It’s impossible to visit the battlefield of Gettysburg without being deeply moved. The Union and Confederate armies together suffered more than 50,000 casualties during the three-day battle.  The course of American history was changed forever by leaders making strategic decisions under grueling circumstances.

When I recently spent three days wandering these hallowed grounds as part of a leadership retreat, I realized that my industry, health care —  and others going through turbulent times — have much to learn from the hard-won lessons of Gettysburg. Here are a few insights that I gleaned:

Convey the leader’s intent. Union Army General George Meade would sit down with his war council sometimes three or four times per day during the battle. This continual “confirmation of understanding” allowed Meade to better to communicate with his commanders and soldiers the tactics and strategies needed to survive the Confederate push.

This notion of the leader’s intent is an important one for all of us. The concept is simple: everyone in the chain of command must know clearly and concisely the mission’s objectives two levels above them and be able to communicate this information two levels below them. This understanding enables anyone in the army to make decisions “in the moment” that are consistent with the overall strategic objective set by the general.

A key part of this concept is to have a “briefback,” or “confirmation of understanding.” Having everyone on the team articulate in his or her own words an accurate understanding of the leader’s intent so that you, the leader, can be confident they understand it and will make the right decisions.

As a leader of a high-growth company with a fast-moving culture, I know I can’t make every decision related to our enterprise strategy. I need to empower my team to make the right decisions based upon not only what I believe but also what our organization’s C-suite believes.

I’ve always felt that timely, accurate, and easy-to-digest communications are a key pillar of leadership — and it certainly was critical at Gettysburg.  I do simple things like weekly e-mails to my team, weekly conference calls on topics of interest, ad-hoc working sessions to collaborate on a particular problem, and lots and lots of open-ended questions through “quick check-ins” as the key to success. (I like to use TED —Tell me, Explain for me, Describe for me — as means of asking open-ended questions to get people talking to really confirm their understanding of something.)

Be prepared to kill what you love. General Lee once said: “To be a good officer you must be willing to offer the death of what you love.”

He was a calculating strategist who was willing to sacrifice soldiers if it meant the numbers would play out in his favor for the greater good of the Confederate Army. Certainly, Lee’s was an extreme view born of war, but it does underscore the importance for leaders to be decisive when executing the mission and vision of their organization.

The entire health care industry knows it needs to change and, given that we’re in a zero-sum $3 trillion game, we need to change fairly dramatically. In such a context, leaders need to be comfortable with their “true north” and be decisive around things necessary to realize that true north. It might mean striking new business-development deals or forging new partnerships that previously would have been uncomfortable. It might mean changes in leadership. It might mean shutting down lines of business, shuttering facilities, or changing a historical position within a community.

The point is that if we’re going to survive with all of this change, leaders need to make tough decisions and be decisive in doing so.

Without leaders who are bold enough to pivot their strategy and do something different, organizations risk going down the path of death by a thousand cuts. Based upon my conversations with health care executives across the country, I think we all feel this pressure and opportunity.

But I was struck by a less-heralded act of leadership, albeit more meaningful. Enlistees from the 2nd Maine Infantry were marched under guard into Chamberlain’s command for refusing to fight after much of their regiment had been discharged and sent home. Chamberlain had orders to shoot the mutineers — his fellow Mainers — if they refused duty. Instead of resorting to violence, he resorted to inspiration and vision to remind these soldiers why they were part of the Union forces. The participation of the 2nd Maine Infantry proved crucial to fortifying his position on Little Round Top.

As I reflect on Chamberlain’s willingness to be on the front lines with his troops and his ability to inspire in the face of massive uncertainty, or Lee’s ability to make cold, calculated decisions, I see massive parallels to the challenges facing executives in health care, a remarkably complicated and extremely people-intensive industry.

Like the legendary leaders at Gettysburg, we must be active listeners. We must be on the front lines with our teams. We must help folks buried in the day-to-day details see the forest through the trees. I can’t think of anything more important than making decisive strategic bets, clearly communicating those decisions to everyone in the organization, and inspiring our teams to be the very best they can be.

This blog first appeared on Harvard Business Review on 10/12/2015.

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