At children’s hospitals, “mission” tends to be built into the architecture of daily operations: play folded directly into clinical treatment, leaders who treat the whole family, not just the patient, as the unit of care, and a baseline expectation of urgency that most adult medicine reserves for its highest-stakes diagnoses.
For adult system CEOs, that depth of integration offers a working model worth studying, not just an inspirational message worth repeating.
Dane Peterson, COO of Dallas-based Children’s Health, has a rare vantage point on what makes that integration possible. Before joining the pediatric system in 2023, he spent 15 years at Atlanta-based Emory Healthcare, ultimately serving as interim CEO, with earlier experience at Medical City Dallas. He described the cultural differences between children’s and adult systems as a continuum rather than a clean break.
“There’s obviously some very fundamental differences,” Mr. Peterson told Becker’s. “We take care of pediatric patients, which, vast majority, unless they have some sort of very unique emancipation, they actually don’t make decisions on their own, and so it brings that concept of patient- and family-centered care, but on a much more integral scale than what I was used to for adults.”
Mr. Peterson likens the baseline expectation in pediatrics to adult oncology care. In his experience leading adult systems, cancer patients and their physicians operated with a heightened sense of urgency that did not extend to every other diagnosis. In pediatrics, he said, that intensity is simply the default: When a child is sick, it is the most important thing in a parent’s life in a way that is not always true for adult diagnoses.
“But it’s not zero to 100,” he said. “It’s just a lot versus some.”
That intensity is shaped, in part, by structural realities. Many standalone children’s hospitals function as the safety-net provider for their region, and Children’s Health has a patient population that is roughly two-thirds Medicaid, leaving the system heavily reliant on public financing. Lower disease prevalence in children also forces pediatric systems to draw from a far larger geographic area than an adult system of similar bed count, while still maintaining round-the-clock subspecialty coverage on lower patient volumes. Building and retaining that bench strength, Mr. Peterson said, is a recruitment and retention challenge most adult systems do not face in the same way.
Even against that backdrop, he pointed to concrete practices that he believes could transfer to adult systems regardless of payer mix or geography. One is establishing a broader perspective around patient and family care: “trying to understand the fifth, sixth, seventh, eighth aspect of the patient care needs, not just the first four or five,” he said. He also pointed to how play is woven directly into treatment at Children’s Health, a posture he said he never applied at an adult system but believes is worth adult leaders examining.
That same deliberateness about keeping mission visible, rather than treating it as backdrop, shows up across other pediatric systems as well. Emily Chapman, MD, president and CEO of Minneapolis-based Children’s Minnesota, told Becker’s that her system keeps patients and families present throughout the organization, not just at the bedside.
“Patient stories are a routine part of huddles, town halls, leadership forums and board meetings,” Dr. Chapman said. “Physical spaces reflect children and families by integrating meaningful art. Leadership stays rooted in frontline care through regular ‘go-and-sees.'”
She agreed that pediatric systems center the whole family, not just the patient, which shapes how staff communicate and lead. These practices, she said, can be transferred to adult health systems to more intentionally integrate mission into daily routines, leadership communication and the care environment.
Lisa Aurilio, MSN, RN, COO of Akron (Ohio) Children’s, described a similar set of mechanisms at work in her organization: integrating patient and family voices into governance and the care team, and reinforcing purpose through storytelling.
“The culture within children’s hospitals emphasizes interdisciplinary collaboration, psychological safety and relational leadership, creating strong alignment between organizational values and frontline care,” Ms. Aurilio told Becker’s. “These children’s hospital characteristics keep the mission alive in the day-to-day.”
For Rick Merrill, president and CEO of Fort Worth, Texas-based Cook Children’s Health Care System, that alignment traces back to a single, unifying statement that travels across every part of the organization.
“At Cook Children’s we are grounded by our promise, ‘Everything for the child,'” Mr. Merrill told Becker’s. “As an integrated pediatric health system, this aligns our board, leadership, physicians and team members across many companies and locations with a single purpose. Our colleagues have chosen to be part of Cook Children’s, and we relentlessly connect our strategic decisions and daily operations with our values. Putting the family and patient, whether a child or adult, at the center is something every health system can do.”
Mr. Peterson offered advice for adult system leaders who are taking steps to further integrate missions. He cautioned against treating “doubling down on mission” as a vague aspiration. Leaders need to define, concretely, what that means before it cascades through a medical staff and team — otherwise people will fill in their own definitions.
“Remember why you chose to be a nurse, a doctor, a healthcare administrator, you chose it because you wanted to help people,” he said. “Let’s connect the head and the heart. Let’s make sure we’re putting programs in place to address both, because our caregivers and team members react to both the emotional and the less emotional aspects of the job.
“The watch-out is if things get out of balance: if you’re so far out on cost and market share that you lose the heart and mission side, you can find yourself in a bad position over a couple of years,” Mr. Peterson said. “It’s about finding the right balance and making sure you define it.”
That balance, in his view, is not a tradeoff against financial performance; it is a driver of it. He pointed to access as an example: Many systems list access among their core strategic priorities, but framing it purely as a business requirement misses an opportunity. Tying access improvements explicitly back to mission, he said, gives staff a reason for the work beyond the metric itself.
“The more you can tie it to mission, the more catalyzing the effort will be,” Mr. Peterson said.
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