The Real Reason Your Decisions Are Stalling

Jeri Garner
May 6
3 min read

Leadership & Operations · 4 min read

It's not a capability problem. It's a clarity problem — and it only gets harder when you add AI to the mix.

LEV

LEV Advisory GroupMay 2026 · Healthcare Leadership

If I walked into your organization tomorrow, I wouldn't start by looking at your tech stack. I wouldn't ask to see your org chart or sit in on your leadership meeting.

I'd watch who flinches before they make a decision.

Because that flinch — that slight pause before someone moves forward — is almost always where your real problem lives.

The gap nobody talks about

On the surface, decisions are happening. Things move. Orders get placed. Plans get documented. But when you slow it down and really look at it, there's usually a gap between people contributing to a decision and people actually owning one.

It's not that your people don't know what to do. It's that nobody clearly told them they're allowed to do it.

So they double-check. They wait for confirmation that never formally comes. They move the work forward — but hold the decision hostage.

"The workflow isn't just about getting to the next step. It's about managing uncertainty around who owns it."

You start to see it in small ways. Someone loops in a senior leader on something that shouldn't need escalation. A decision gets made — but then quietly revisited. Meetings end without a clear owner. And over time, that creates hesitation at every level of the organization.

What happens when you add AI to unclear ownership

This is where things get interesting — and where most organizations underestimate the challenge.

When you layer AI into a workflow where decision ownership is already murky, you don't solve the problem. You accelerate it. Now it's not just people hesitating. It's people hesitating about what a system suggested.

And when something doesn't feel right, the question isn't just "what should we do?" It becomes: "who owns this call?"

If no one can answer that clearly, no one wants to be the final decision point. So the work keeps moving. The decision doesn't.

This isn't a capability issue

Most organizations that struggle with decision-making don't have a knowledge problem or a talent problem. They have a clarity problem.

The people sitting in those roles are capable. They know the work. But when the lines of authority are blurry — especially in complex, matrixed healthcare environments — even the most capable people will hedge, escalate, or defer.

Adding more decision support tools, dashboards, or AI overlays doesn't fix that. It adds more inputs to an already unclear process.

What fixes it is knowing who owns which decisions — and making sure they know it too.

Where we start

When we work with an organization at LEV Advisory Group, this is almost always where we begin. Not with the tools. Not with the timeline. With a simple question: who owns this — and do they know it?

When ownership is clear, decisions move. When it's not, everything starts to stall around it. And once you see that pattern, you can't unsee it.