In today’s healthcare landscape, the need for strong, adaptable leadership has never been greater.
The best leaders develop other leaders. They drive change proactively and create resilient organizations in the face of uncertainty. Future-proofing leadership requires a deliberate approach to change management — and strategic prioritization. Healthcare leaders can’t wait to react; they must create the roadmap, set the tone, establish the pace and prepare for what’s coming.
Throughout my leadership journey at UVA Health University Medical Center, as well as at organizations like The Ohio State University Wexner Medical Center and UW Health, I’ve observed consistent themes in what it takes to lead effectively in the present while also preparing strategically for the future.
- Drive change before change happens to you.
Effective leaders don’t wait for disruption to force their hand. They pick their head up, anticipate change, identify emerging trends and position their organizations to lead rather than react.
Change management is not simply about responding to external pressures. It demands proactivity. Leaders must embrace a mindset of continuous evolution, adapting strategies, structures and operations in anticipation of industry shifts. By instilling this proactive approach within their teams, they empower others to be forward-thinking and agile leaders.
Two recent examples at UVA Health reflect this proactive approach to leadership. In cancer care, we’ve brought BiTE therapy (bispecific T-cell engager), a cutting-edge immunotherapy, to patients whose cancers resist traditional treatments. BiTE helps the body’s T-cells recognize and destroy cancer cells that typically evade detection. UVA Health was among the first in the country to offer this therapy, which is now FDA approved, and the first in Virginia to treat small cell lung cancer patients. We participated in early clinical trials and pioneered outpatient administration, allowing patients to receive treatment without a hospital stay.
On the pharmacy front, we anticipated growing demand for specialty medications, home delivery and expanded pharmacy support services. Years ago, we invested in pharmacy leadership and set a new vision to meet the evolving needs of our aging population. That investment is now taking shape in a 40,000-square-foot centralized pharmacy services center that will add 50 jobs and feature state-of-the-art automation and supply chain systems.
In both examples, our leadership team empowered in-house subject matter experts to lead the way — fostering a culture where individuals have the autonomy to drive change before it’s forced upon them. This is what forward-thinking leadership looks like: bold vision, early action and trust in those closest to the work to shape what comes next.
- Develop leaders at every level.
Leadership is not reserved for the executive suite. Everyone in an organization has the capacity to lead. A culture of leadership development ensures that individuals at all levels feel empowered with autonomy to take ownership, make decisions and drive progress. The best leaders meet people where they are, take time to get to know them, understand their motivations and provide the right support. Respecting people and recognizing their potential fosters self-value and institutional engagement, strengthening the entire organization.
UVA Health began its Health Leadership Institute in July 2023 for this reason — to identify and grow emerging leaders from all levels within our ranks and cross-pollinate ideas that will make us stronger. Within just a few years, more than 100 people have completed the Institute, and we are beginning to see participants applying their leadership skills through promotions, collaboration and active engagement on committees. When front-line team members, managers and teams embrace their roles as leaders, organizations thrive.
- Keep patients front and center.
One guiding principle must remain constant: patient first, always. Leaders must ensure that every decision, every initiative and every strategy aligns with the fundamental mission of improving patient outcomes. It is also important for leaders to deeply and genuinely care for patients.
Transparency and authenticity are critical; teams must trust that leaders will do the right thing, even when it’s hard. When leaders share what they know, openly communicate about challenges and consistently reinforce the mission, they build cultures of trust and accountability.
Even in the most advanced health systems with world-renowned teams, medical errors happen, and patient outcomes can change unexpectedly. Modern medicine is powerful, but it is not infallible. In those moments, leaders must show up — literally and figuratively. To walk alongside teams and families, to come into the hospital in the middle of the night, to sit face-to-face with those impacted and be fully transparent — that is where leadership is tested and where the heart of the mission is most visible.
True commitment to quality and patient safety means never accepting harm as inevitable. It means learning from every mistake, discussing near-misses openly and relentlessly driving toward root-cause solutions. That is how we honor every patient and our pledge to be better for future patients.
- Be courageous and do the hard things.
True leadership means choosing what is necessary for the organization’s lasting success, rather than opting for the easy path. It takes courage to make difficult decisions, take accountability and face adversity. This means embracing challenges head-on, tackling tough conversations and committing to strategic execution.
“Eat the frog” — tackling the hardest, most critical tasks before anything else — is a mindset I come back to consistently. As leaders we must break challenges into bite-sized chunks and communicate clear expectations amid uncertainty. Hard decisions become manageable when leaders take deliberate, measured steps forward while maintaining focus on the bigger picture.
- Set the tone, know your culture.
Great leaders have a deep sense of their organizations. They understand the culture, the challenges and the pulse of the people. They set the tone and lead by example.
Get out there and round on your teams daily, making time to be with the teams caring directly for patients — this will be the most fruitful and satisfying time of your day. Carving out this time helps me remember my “why,” and also builds deeper connections with patients and teams. By spending time with those who need the most support, providing guidance early and often, and actively listening, leaders create an environment of trust and engagement. They communicate, clarify expectations and ensure teams feel heard and valued.
- Pacing and prioritization: the right next things
One of the greatest challenges in leadership is balancing urgent needs with the long-term vision. Prioritization is key. Leaders must determine the most pressing needs and align their actions accordingly. Pacing matters — moving too quickly can create instability, while moving too slowly can result in missed opportunities. Leaders must master the art of paced prioritization, ensuring that the “right next things” are identified and artfully executed.
Hospital capacity pressures, especially at academic medical centers, are intensifying and projected to grow as the “silver tsunami” of an aging patient population continues. At UVA Health, we recognized an opportunity to improve patient flow, capacity and throughput by rethinking geography. We recently completed a major bed move to ensure care teams are co-localized and that the number of medical and surgical beds is better balanced to meet demand.
This effort required careful pacing to get it right. It involved revamping discharge bundles, enhancing our discharge lounge and creating a new surgical observation unit. Each decision was deliberately timed to minimize disruption while moving us closer to our long-term goals. This work exemplifies how thoughtful pacing and prioritization can drive meaningful change in complex environments.
- Be bold. Prepare for tomorrow, today.
The future of healthcare will bring new challenges, tech advancements and shifts in care delivery. Leaders who embrace continuous learning, adaptability and strategic foresight will be the ones who shape that future. By developing new leaders, fostering a culture of innovation and relentlessly ensuring the patient remains at the center of everything we do, we will ensure that our collective organizations remain strong, resilient and prepared for whatever comes next.
In the end, leadership is about more than just guiding an organization — it’s about empowering others to lead, driving meaningful change and making a lasting impact. As we look ahead, the call to action is clear: be bold; lead with courage, clarity and purpose. The future of healthcare depends on leaders who are willing to lead other leaders and build organizations that can withstand the challenges ahead. We’re preparing for tomorrow and we’re building it. And with every bold step we take, we’re creating a future that’s better for our teams, our patients and our communities.
Wendy Horton, PharmD, MBA, FACHE, is CEO of UVA Health University Medical Center, a nationally recognized academic medical center in Charlottesville, Va., offering advanced specialty care, a level I trauma center, and serving as the teaching hospital for the University of Virginia School of Medicine.
