Session Notes: One Asset, One Decision? Moving from Individual Ownership to Group Decisions in Pharma
Session: One Asset, One Decision? Moving from Individual Ownership to Group Decisions in Pharma Event: PPM Summit Basel 2026
Recorded: 23 April 2026 at 10:08 Published: 23 April 2026 at 10:08 attendees-only
cross-functional-teamsdecision-makingproject-managementdac-frameworkteam-leadershippharma-governancerisk-managementaccountabilityorganizational-designasset-management
Executive Summary
Dalia Ghoneim from NSD addressed the chronic challenge of fragmented decision-making in pharma, where cross-functional teams say they're aligned but each function pursues separate agendas. She presented the DAC framework (Direction, Alignment, Commitment) as a solution, emphasizing how project managers must evolve from process facilitators to strategic integrators who anchor decisions to shared KPIs, replace opinion-based discussions with implication-focused dialogue, and use social pressure through verbalized accountability to ensure genuine team commitment.
Full Notes
The Fragmentation Problem in Pharma Teams
Ghoneim opened with a scenario familiar to every pharma professional: the illusion of alignment. Teams gather, discuss an asset from multiple functional perspectives, declare consensus, then scatter to pursue their individual agendas. This creates what she termed 'decision chaos' - where one asset faces multiple, often conflicting decisions from different stakeholders. The traditional cross-functional team model, while well-intentioned, fails because it lacks mechanisms to ensure genuine coordination beyond the meeting room. Her team at NSD focuses specifically on this cross-functional management challenge, positioning them as neutral integrators who see the complete asset picture rather than functional silos.
Case Study: From Clinical Success to Commercial Confusion
Through a detailed hypothetical scenario, Ghoneim illustrated how decision ownership shifts can create chaos. A Phase III asset with strong primary endpoints moves from clinical head ownership to cross-functional team decisions - a critical inflection point. The team faces labeling decisions where regulatory wants scenario planning, market access flags payer evidence gaps, leading to three-month delays. Later, medical pushes for narrow robust labeling while commercial wants broad positioning, creating analysis paralysis and requests for more data. Finally, supply chain makes unilateral readiness decisions, causing market confusion and countries launching without adequate supply. Each decision point revealed the absence of unified decision-making frameworks.
DAC Framework: Direction, Alignment, Commitment
Ghoneim introduced the DAC model as a solution framework. Direction requires shared understanding of asset objectives and clear north star vision. Alignment goes beyond saying 'yes' in meetings - it demands coordinated work where functions operate in tandem rather than parallel. Commitment involves collective ownership of decisions and follow-through accountability. She emphasized this isn't about tools but about leadership behaviors that project managers must develop. The framework helps teams recalibrate when facing uncertainty, approach risk systematically, and maintain commitment to shared vision even when individual functions face pressure to diverge.
Practical Skills for PM Leadership
Moving beyond traditional project management tools, Ghoneim outlined specific behavioral skills. PMs must anchor all discussions to agreed objectives and KPIs, stopping conversations that drift from direction. They should transform meetings from update sessions to discussion forums, replace opinion-based arguments with implication analysis, and ensure every voice contributes to decisions. Risk management becomes a decision-enabling tool rather than just problem identification - teams must define their collective risk appetite and acceptance levels. Verbalized accountability, though uncomfortable, proves more effective than documentation alone for ensuring commitment follow-through.
Organizational Evolution: Project-Centric Models
The discussion revealed industry movement from function-centric to project-centric organizational models. When team members face conflicts between team decisions and functional priorities, clear governance structures become essential. Ghoneim advocated for decision-making authority defined in team charters, with escalation paths for impasses. The goal isn't to eliminate functional expertise but to ensure asset success takes precedence over functional optimization. This requires organizational support, including informal coaching resources and formal governance structures that empower cross-functional teams to make binding decisions.
Key Decisions
- ✓ Team charters should define decision-making authority for functional impasses
- ✓ Organizations need to choose between project-centric vs function-centric models
Action Items
- → Project Managers — Define decision-making authority and escalation paths in team charters open
Key Insights (15)
summary
Cross-functional decision chaos addressed
Traditional pharma model fails — each function views assets from their perspective, leading to fragmented decisions despite alignment meetings where everyone says yes but does their own thing
Dalia Ghoneim cross-functional-teamsdecision-makingpharma-challenges
summary
Project managers as strategic integrators
PM role evolving beyond tools — from process managers to strategic integrators who see the big picture across functions, acting as 'Switzerland' - unbiased and focused on asset success
Dalia Ghoneim project-managementstrategic-leadershipcross-functional-teams
summary
DAC framework for unified decisions
Direction, Alignment, Commitment model — effective teams need shared understanding of goals, coordinated work across functions, and commitment to collective ownership of decisions
Dalia Ghoneim dac-frameworkteam-leadershipdecision-making
summary
Risk appetite replaces data paralysis
Organizations lack agreed limits — teams request endless data to avoid uncertainty; need clear risk appetite and decision triggers rather than perfect information
Dalia Ghoneim risk-managementdecision-makingdata-analysis
key Insight
Verbalized accountability drives commitment
Social pressure ensures follow-through — verbalizing actions and commitments in meetings, putting people on the spot, is more effective than just documenting in action logs for achieving real team commitment
Dalia Ghoneim accountabilityteam-commitmentmeeting-management
key Insight
Replace opinions with implications
Strong personalities drive opinion-based discussions — PMs must redirect team members from stating opinions to articulating implications for the asset and product outcomes
Dalia Ghoneim meeting-facilitationdecision-qualityteam-dynamics
key Insight
Risk log as decision enabler
Risk identification must drive action — effective risk logs identify affected functions, decision impacts, mitigation owners, trigger points, and collective risk acceptance levels
Dalia Ghoneim risk-managementdecision-toolscross-functional-alignment
key Insight
KPIs anchor team decisions
Business goals like HTA reimbursement timelines — teams need shared KPIs (e.g., achieve reimbursement in specific countries by target year) to evaluate every decision against common objectives
Dalia Ghoneim kpisteam-alignmentbusiness-goals
key Insight
Project-centric over function-centric
Pharma shifting organizational model — industry moving from functional decision-making to project-centric teams to avoid fragmented asset decisions and delays
Dalia Ghoneim organizational-designproject-managementpharma-trends
action Item
Define decision-making authority in charter
Team charters must specify — when teams reach impasse on functional decisions (e.g., supply), that function retains decision authority but team frames and understands associated risks
Dalia Ghoneim team-charterdecision-authoritygovernance
quote
Switzerland analogy for PM neutrality
We are like Switzerland. We are unbiased. We really want the asset success, right? This is what we see. We see all the functions and we see their objectives.
Dalia Ghoneim project-managementneutralityasset-success
quote
Data appetite versus risk acceptance
Organizations do not like data. They lack agreed limits to acting under uncertainty.
Dalia Ghoneim risk-appetitedecision-makinguncertainty
resource
DAC Leadership Framework
Direction (aligned understanding of goals), Alignment (coordinated work across functions), Commitment (collective ownership of decisions) - three components that create effective team leadership
Dalia Ghoneim frameworksteam-leadershipcross-functional-teams
resource
Risk Log Decision Framework
Structured approach: which functions affected, what decisions impacted, mitigation actions and owners, data trigger points, collective risk acceptance levels
Dalia Ghoneim risk-managementdecision-toolsframeworks
resource
Meeting Transformation Principles
Shift from update meetings to discussion forums, replace opinions with implications, ensure every voice heard, encourage tradeoffs, define and articulate risk
Dalia Ghoneim meeting-managementfacilitationteam-dynamics
Full Transcript (click to expand)
Apr 23, 2026 One Asset, One Decision? Moving from Individual Ownership to Group Decisions in Pharma - Transcript 00:00:00 : Now it's working. Yes. So looking forward to getting to know you all and connecting and um getting all the potential. I am the team lead and director of the global portfolio and alliance management team at NSD and my team is really focused on cross functionality management. So this topic is very dear to my heart because this is what what we primarily do. So let's talk about the the the issue or the challenge to begin with right we have one asset in pharma but we most usually have multiple people taking different varied decisions that lead to chaos right so this is a very common model in pharma where each function looks at the asset from one angle and sees what they want to see because they see their functional perspective and I did medical efforts growing. So I completely relate the goal, right? So I completely understand this happens in farm. So what was the solution? The solution was to develop cross functional teams. But then these cross functional teams will come together, align and discuss and everybody then moves forward to do their own thing as well. 00:01:16 : Right? So there was no consistency. I'm sure you've all been in meetings when people say are we aligned? Yes, we're aligned. and then everybody does their own. So you can completely relate with that. Then comes the really the role of the project manager and this is I really like the discussion that we were having about AI because this this is also an evolution in the role of the project manager because here the project manager is a strategic contributor is a strategic integrator is not just somebody who manages tools it is somebody who sees the big picture and is not related to a function. I usually tell my team we are like Switzerland. We are unbiased. We really want the asset success, right? This is what we see. We see all the functions and we see their objectives. But how can we then drive this team to a unified decision? I appreciate your mention about the patients because this is what it's all about, right? It's more disciplined decisions. 00:02:24 : It's faster decisions let lead to patient access in a faster way. So let's look at this hypothetical case scenario and I'm sure you can all relate with some parts of it. So um phase three data read out is there we have strong primary end points. We have secondary endpoints that are a little bit mixed but then the team here is formed and the team meets regularly. It's a good cross functional team has the right expertise and they do take a decision to proceed to writing and here a massive shift happens right this decision moved from head of clinical to then the cross functional asset team. So decisions now become a group decision not just one person or head of clinical who takes decisions on how to proceed with a clinical trial. Although that's also more of a crossf functional decision but here we see a massive shift because all the functions start to participate and then you have the first inflection point which what is our label and indications score the team needs to take that decision and different views start to occur. 00:03:39 : Regulatory request scenario planning market access flags that the payer evidence gets clear decision stalls and then there's a delay of three months. We move to global finance strategy. Another decision is making and that's t minus 12 mark where a decision is needed. What is our labeling strategy here? Medical pushes for a narrower more robust label. commercial of course which is for broader positioning again team is conflicted and they don't know what which way to proceed they request more data and we all seen that they requested more data I'm going to talk about a little bit as well which is how data leads to analysis paralysis sometimes and then there's confusion as well with regulatory authorities for the filing strategy that we just had aligned on then we move to non readiness back and I have experienced this in my career as well. Supply chain raises readiness constraints. Markets are pushing you know they want to be first in line but then supply chain takes a decision on their own and that leads to market confusion. It leads to um some countries launching without supply. 00:05:00 : I'm sure you've seen one of these situations happen, right? And we're talking here about a cross functional team that is formed. So, how can we then help that project manager have the skills, not the tools? So, I'm going to talk about the tools, but I really want to focus on the skills that help them lead the team forward. And I would like to talk a little bit about a framework called the DAC model. Some of you may already already be familiar with it, but it talks about that a good leadership arises when a team has an aligned direction, a shared understanding of what we want. What is our focus for that asset alignment? And it's not just that we align that we're going to do our separate thing. No, we align that we're going to be working together. We're co-working. It's not I do my thing, you do my thing. No, we do things in tandem. So, it's the coordination of the work and decisions across functions. And last but not least, commitment, right? 00:06:03 : So, how are we committing to what we agreed upon? We feel that we all own the decision and the direction that we agreed upon. So, the DAC framework proposes that when these three things come together, leadership in a team is formed. So then let's go back to our um hypothetical case scenario. If we look at these stack models, this back training in the first part is the team direction really clear is alignment really in place. Would have converged that way if they had this um in place or not. And then if we took that label and indication scope again the direction diverse the team needs to recalibrate what is the north star for that asset how are they leading together towards that and most importantly this is where we have a little bit of we need more data we need more data so how is the team approaching risk because we are risk averse right in we are risk averse we don't like risk we move away from it we shy away from it so how is the team approach And then last but not least, when supply chain decided to take their own decision, is there really a commitment to the vision of that asset? 00:07:30 : Are they really looking at the same direction or not? And how is that commitment achieved? So if we look at these D principles, I do want to talk about the skills more than the tools, right? Of how a PM can achieve these D principles that will help them drive a team forward. So we all are very familiar with the team chart of course that's the basis for formation of a team. But is the aligned objectives and KPIs there? And KPIs is really important, right? Do they have the KPI set? Because the KPIs helps them to make decisions for it and helps them as well to determine risk and helps them with a lot of things. And what is the team output? What is output out output as a class function but most importantly how can the PM make sure that this team is working towards the direction and this is where the PM becomes a leader in the teams. So they need to anchor decisions to the objectives and KPIs of it and if that direction cannot be articulated they need to stop the discussion and recalibrate it and move it in a different direction. 00:08:43 : So this is where the leadership of the PM really truly arises and the PM becomes a leader on the team not someone who is um managing the tools or the process but a leader on the team. And then let's talk about alignment a little bit because this is a big one, right? So alignment is really an issue with all of the cross functions working across the different departments because again we are aligned does not mean we're working towards the same basically working towards the same direction. This is where we as PMS have a lot of tools, right? So the project manager has a lot of tools to keep their team on track. Most importantly, are the meetings focused on discussion? We regularly see meetings that are just updates and not discussion forums. So are the meetings really discussions and not updates? Are we driving towards that? Are we setting the right pace for a meeting before we head into a meeting itself? Of course, you're all very familiar with meeting management principles, so I'm not going to go there, but this is a big one. 00:09:58 : What PMs really struggle with that meetings turn into updates. And then the risk log and I'm going to talk about the risk log for uh for a bit after this because I think the risk log is a really not just about risk, but it is a decision- making tool. It helps the team make decisions. And then actions and decisions love of course right so this helps the team be aligned. Last but not least decision metrics. So if the team is facing an impass you know how are we then looking at the decisions to make sure we're going to see action. But again I want to focus on the right hand side or that my left your right where the skills and behaviors of the PM should shine in the team. Replace opinions with implications and we see that a lot right we have strong personalities in the team that are usually speaking with some people just say you know my opinion is but your opinion has an implication. So what is that implication and how does it impact the product and how does it impact the asset. 00:11:07 : So to replace the opinion with implications, actions and decisions of course right. So once the implication is there it can then move into an action decision. Ensure every voice is heard. Again this is um very important them skills to really call out people you know ask them for their opinion if a decision is being encourage tradeoffs which is again really important because every department wants their perspective wants their functional um perspective to take the lead here but what is the tradeoff that we're working towards and then define and articulate risk as well. So it's very important to voice the risk. So once we have aligned on something, we're agreed on something. What is the risk that we're facing and was what is the implication of that risk? And I do want to focus a little bit on risk because said um in pharma there is usually um request for more and more and more data, right? We're talking about the huge amount of data that that AI can help us with, but there's always need more data because we never have that perfect scenario or that perfect situation. 00:12:22 : So I love that quote which says organizations do not like data. They lack agreed limits to acting under uncertainty which is true. What is the risk that we are willing to take? What is our risk appetite? And this is what the risk lock helps to achieve. So it's in in my perspective it's not just here's a list of risks but what is what is did that risk mean and how can we then take decisions based on that risk it's not just we have a risk but what is our decisions so all of these questions are really important which functions are affected by the risk what decisions does this risk affect what are the mitigation actions that we are taking to help with that risk who owns the the occasion as action and what data points will trigger that action and what risk are we collectively willing to accept. So identifying and framing risk is really important in a cross functionality management to help them make decisions and enable effective decisions that actually it's not just looking at that risk. 00:13:34 : So then we go to the last point which is commitment and I think this is one of the hardest to achieve right. Um one of the effective tools of course is action and decision logs. But what really works is verbalizing the actions. It's kind of putting people on the spot unfortunately but it is what really works. When we say we agreed X person to Y and Z then you are holding them accountable for carrying that action through. But when that is verbalized and committed that social pressure ensures that people follow through with what they need to do. So an EDI is effective. Yes. But again the project manager role on the team as a leader is making sure that as they manage the team as they drive that team forward to really make sure that everybody is held account. Verbalizing is one way to do that but also following up on documented actions of course is another way to do that. So we started off the next meeting with saying, you know, this is where we left off and this is what we done last time and you know, um, X, Y, and Z person did is explain that person did not do that. 00:14:54 : It is very hard to do that. It is not easy but it is what cross functional teams really do need in order for them to move forward and not to diverge from what they decide about. So um it's really this is a summary of what I just um discussed. How is the PM driving the team? It's anchoring the team through the direction. It is aligning the team through the multiple resources that we have as project managers. And then it is blocking that commitment. That way stepwise really the the project manager can look at how is that cross functionality moving forward and how are they achieving the objectives of the organization and the objectives of the asset. and not for everybody working towards their functional objectives. Um with that um it's really one team, one decision and hopefully one outcome of what and happy to take questions of course. Hi, great talk. Thanks. Uh, isn't and shouldn't the TPP be the basis of all alignment and how and where does it fall short in that regard? 00:16:33 : Completely agree. TPP is the north star, right? So, it's what guides the team but still the team's churn. So this is more about the behaviors of the team not what the north star is. But completely agree the TPP is what really guides the north star. Thanks. Correct. So you mentioned on your slides um KPIs for teams um concept that I like. So we don't have that. We have KPIs for for other things but not for team behaviors. Just curious if you could give some examples. Is it for example you also mentioned um that it should be ensured that team meetings are not updates but discussions is that one of the KPIs or because sometimes you know KPIs should be measurable clearly measurable so yes and thank you for that. So KPIs is exactly as you mentioned it is business goals which the team is driving towards but I do so my team and myself we do manage teams that are one step beyond clinical. So KPIs for us is very important because it really keeps that team aligned and then do you have concrete examples of yes a KPI would be achieve HTA reimbursement in countries X Y and Zed by X year or um it would be um in support guideline adoption. 00:18:08 : Okay. So it's more um KPIs for content not for team behavior. Then I misunderstood that. Yeah, I thought it would be a KPI on how the team behaves. This is the team norms, right? This is also a great point which is the team norms which is how we agree to come together and that's already part of the charter. Okay, but thank you for the clarification. I appreciate the question. Does the team own the same goals around the project which drives a lot of the common working together behavior as well and a lot of churn right so it it takes a while for them to agree on those KPIs but then it also takes it's a lot of turn until they agree on them but once they have them set it really becomes very you know they come align every action and every decision leads to back. Are we going to achieve this with that decision? Are we if we do that tactic are we going to achieve that it's also it's also saves a lot of money because tactics have more purpose. 00:19:17 : Yeah. So thank you love the DAG model. So you're what you're talking about here is it does it work best in a project central model or functional because you know my experience has been sometimes you team supporting team excellent the decisions functional level that over override what the team member has said. So what is this about what your children what were you here that decisions for sure? So functions should be aligned. So how we empower our teams is align with your function is perfectly fine. We can post the decision to the next meeting and that way they can have that functional alignment and then come back with a more confident for the team. Does that answer the question? In a way, sometimes the function may take a very different view, Joe. You can be as a team member, you're I guess you're sitting in both caps. You're sitting with the team, you're sitting with the function. What might be right for the team is not right for the function. 00:20:23 : So, this is where it's very important that organizations say are we a project centric or are we a function centric? You know, which one are we operating in? So definitely the direction I see across the pharma organizations is that we're moving to a projectentric teams. It's not functionalentric anymore because that leads to the fragmented decision making of the asset and that le has led to delays concerns. I'm sure everybody has seen some of this um yeah I think that's the key as well. So as you're focusing on that you also need to be aware of that functional dimension you know be ready for it. Thank you. More questions. Just just a question um for my group. What how do you deal with situation that for for Christ's sake you cannot get to an alignment if it's finally made in the call and that is that is a good point because that should be defined in the charter from the beginning right so if we can if we reach an impass on a decision regarding supply then supply takes that decision but the team then needs to make sure that they understand the risk around it so the risk is framed and what does it So that they are on on the risk at the end, right? So they know how to manage the pro the the asset itself moving forward. But the decision- making authority lies with that function. So you have a support person for the project leaders and project managers like an organizational coach. they can reach out for team building and solving issues that officially never happens but people not working together. Yes. Yes. Uh we do so in our organization the staff manager so the team lead would be really the the one person of when and how to escalate. So we do have the governance in place like if the team reaches an impass to escalate those issues as well. This is more of an official way, but some kind of a coach person, they could informally get involved or ask for help, more questions then I thank you for a very interesting discussion and presentation which is a bit of the method tour discussion we had so far. Thank you. Transcription ended after 00:24:15 This editable transcript was computer generated and might contain errors. People can also change the text after it was created.