care centre leaders gain the skills required for their role and familiarise themselves with the tools that will enable their success. Through a series of intensive interviews, BTS created a customised program to fit the healthcare company’s specific needs.

The program was a two-day offsite, during which participants embark on an experiential learning journey to practice their business acumen and leadership skills. In addition to the 25 care centre leaders in attendance, there are also a handful of regional heads who participate, making a total of 30 participants, with several senior observers overseeing the program. The goal of the program is to reach all care centre leaders within the organisation, equipping them with the skills and tools to successfully lead and grow the business.

Before the program kicked off, participants were asked to read a short article on Liz Wiseman’s Multipliers, which prepares them for their leadership learning journey.

On the first day of the program, leaders immediately jump into a customised business simulation, running a care centre in a simulated environment. Both new and tenured leaders test the behaviours and skills required for the job in a risk-free environment where their mistakes will not affect the business. In this first round of the simulation, leaders focused on optimising their caregiver mix and utilisation levels, ensuring resources are adequately meeting patient needs and providing the best care profitably. This round took half of a day, but simulated an entire quarter of running a care centre. Participants later received feedback on their performance in the simulation, learning how their decisions impacted their simulated business. All of the results are contextualised in the company’s service-value chain so that participants can understand how both their business and leadership choices make a measurable difference.

In the afternoon, leaders were exposed to the BTS Multipliers Framework, based on the concepts from Liz Wiseman’s Multipliers, which describes how leaders can encourage those around them to reach their full potential by tapping into their teams’ natural talents and 'multiplying' their impact. Leaders were also exposed to 'accidental diminishers', which described well-intentioned behaviours that accidentally inhibit people’s ability to make mistakes and subsequently learn and grow. Participants engaged with these concepts through a moments-based playbook, learning What Great Looks Like and What Not So Great Looks Like in the most pivotal moments they encounter in their role.

For the remainder of the day and in the following morning, leaders were divided into two cohorts, one of care centre leaders and the other of regional heads, to respectively practice giving feedback and coaching skills. The division of these two cohorts allowed for more candid conversations and targeted learning opportunities, as they discussed existing challenges they face in their role and potential ways forward.

In the second round of the simulation, participants had the opportunity to run their care centre again, and this time are better equipped for success. The results of this round allowed participants to see how applying their learnings could enhance business performance, and what mistakes to avoid when applying their skills to their care centre in the real world.

At the close of the two-day program, the company’s Chief Operating Officer and President presented the company’s future outlook, inspiring participants to apply their learnings in support of the company’s ambitious growth goals.

Results

Since the program’s inception, net income from operations (NIFO) has improved by roughly $10M, fostering a business-focused, feedback and coaching culture through improved alignment. Based on post-program interviews, the organisation estimates that at least 30% of the $10M in additional NIFO was due to the training initiative.

In addition, the program received world-class results with an average NPS of 9.2. Over 350 care centre leaders and regional heads have been through the program, with more than half (63%) reporting knowledgetransfer and nearly all (97%) participants reporting behaviour change.

The healthcare provider is still on its leadership journey, but the results so far prove the program provides significant impact on the skill level and tool application for leaders, giving them the capabilities they need to successfully run the business while continuing to provide the care that their patients deserve.

“I would definitely recommend this experience to my colleagues. Information shared on giving feedback both positive and negative will be a game changer for this organisation.”

“I learned more about my leadership abilities and ways to improve it or correct it than any other meeting I have attended”.

“This conference brought to light more of what I have been doing ‘wrong’ but certainly opened my eyes to what I can do better to assist my care centre in future growth. Thank you!”

Client need

A leading telecommunications organization in the Middle East had long partnered with BTS on strategy implementation and business acumen-building initiatives. Two years into the partnership, the organization embarked on a new strategic direction: providing digital services such as fintech, on-demand video, IoT enablement, analytics, and cybersecurity. To bring this transformation to life, the organization’s mid-level managers needed to shift existing mindsets and behaviors and develop the requisite digital knowledge.

To execute key strategic objectives outlined in the new strategy, the organization and BTS co-created a digital excellence program that combined the organization’s existing curricula on IoT with BTS’s expertise in AI- and data-driven decision-making. The organization had already embarked on two training initiatives: the knowledge transfer program, which fostered a culture of knowledge sharing and collaboration by tapping into the organization’s collective intellectual capital, and the specialty development program, which sought to position employees as trusted digital advisors by cultivating specializations according to industry trends. Together, the organization and BTS incorporated both initiatives into a single, streamlined digital learning journey.  

Solution

To reach both target audiences, executives (general managers and vice presidents) and mid-level leaders (section managers and directors) attended specifically-designed versions of the digital excellence program to address each group’s specific needs.  

Busy executives experienced an abbreviated version of the journey, while mid-level leaders went through a longer program, which included an additional day of AI training and an additional two days of data-driven decision-making training. For the AI component of the program, BTS facilitators built a simulation that leveraged BTS IP on the topic. For the data-driven decision-making portion, BTS built a big data simulation with input from the organization’s senior data scientists.

The program is comprised of six modules, each of which was carefully designed to address specific technologies relevant to the organization’s growth trajectory. As a result of the experience, people would become better equipped to drive innovation, adopt emerging technologies, and lead their teams towards the organization’s strategic goals.

• Module 1, Data-driven decision-making: A two-day, BTS-led experience to help leaders understand how to frame business problems like data science problems in order to derive strategic insight from the organization’s big data.
• Module 2, Innovation leaders lab: A one-day experience equipping leaders to create an environment in which innovation can flourish.
• Module 3, Artificial Intelligence for business growth: A two-day, BTS-led experience about capitalizing on artificial intelligence to drive business growth.
• Module 4, Master classes: Two-day sessions featuring the organization’s internal experts on exploiting cyber security, 5G, and cloud technologies.  
• Module 5, Emerging technologies: A four-day, joint-facilitation effort covering IoT, smart cities, and robotics.  
• Module 6, Digital excellence symposium: A daylong set of internal expert-led knowledge sharing sessions featuring data visualization, drones, and other emerging technologies.

Results

To date, the initiative has reached eight cohorts of leaders. 87.6 percent of those leaders reported that they would recommend the program to a colleague. Given the program’s success so far in transforming the traditional telecommunications organization into a digital services provider, the organization plans to run many more cohorts in the future. Overall, the experience has catalyzed the organization’s continued growth by empowering its middle management to navigate the digital landscape with confidence.

Client challenge

Wellstar Health System, one of Georgia’s largest healthcare systems, had already invested heavily in leadership development for senior leaders. But as the organization navigated rapid growth, a major acquisition, and the demands of a shifting healthcare landscape, it became clear that the greatest leadership challenges were happening at the front and midline.

“Some of the greatest leader challenges are really at the front and midline levels… we’ve invested heavily in leadership development, putting more emphasis on our front line and mid-level leadership in terms of outcomes, said Laura Dannels, Chief Talent Officer at the time.

We’re not an organization who believes in just investing in high performers… you’ve got to invest in your entire workforce.”

Wellstar partnered with Sounding Board to bring a more scalable, flexible coaching solution to leaders across the organization.

The solution

Partnering with Sounding Board, Wellstar designed a scalable, personalized coaching program to extend leadership development across the organization while maintaining the quality of one-on-one coaching.

A proprietary 360 assessment, aligned to Wellstar’s leadership behaviors, served as the foundation for each coaching engagement. This ensured development was directly tied to how leaders show up and lead in practice.

“We really wanted to ground the coaching to a framework that matters to our organization,” said Garry Gross, Executive Director of Leadership Development. ‍

“Helping our leaders create an environment where our mission, vision, and values come to life was paramount.”

Program goals:

• Develop leadership capabilities aligned to Wellstar’s mission, vision, and values
• Deliver personalized, relevant development for leaders at all levels
• Strengthen the leadership bench and support succession planning
• Foster a culture of innovation, learning, and engagement

Program overview:

• Personalized, one-on-one coaching for leaders at all levels
• Capability development aligned to Wellstar’s values
  • Serve with Compassion → Builds relationships
  • Pursue Excellence → Drives results, leads teams, and plans strategically
  • Honor Every Voice → Fosters inclusion and respect for differences
• Scalable delivery across frontline, mid-level, and clinical leaders
• Digital tools to track goals, capture insights, and measure progress

This approach made it possible to deliver consistent, high-quality coaching across roles and locations while keeping development relevant to each leader’s day-to-day work.

Results

As the program unfolded, Wellstar began to see a shift in how frontline and mid-level leaders showed up across the organization. Leaders in these critical roles had more consistent support navigating day-to-day challenges, and managers gained better visibility into how their teams were developing. Coaching became a more practical, embedded part of how Wellstar supports leaders in a complex healthcare environment.

Higher engagement and satisfaction

• 96% of participants said the coaching experience was worth the investment
• 99% said they could immediately apply what they learned to their day-to-day work

Measurable leadership growth

Participants reported double-digit growth across leadership capabilities including:

• Executive presence (+16%)
• Organizational collaboration (+14%)
• Strategic thinking (+13%)
• Time management and prioritization (+13%)
• Communication (+11%)

Stronger retention and mobility

• Coached leaders achieved a 90% one-year retention rate
• Retention for coached leaders was 31% higher than non-coached peers
• 3% of participants were promoted into new roles, exceeding organizational goals and industry benchmarks

Learn more about Wellstar’s leadership coaching journey with Sounding Board in this feature in Becker’s Hospital Review.

Client need

For a 175-year-old technology company, competitive advantage isn’t just built on technical innovation: it’s built on leaders who know how to get the best thinking from every person around them. That culture of drawing out ideas, developing people, and driving innovation through engaged teams had been a defining feature of the organization for generations. And it depended on having the right infrastructure to keep developing frontline leaders at scale.

In 2020, that infrastructure was disrupted. The COVID-19 pandemic forced the organization to pivot its in-person development to virtual almost overnight, risking the erosion of frontline leadership capability while simultaneously needing to navigate the broader shocks of the pandemic: supply chain volatility, shifting materials costs, and a workforce managing profound uncertainty.  

Stalling frontline leadership development meant risking productivity, employee engagement, talent retention, job performance, and downstream impacts on quality and operating margin, at a moment when the organization could least afford it.

The question now was how to reimagine frontline leader development to equip thousands of global leaders to continue supporting their teams through disruption, and to ensure the next generation of managers could help their people do their best work under any conditions.

Solution

The client partnered with BTS to reimagine frontline leader development from the ground up, equipping leaders globally with the practical skills, tools, and mindset shifts needed to support their teams in doing great, innovative work.

The partnership began in 2019, and over five years has reached over 1,600 frontline leaders capturing 700+ documented behavior change actions. In 2022, BTS collaborated with the organization to refresh the program to reflect their evolving strategy and develop a sharper focus on supporting a culture of continuous improvement and innovation with coaching and feedback.  

The blended program experience combined the following elements:

• Immersive leadership simulations: Scenario-based experiences placing leaders in realistic situations, surfacing Multiplier and Diminisher tendencies in real time and making the learning immediately personal and actionable

• Multipliers and Diminishers framework: A structured exploration of how leaders either amplify or diminish the intelligence of those around them, including specific “experiments” leaders could use to better understand their own leadership approaches

• Custom leadership frameworks: Including a structured, step-by-step process for having significant feedback conversations, a tool to understand and flex to communication preferences, and a coaching approach designed to help leaders guide team members toward their own solutions, building capability and long-term ownership.

• Structured application sessions — on-the-job practice components designed to bridge the gap between the program experience and day-to-day behavior, giving participants specific frameworks to apply immediately with their teams

• Peer networking and breakout groups — cohort-based learning that participants identified as a standout feature, both for deepening the learning and for building cross-functional relationships that extended beyond the program

• A commitment-capture platform integrated into the program to log participant actions and reinforce behavior change after the program ended; over 670 participant actions were captured across the program’s delivery

Throughout the program, leaders examined the impact of their own behaviors, recognizing where they were unintentionally diminishing their teams, and built new habits around challenging, creating space for mistakes and learning, listening, questioning, giving developmental feedback, and creating ownership. The feedback model gave participants a practical process for the positive and constructive conversations that actually change performance.

Results

More than 1,600 frontline leaders and individual contributors have participated in the program—the population closest to daily execution, quality, and operations. A recent impact study told a clear story about the effects of the program across participants:  

100% of participants reported actively applying what they learned. 59% reported producing significant, measurable business impact, with concrete evidence to describe it.

The results weren’t theoretical. One engineering leader restructured how his team developed project plans, creating space for debate and ownership instead of coming in with the answer. His team exceeded their quality target by 10 percentage points and accelerated the project timeline by +4 months.

One production leader used the feedback model to coach a struggling supervisor and cascade the process across his entire leadership layer. His unit reached #1 performance in its division, improving a key quality KPI by more than 18% year-over-year. A department head with over a decade in leadership set new production records after learning to flex his communication style and draw out quieter team members. And a development lab supervisor used the program to clarify her leadership identity, earn a promotion, and coach her direct report to one as well.

The study also confirmed that when managers actively supported participants post-program, the likelihood of significant business impact increased substantially, shaping the organization’s next phase of reinforcement and cohort follow-up.

For an organization whose competitive advantage rests on the innovation and intelligence of its people, the program gave its leaders something technical training rarely delivers: the confidence, the tools, and the self-awareness to make everyone around them better.

Testimonials

“The program gave me greater confidence to try new things as a leader. It helped me realize what I do and what I don’t do.”  - HR Leader

“The skills I learned in the training helped me be more efficient. It helped me do the right thing, right away.” - Production Manager

“Feedback is very important to create a positive environment; and how to [give] feedback is a specific skill I learned from this training and how to share constructive feedback.” - Production Leader

Client need

A large U.S.-based health insurance organization operating at the center of a complex national ecosystem had already made a serious investment in enterprise AI. Leadership was not experimenting at the edges. They were leaning in.

Capability and commitment existed across the organization, but unevenly. Some teams were already pushing boundaries. Others hadn't yet found their footing. Most of the gains had come in personal productivity. Valuable, but the core work itself had not yet fundamentally changed. The opportunity was to go deeper, to move from AI-assisted individuals to AI-reinvented workflows.

Across the health insurance landscape, pressure was intensifying. Medicaid and government program contracts were becoming more competitive. Decision cycles were faster and more analytics-driven. Clinical evidence was evolving rapidly. Regulatory scrutiny was high. Security risks were constant. AI was no longer a future conversation. It was a present expectation.

Inside the organization, world-class experts were still constrained by manual processes.

Specialized teams were synthesizing large volumes of complex, fast-moving information, working to keep pace with an environment where the inputs never stopped changing. The work required deep expertise and judgment, and it also demanded repetitive processing that consumed days when it needed to take hours.

Other teams faced pressure where speed and precision directly influenced competitive outcomes. Manual approaches were creating lag at exactly the moments when faster insight mattered most.

Across functions, the pattern was consistent. Highly trained professionals were spending valuable time on low-leverage tasks, stitching together data, transforming files, and correlating inputs that AI could handle.

Leadership understood that AI licenses alone would not create advantage. To compete in an increasingly analytics-driven insurance environment, expertise had to scale. Insight had to move faster. Teams needed to reinvent how core work happened.

Solution

BTS partnered with the organization to move from AI access to AI application.

Through a series of focused design sprints, intact teams worked on their highest-value workflows using our GROUNDING → EXPERIMENT → BUILD → AMPLIFY methodology. The structure was simple and disciplined. Set context. Experiment quickly. Build against real work. Create a path to scale.

Participants brought their actual work into the room. Analytical frameworks. Competitive and operational documents. Risk and intelligence inputs. Data pipelines.

No generic demos. No abstract hypotheticals.

The turning point came when AI began working on their actual content.

Research syntheses that previously took days began structuring themselves in minutes. Competitive analysis that once required manual review surfaced patterns instantly. Data transformation workflows streamlined in real time.

Skepticism shifted to possibility.

We positioned AI as augmentation, not replacement. In a sector defined by professional expertise and accountability, that framing was critical. The goal was to elevate expert judgment, not automate it away.

Some teams left with working prototypes. Others left with detailed blueprints aligned to enterprise privacy and security requirements. Another team took away a re-prioritized set of additional tools to incorporate into a HIPAA-compliant environment. Every team left with a redesigned workflow.

Results

In five days, more than 100 leaders advanced 30 priority use cases tied directly to operational performance and competitive growth.

Early outcomes included:

• Significant reduction in manual research synthesis and data preparation
• Faster, more structured competitive intelligence to support high-stakes decisions
• Clear implementation pathways aligned to security and regulatory constraints
• A scalable model for continued AI-enabled workflow reinvention

Just as important was the mindset shift.

Participants stopped viewing AI as a tool sitting outside their work and began treating it as embedded infrastructure for how work gets done.

“This showed immediate relevance to our work.”

“Now I understand what’s actually possible for my team.”

“We just accomplished in two hours what used to take us two months.”

In a U.S. health insurance market where insight, speed, and precision directly influence who wins and who grows, the organization moved decisively from AI access to AI advantage.

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