> I assume that even an established company needs to go through 0-to-1 all the time
Not significantly. Massive product and strategy pivots are rare because they can fail horribly (eg. For every turnaround like Apple there's a failure in execution like Yahoo)
> How the great CEOs achieve their successes are beyond me
Luck in most cases.
I've worked with plenty of CEOs and in most cases, most people at the C-Suite and SVP level of large organizations are comparable to each other skills and intellect wise.
Administration/mid-level management buy-in is also critical. C-Suite doesn't have much visibility into the lower levels of an organization (it's unrealistic), so management is their eyes and ears.