As the new chief medical officer of St. Vincent Regional Hospital in Billings, Mont., Christopher Strear, MD, looks to employ a tried-and-true management framework to tackle capacity strain.
The theory of constraints, a decades-old management methodology focused on identifying and resolving system bottlenecks, has proven transformative in healthcare, according to Dr. Strear. He credits the framework with helping to drive improvements in patient throughput, operational efficiency and care coordination in his previous leadership roles. In May, Dr. Strear was named CMO of the Level 1 trauma center, which is part of Salt Lake City-based Intermountain Health.
Becker’s recently connected with Dr. Strear to discuss his vision for operational efficiency, care access in rural Montana and the evolving demands of today’s CMO role.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What drew you to Intermountain Health and the CMO role at St. Vincent Regional Hospital, and what are your top priorities for your first year in the role?
Christopher Strear: My first job out of residency was in the emergency department of a Level 1 trauma center in Portland, Ore. It was a hospital very similar to St. Vincent Regional Hospital. I spent nearly 20 years there before transitioning to a CMO role at a critical access hospital on the Oregon coast. While my new hospital was exceptional in many ways, I missed having the resources of a large, complex facility where we could manage nearly anything that came through the doors.
At the same time, working in a critical access hospital gave me a new perspective. For the first time, I truly felt what it meant to care for an entire community. In a community with fewer healthcare options, the impact of our work was immediate and palpable. When we did something well, the entire community benefited. That sense of responsibility was deeply personal and incredibly rewarding.
When I learned about St. Vincent and its role in caring for Billings and a broad region of Eastern Montana, I felt I could truly have the best of both worlds. It offers the resources and capabilities of a Level 1 trauma center, STEMI center and comprehensive stroke center, while also providing the opportunity to make a meaningful impact in the community. It’s a place where we can live out our mission: helping people achieve their healthiest lives possible.
Intermountain Health has a strong reputation, and I was fortunate to have worked with several exceptional leaders who came from the Intermountain system. They all spoke about the organization’s integrity and culture, and encouraged me to explore this opportunity. I’m glad I took their advice.
Q: You previously led patient flow and operations at Legacy Health. What’s one strategy or framework from that experience that you plan to apply to ease capacity strain and improve operational efficiency at St. Vincent?
CS: I was introduced to the theory of constraints 20 years ago — a management philosophy that focuses on identifying and addressing the most critical limiting factor (or constraint) that stands in the way of achieving a goal. We applied this methodology across hospital operations, including the ICU, inpatient units and the emergency department. In my first experience leading patient flow initiatives, we saw significant improvements within just a few months — it was truly transformative. What’s powerful about this methodology is its versatility; it can be applied to virtually any domain. I’m excited to bring this strategy to St. Vincent to help improve throughput and uncover hidden capacity.
Q: St. Vincent serves a large, rural population in Montana. How are you approaching access and care coordination in such a geographically dispersed region — where do you see the biggest opportunities to improve outcomes?
CS: As someone still new to the organization, I’ve been impressed by the meaningful work already underway at Intermountain Health — led by physicians, providers and caregivers — especially in this area. One of our overarching goals is to keep patients close to home whenever it’s safe and appropriate to do so. I didn’t fully appreciate how vital this is to patients and their families until I worked in a critical access hospital. Tools like virtual care, outreach programs, and takeback transfer protocols between Intermountain hospitals can help us achieve this goal. Additionally, our centralized command center can be very effective in helping coordinate care across regions, ensuring patients receive the right care in the right place.
Q: How have you seen the CMO role evolve over the past few years? What new skills or leadership competencies do you think today’s CMOs need to succeed?
CS: Although I’ve only served as a CMO for a few years, I’ve quickly learned that the role demands versatility. To be effective, a CMO must wear many hats — touching on operations, finance, quality and safety. As organizations strive to become leaner while tackling increasingly complex challenges, it’s essential for every member of administration to step beyond traditional boundaries and collaborate fluidly across functions.
Q: What’s one trend or challenge in healthcare you believe more hospital and health system leaders should be paying attention to and why?
CS: Labor and recruitment challenges have remained a persistent trend in healthcare since the COVID-19 pandemic. Today’s workforce is increasingly prioritizing work-life balance, with many professionals seeking less-than-full-time positions, and there is a lot more movement from one job to another. This shift compels us to rethink how we attract and retain talent, encouraging more creative and flexible approaches to hiring and staffing. By embracing these changes, we have the opportunity to foster greater job satisfaction and longevity, ultimately benefiting our teams, our communities and the patients we serve.
