Pressure & Performance: How Crisis Reshapes the System with Dr. Saleh Altamimi - 2026 Cosmic Conference LinkedIn Live Session

About the Session

This session explores how pressure shapes systems, organizations, and leaders, showing how crises can unlock hidden capacity, drive innovation, and strengthen collective purpose. Through Dr. Saleh’s experience leading the Riyadh First Healthcare Cluster, it highlights how clarity of purpose, system design, and human-centered leadership turn pressure into performance and long-term resilience and innovation.

About the Speaker Dr. Saleh Al-Tamimi is a pediatrics emergency medicine consultant and national healthcare leader. He is the CEO of Riyadh First Health Cluster, overseeing a system of 17 hospitals, 160+ primary care centers, and over 28,000 employees, playing a key role in Saudi Arabia’s healthcare transformation under Vision 2030.

Key Takeaways

1. Crisis Activates Hidden Capacity and Builds Lasting System Strength

The COVID crisis at the Riyadh First Healthcare Cluster revealed that organizational capability often remains underestimated until it is tested. Under immediate and intense pressure, the system was pushed to its limits and proved it could absorb far more than expected. ICU capacity was doubled, and staff were rapidly redeployed and trained into critical roles. These capabilities did not emerge overnight. They were built over years and only became visible under pressure, showing that crisis is where the true strength of a system is tested.

At the human level, pressure reshaped how people showed up. Individuals moved beyond fear and acted with a clear sense of purpose, continuing to serve despite personal risk. 

Many isolated themselves from their families, reinforcing their commitment to their role. This shared experience strengthened bonds across teams, deepened trust, and created a strong sense of unity around a common purpose.

This became a period of accelerated learning. The cluster scaled under extreme conditions, building a model for future shocks and strengthening its ability to expand capacity, sustain pressure, and adapt in real time. This strengthened both operational capacity and human connection, leaving the system more agile, aligned, and confident in navigating uncertainty.

2. Limited Resources Push Systems to Innovate and Scale

Operating with limited resources is becoming the norm, not the exception. This reality pushed the Riyadh First Healthcare Cluster to innovate in ways that maximize impact and scale despite constraints. What enables such a shift is having a clear goal combined with openness in how to achieve it. The cluster aims to increase life expectancy to 80 years, which led it to expand beyond treatment to prevention, early diagnosis, and mental and social wellbeing.

This clarity drove a shift from a reactive model to a proactive one, where the system actively reaches people rather than waiting for them to seek care. One example is outreach programs to remote areas around Riyadh, where medical teams spend time conducting screenings and providing care directly within communities. Another initiative targeted vulnerable populations in partnership with the Ministry of Human Resources and Social Development, identifying individuals on social assistance, reaching them at home, and enrolling thousands into healthcare programs with dedicated support.

Innovation also extended into how the cluster operates. Through a partnership with a UK-based startup to adopt AI tools that convert doctor-patient conversations into structured medical reports, improving efficiency and decision-making.

These efforts show how constraints combined with a clear end in sight accelerated a more agile and outward-looking system, where innovation is driven by clear purpose, openness, and the ability to scale solutions beyond traditional models.

3. Efficiency and Innovation Complement Each Other

Dr. Saleh emphasizes that efficiency and innovation are not opposing forces. They operate together through a dual focus: exploiting existing capabilities to improve efficiency, while exploring new technologies and methods to deliver greater value. Relying on the same approaches leads to repeated outcomes, while innovation introduces new ways to improve performance at scale.

Using telemedicine is one example at the Riyadh First Healthcare Cluster, where virtual care replaced the need for patients to travel long distances for short appointments, improving access while optimizing system capacity.

Another example is the shift in the healthcare funding model. The system is moving from fixed annual budgets, which encourages full spending, to a capitated model where the cluster receives a fixed amount per beneficiary and can retain savings when performance targets are met, on the conditions that savings are reinvested in innovation programs.

This creates stronger incentives for efficiency while maintaining quality outcomes. It encourages teams to deliver care at lower cost, reinvest savings into improvement, and continuously evolve how the system operates.

By aligning efficiency with innovation through both practice and incentives, the system becomes more scalable, adaptive, and capable of sustaining performance over time.

4.Trust and Alignment Are Built Through Leader Proximity and Accessibility

Managing the emotional and psychological reality of change at scale requires an approach grounded in engagement, respect, and empowerment.

With 28,000 employees, Dr. Saleh emphasizes that trust cannot be built at a distance, which is why he remains visible through regular visits to facilities, engaging directly with managers and frontline teams. In these interactions, he asks for support rather than mandating action, reinforcing a mindset of shared responsibility.

Leadership accessibility is also central. Dr. Saleh ensures open access to him for all employees, creating a culture where people feel heard and valued, while strengthening accountability as managers become more responsive knowing issues can be escalated.

Over time, this approach builds loyalty and alignment, unlocking the full commitment of the workforce and strengthening the connection between people, leadership, and their purpose.

5.Effective Leadership Depends on Resilience, Perspective, and Personal Renewal

Leading at this scale requires managing constant pressure and maintaining personal stability. Dr. Saleh emphasizes the importance of accepting that leadership includes both success and setbacks. Resilience comes from recognizing that challenges are part of the role and staying steady through both positive and difficult periods.

This requires conscious effort. Leaders need to reflect on setbacks, avoid reacting impulsively, and focus on overall progress rather than isolated events. As long as the organization is moving in the right direction, short-term difficulties remain part of the process.

Sustained performance also depends on protecting personal energy. Time with family, rest, and moments of disconnection from work are necessary to recharge. Without this, burnout develops gradually over time and affects both the leader and the organization. Managing this balance helps maintain clarity, consistency, and long-term effectiveness.

Over time, this discipline allows leaders to focus on what matters most: building strong teams and embedding ways of working into the system. This, in return, ensures the organization continues to perform, even without constant direct intervention.

6.Lightning Round

What keeps you grounded? My family.

What helps you be limitless? I always ask myself “What else?” I don’t assume there is only one option or solution.

What is one leadership quality from the Arab world that the rest of the world can learn from?

The connection between spirituality and work reflects a deeper sense of purpose. Work for us is not only a job or a way to earn a living, but a mission and an act of service. It is seen as part of worship, where doing good and helping others is dedicated to God, with the belief that this brings blessing in return.

Based on our conversation, what are the top three things you would advise leaders to do right now

• Accept and learn from failure.

• Recognize that stress is part of leadership and build ways to cope and recharge.

• Trust and empower your people, and build a system that can operate without relying on you

https://www.youtube.com/watch?v=d7IIDny6W50

About Cosmic Centaurs

Cosmic Centaurs is an organizational and leadership development consultancy helping leaders and leadership teams make better decisions and drive sustainable change.

The Cosmic Conference is our annual, open platform for learning, reflection, and connection, bringing together leaders, thinkers, and practitioners to explore the questions that matter most to leadership today.

You can listen to this session as a podcast here.