The problem starts after approval


Run the Room

The gap between "endorsed" and "adopted"

Ever been to that meeting?

A group of thoughtful people comes together to wrestle with an important problem. They produce something careful, well-reasoned—often elegant. The document circulates. It is praised. It is endorsed.

And then—very often—nothing much happens.

I know this pattern because I lived it early in my career. I thought if we could just get the right people to agree, adoption would follow. It didn't.

What actually moves institutions isn't consensus. It's design.

Specifically: making the new practice easier to adopt than the old one is to keep.

That's the gap between endorsed and adopted. And it's almost never about the quality of the idea.

Over the next five weeks, I'm going to walk you through exactly how I close that gap — a framework I call D-R-I-VE: The Uptake Engine. Five phases, each with a specific job. Skip one and the whole thing stalls.

Next week: why most standards fail before they're even written.

Try this:

Think of a standard or initiative you're currently pushing.

Ask yourself : do you have endorsement, or do you have adoption?

If you can't point to a changed SOP, a budget line, a requirement — you have the first one.

🌿 The gap between endorsed & adopted is a design problem. Yours to solve.


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Run the Room

Get in the room. Run it. Change what happens when you leave. That's the work I do with senior leaders moving standards from concept to institutional adoption. My work has been featured in The New York Times, TIME, The Lancet, and Foreign Policy. Each Saturday, one short note on making it easy to move decisions that matter—three minutes to read, used in next week's meeting.

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