The 2020 Covid-19 pandemic starkly revealed fundamental deficiencies in health care delivery around the world, including endemic racial disparities, the fragility of supply chains, the vulnerability of staff, and the depth of uncertainty about both a novel disease and our own systems. It also sparked innovations in the delivery of care and a transient change in how our organizations are managed. Many credited their successful Covid-19 response to flatter hierarchies, easier access to senior leaders, a sharper focus on what really matters, quicker decision-making, rapid experimentation and tolerance of experimental failure, and less-experienced staff spontaneously stepping up to lead. As one academic observed, “In a small crisis power moves to the center,” but in a big one, “it moves to the periphery.”