We speak to Janet Pillai, founder of Multilayer Trade Corporation (MLT Corp) and Certified Director (CD(SA))®, on what it really takes to lead at the top, from driving operations and governance to building high-performing, scalable businesses, with insights for women navigating leadership and influence.
1. What does “operations” really mean at the executive level, beyond processes and systems?
At the executive level, “operations” is really about making the strategy real every day, at scale, without drama. It goes way beyond flowcharts, SOPs, and software. Strategy sets direction. Operations ensure the organisation can actually get there repeatedly, under pressure, with the people you have. Strategy sets direction. Operations ensure the organisation can actually get there repeatedly, under pressure, with the people you have.
2. What are the most overlooked responsibilities of a Chief Operating Officer?
Translating CEO intent into organisational reality, not strategy creation, strategy interpretation.
- Turning ambition into sequenced, resourced action
- Stress-testing goals against clinical, financial, and human limits
- Saying “this will break the system unless we change X”
The COO is the truth-teller when vision outruns operational capacity. Managing the “White Space” between functions. The gaps kill performance, not the silos.
- Clinical ↔ admin
- HR ↔ staffing reality
- Finance ↔ care delivery
- IT ↔ frontline workflows
The COO owns the interfaces, not just the departments
3. How do you balance long-term strategy with the day-to-day realities of execution?
Build strategy into the operating rhythm.
This is the secret sauce.
- Daily/weekly ops meetings = delivery & risk
- Monthly reviews = trend vs strategy
- Quarterly forums = recalibration
Strategy doesn’t live in an annual offsite. It lives in how often leaders ask strategic questions in operational spaces. Executives who disappear into strategy decks lose execution reality fast.
- Regular time with frontline teams
- Seeing work as it actually happens
- Listening for friction, not filtered reports
4. What skills are essential for running complex operations across multiple business units?
Running complex operations across multiple business units isn’t about being the smartest person in every room; it’s about seeing the whole system clearly and keeping it coherent under pressure.
- You must see interdependencies, not silos
- How one unit’s efficiency creates another’s bottleneck
- How policy changes ripple into care quality, staff load, or revenue
- Where risk concentrates when volume or complexity increases
- This is rarely acknowledged, and essential
- Staying calm in ambiguity
- Absorbing pressure without passing it down destructively
- Modelling steadiness during disruption
- Multi-unit operations amplify leadership behaviour
5. How do you build operational structures that can scale without losing efficiency?
Most organisations don’t fail at scale due to strategy; they fail because their operating model doesn’t evolve fast enough. Scaling without losing efficiency isn’t about adding layers or systems. It’s about designing the organisation to absorb complexity gracefully. A classic scaling mistake is a bloated head office.
- Centre sets standards, guardrails, and shared services
- Units’ own execution and results
- Minimal duplication, maximum clarity
6. What role does governance play in driving sustainable operational performance?
Before strategy or execution, governance defines how the organisation behaves under pressure.
- What decisions require escalation
- Where authority genuinely sits
- What cannot be traded off (safety, ethics, compliance)
- Strong governance stops the organisation from chasing everything.
- Forces prioritisation
- Test ambition against capacity
- Holds the line on long-term objectives when short-term noise hits
This is how strategy survives the quarter-to-quarter grind. Sustainable operational performance is not driven by heroics. It’s driven by governance that makes good behaviour inevitable.
7. How do you make high-stakes decisions when information is incomplete or time is limited?
First, classify the decision (Fast), and before deciding what to do, decide what kind of decision this is.
Ask:
- Is it reversible or irreversible?
- Does delay increase harm or risk?
- Is this a safety / ethical issue or a performance one?
This determines how much evidence you need. Most leaders skip this and over-analyse the wrong things. Waiting for perfect data is a decision in itself. If you have ~70% of the critical information, from credible sources with known risks articulated…you decide. The rest you manage through mitigation, not delay.
8. What does effective leadership look like behind the scenes, when no one is watching?
It looks quiet. Unglamorous. And deeply intentional. The best leadership work happens out of sight, long before results show up. When no one is watching, strong leaders:
- Say no to tempting but destabilising opportunities
- Slow things down when the system isn’t ready
- Cancel or re-sequence work before it becomes visible failure
This kind of leadership prevents heroics, and heroics are a sign that something else failed.
Effective leaders:
- Absorb anxiety instead of passing it down
- Regulate their own reactions before responding
- Hold space for disagreement without defensiveness
9. How do you develop teams that are both operationally strong and leadership-ready?
- Leadership develops where judgment is required
- Give roles decision scope, not just delivery targets
- Be explicit about what they can decide without permission
- Hold people accountable for how decisions are made, not just outcomes
If a role doesn’t require thinking, it won’t develop leaders. You build leadership-ready teams by turning everyday operations into judgment, ownership, and values in action.
10. What operational lessons did you learn from working across government, academia, and private enterprise?
Government: Patience and Process Discipline
- Lesson: Policies, compliance, and approvals will always move more slowly than you think.
- Operational takeaway: Build structures that don’t rely on heroics. Map dependencies early and create a buffer for inevitable delays.
- Example: In healthcare or public projects, approvals for licenses or funding cycles can take months; scaling execution without anticipating the bureaucracy is a recipe for suicide.
Academia: Systems Thinking and Knowledge Flow
- Lesson: Success is rarely linear; research, education, and clinical evidence emerge from iterative cycles.
- Operational takeaway: Value learning loops. Embed mechanisms to capture insights, validate assumptions, and adapt before scaling.
- Example: Academic partnerships in hospitals teach that procedures must be evidence-backed, and piloting first prevents large-scale mistakes.
Private Enterprise: Execution Speed and Accountability
- Lesson: Market competition doesn’t wait; efficiency and accountability are everything.
- Operational takeaway: Clear metrics, rapid feedback, and ownership culture drive sustainable performance.
- Example: In corporate healthcare services, missed operational KPIs immediately affect revenue and patient outcomes. Clarity of roles and decision rights is essential.
11. How do you maintain personal well-being while carrying executive-level responsibility?
This is the real leadership question nobody talks about at the top. Executive roles are high-stakes, high-pressure, and often invisible in their demands. If your well-being collapses, everything else, strategy, operations, culture, collapses with it.
- Mindset shift: Your mental, physical, and emotional health isn’t optional; it’s critical infrastructure.
- Practical steps: Block time for exercise, reflection, and recovery like a board-approved budget item.
- Why it matters: Decisions made under stress are slower, riskier, and more reactive.
12. What advice would you give women aspiring to lead operations at the executive or board level?
Absolutely, this is a crucial question. Leading operations at the executive or board level is challenging for anyone. Still, for women, there are unique dynamics in play: from systemic bias to expectations around leadership style, visibility, and risk tolerance.
Women who thrive in operations at the executive or board level do three things exceptionally well:
- They make complex operational realities strategically visible.
- They cultivate influence without waiting for formal authority.
- They protect their capacity and their integrity while scaling impact.
Jet Setting With Janet:
