When CEOs take the helm of an organization, there are often listening tours, discussions with employees and time spent getting to know the people of their organizations. Many times, those early weeks lead to some of their first decisions, which can involve balancing what an organization needs at the moment with where it needs to go next.
“I’m a big believer that leaders need to be closest to the work and hear and see things for themselves,” said Ketul Patel, president and CEO of Marietta, Ga.-based Wellstar Health System.
For Mr. Patel; Andrew Davis, president and CEO of Buffalo, N.Y.-based Erie County Medical Center; and Christopher Longhurst, MD, CEO of Seattle Children’s, those first decisions involved their leadership teams, their workforces and their quality and growth goals. Becker’s spoke with the three CEOs, each about a year or less into their current roles, about the moves they made first.
Dr. Longhurst started at Seattle Children’s in January after a decade at UC San Diego Health, most recently as chief clinical and innovation officer. Within his first two weeks, he said, he learned some physician leaders wanted to have access to the executive team, so he worked quickly to make it happen.
“We didn’t just say, ‘You have access.’ We said, ‘Hey, we want you to come visit us,'” Dr. Longhurst said.
He also introduced monthly office hours, giving physician and administrative leaders opportunities to connect informally with the executive team.
“That’s been a tremendous relationship builder, particularly for me in my first year, but also for these leaders who may have inadvertently felt not part of the senior leadership team, or not welcomed,” he said.
The emphasis on bringing employees together also informed a more recent decision to establish a three-day-a-week office expectation for Seattle Children’s hybrid workforce, which accounts for about 20% of employees. Previously, individual departments had different requirements, sometimes for employees working alongside one another.
Dr. Longhurst said the change was intended to improve collaboration rather than productivity. He pointed to employees reconnecting in person and canceling meetings because they could resolve issues or brainstorm what’s possible through informal conversations.
“The reason for the return to office is building community, connection and collaboration,” he said.
Mr. Davis took a different path to the top job at ECMC, where he had spent about a decade as COO and then president before becoming CEO. Having helped build the executive team, one of his first decisions was to keep it intact.
“Anytime someone takes over, it doesn’t matter if they’ve been there for a long time, people always wonder what he’s going to do,” Mr. Davis said. “So one of my first concrete decisions, and it’s probably one people don’t know about because I made it without having to make it public, was to say, ‘This team is good.'”
With the leadership team in place, he outlined five priorities: people, service, finance, quality and growth. Growth has received particular attention as the safety-net hospital works to address financial pressures.
Mr. Davis said ECMC is projecting a loss in the high $40 million range for 2026. Rather than initially concentrating on expense reductions, he has focused on strengthening service lines, physician recruitment and grant opportunities to expand access and bring in additional revenue.
The hospital is identifying recruitment firms for several service lines and working with clinical leaders on service development. Mr. Davis also pointed to investments in specialty care, including thoracic services, as examples of the growth opportunities he wants to pursue.
“We have to look at our service lines and strengthen them, and strengthen our recruitment efforts,” he said.
For 2027, ECMC anticipates exceeding $1 billion in gross revenue for the first time, according to Mr. Davis. That revenue projection is separate from the hospital’s expected operating loss in 2026 and does not indicate that ECMC expects to be profitable.
Mr. Davis, who first became a hospital CEO at 35, said his experience has also changed how quickly he approaches decisions. Now 56, he places greater emphasis on consistency and recognizing that organizational change takes time.
“Twenty-one years later, I understand better that it’s much more of a journey than a sprint,” he said. “You have to understand that it takes discipline and consistency over and over again.”
At Wellstar, Mr. Patel is approaching his first anniversary as CEO. He spent his first two months visiting facilities across the health system, listening to employees and learning about its operations before launching four major initiatives. Among them was a systemwide quality goal that has since been adopted by Wellstar’s board.
“Our quality at Wellstar is very strong, and in pockets we’re top decile. But the expectation we set, which our board has now adopted, is that we need to be top decile in quality for the entire system, and we need programs that patients come to from all throughout the Southeast and maybe even nationally,” Mr. Patel said.
The initiative includes measures for quality and patient safety outcomes, along with expectations for strategic service lines. Mr. Patel said setting that standard early was important because patient care remains the organization’s central responsibility.
Mr. Patel has also emphasized communication with employees as Wellstar makes organizational changes. Since July, Wellstar has cut 761 jobs, completed its acquisition of its 12th hospital, opened its 13th and announced plans to add its 14th. Reflecting on conversations with first-time CEOs, he said leaders should communicate more frequently than they initially think necessary, particularly with front-line employees.
For Mr. Patel, that direct connection with employees is as important as the priorities a CEO sets in the first months on the job.
“Whatever you’re thinking about communications, triple the amount you’re doing,” Mr. Patel said. “Nobody is going to shape your voice better than you.”
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