Following a year of significant financial, workforce and operational challenges, hospital and health system CEOs are redefining leadership and adopting new mindsets and approaches to meet today’s complex environment.
Becker’s asked leaders: Looking back over the past year, what is one decision that has shaped your view on health system leadership — and what new mindset or approach would you encourage fellow CEOs to adopt as a result?
Below are their answers, ranging from topics such as accountability to encouraging experimentation.
Editor’s note: Responses are lightly edited for length and clarity.
Jandel Allen-Davis, MD. President and CEO of Craig Hospital (Englewood, Colo.): “Constant vigilance” has taken on new meaning. We keep hoping things will stay settled once they seem settled, yet the pace of change and disruption across health, finance, technology and labor shows no signs of slowing. That reality requires us to lean more deeply on the wisdom of our teams, stay alert to signals we might not usually notice, and adopt a more agile stance in how we meet challenges and opportunities.
We also have to be honest in how we communicate while still offering hope — and recognize that traditional ways of looking at data may steer us wrong. It’s time to pay closer attention to the story our data tell collectively and strengthen our use of predictive analytics and modeling. And personally, we must protect our own health and well-being so we can show up fully for our teams, patients, families and communities.
It’s a tall order — but together, we can meet it.
Abel Biri. CEO of AdventHealth Orlando (Fla.): Over the past year, the most defining decision for me was doubling down on complexity — specifically, expanding our quaternary and destination-care capabilities while simultaneously holding expectations for patient experience, reduction in length of stay and managing expenses. Size and acuity cannot be an excuse for variability or diluted accountability. It’s understanding, at a deep level, that complexity isn’t something we “manage around” — it’s the strategic gift we must leverage.
Frank Citara. President and Chief Hospital Executive at Hackensack Meridian Ocean University Medical Center (Brick, N.J.): Over the past year, I learned that the most impactful leadership decision was to pair transparency with genuine accountability — for myself and the entire organization. In a challenging year of financial pressure and workforce issues, it was evident that transparency is meaningless unless leaders take responsibility for results, admit errors and apply the same standards to themselves as they do to others.
By sharing our goals and how we measured them, we built trust and improved performance, adjusting our approach based on data and feedback from our front-line teams. This accountability aligned our efforts instead of slowing us down.
I urge fellow CEOs to see accountability as an empowering tool, not a punitive one. It clarifies purpose, speeds up decisions and helps everyone see how their work contributes to our shared goals. Leadership in a field as vital as healthcare cannot afford to dodge difficult conversations or hide results. To inspire excellence, we must consistently model accountability.
Joan Coffman. President and CEO of St. Tammany Health System (Covington, La.): While not new, I would encourage all leaders to practice servant leadership, where we place ourselves second in service to others. It has carried me throughout the years and kept me grounded in our true calling of caring and serving others during good times and through transformational change. Stay positive; lead with integrity, vision and purpose.
John Couris. President and CEO of Florida Health Sciences Center | Tampa General Hospital: One of the most important lessons I’ve learned this year is the ongoing need to practice strategic improvisation. This means holding on to a clear strategy while staying agile enough to pivot when the unexpected happens. In our industry, change is constant and variables shift daily. We must be comfortable with being uncomfortable.
I’ve also continued to be reminded of the power of resiliency. Resiliency isn’t just about bouncing back. It’s about moving forward with strength and clarity, even when the headwinds are strong. At our health system, that strength comes from our people. We believe team members come first because when they have the support they need, they can deliver the best care possible to our patients.
Keith Dacus. CEO of St. Charles Parish Hospital (Luling, La.): When I look back over the past year, the decision that changed me the most as a leader wasn’t a bold strategic pivot — it was choosing to slow down and really listen to the people inside our system who were telling us, in so many ways, that the pace and pressure had become unsustainable.
We’d been trying to “optimize” our way through constant disruption, but the truth was that our teams needed more flexibility, not more perfection. So, we shifted. We created quicker decision loops, gave front-line leaders more room to act and built cross-functional groups that could move faster than our traditional structures allowed. What surprised me was how much relief and creativity surfaced once people felt genuinely heard. That experience reshaped my view of leadership more than any strategic plan ever has.
If I could encourage fellow CEOs to adopt one mindset, it would be this: We don’t need to be the heroes with all the answers. We need to be the architects of organizations where people have the freedom, trust and support to solve problems together.
What that means to me is:
- Letting go of some control so teams can respond in real time
- Making experimentation feel safe, not risky
- Investing in leadership at every level, not just the highest levels
- Celebrating learning — even when it comes from things that didn’t work perfectly
Healthcare is unpredictable right now. But what I keep coming back to is this: When we create the conditions for people to thrive, the organization becomes resilient almost naturally. That’s the kind of leadership I think our industry needs — more human, more humble and far more adaptable.
Jeff Flaks. President and CEO of Hartford HealthCare (Hartford, Conn.): “Always answer the phone.” That’s something I share often because it’s a timeless leadership lesson — especially when we’re all so busy. It reminds us that being a leader really means serving others. At Hartford HealthCare, we talk a lot about servant leadership — executive responsibility and not executive privilege. Answering the call — literally or figuratively — might be a patient needing help, a colleague seeking guidance, or someone offering a new opportunity. As leaders, we have the privilege of being the person on the receiving end of that outreach.
And we have the capacity to help someone when they most need it — but only if we answer their call.
Paul Hiltz. President and CEO of Naples (Fla.) Comprehensive Health: This year has reinforced my belief that partnerships are essential for succeeding in the complicated healthcare landscape. Our patients want to see us partner with the very best to deliver great care. These partnerships include physicians, other organizations, public health agencies and employers. By working collectively, we can look for new ways to address affordability and quality.
Chad Lefteris. President and CEO of UCI Health (Orange, Calif.): Despite the volatility facing healthcare and higher education across the country, we’re focused on the fundamentals we can control. That means supporting our people, stewarding our resources wisely and staying grounded in our mission to deliver exceptional care — regardless of the uncertainty around us.
