On Aug. 3, Susan Carroll will become chief of clinical enterprise operations at Inova Health System — a role overseeing all five hospitals that she has, one by one, already run.
That arc is rare. Ms. Carroll told Becker’s she is the only person to have led every hospital in the Fairfax, Va.-based system. She has spent 28 years with the system and has worked, she said, at “very different versions of Inova” as it grew from a cluster of community hospitals into an integrated network.
Reflecting on her career and leadership lessons, Ms. Carroll shared a story about feedback she heard from a charge nurse roughly 17 years ago, when she was a hospital COO and about to take over as president.
During a visit to a unit she could tell was struggling, a charge nurse told her, “The fish rots from the head down.”
Ms. Carroll said she was halfway back to her office before it landed — the head was her. A friend and coworker gave her a fish pillow, which sits in her office as a reminder of that moment.
“Culture is leadership-led. If your teams are struggling, it’s not your teams that are struggling — you’re the one that’s struggling,” said Ms. Carroll, who is currently president of Inova Loudoun Hospital in Leesburg, Va. “You can’t blame ‘down.’ You just can’t. You have to be able to be willing to listen and hear.”
As chief of clinical enterprise operations, her job is to run operations across every hospital and service line, benchmark them against one another and outside systems, and act as the conduit that spreads what works.
Her near-term focus is access — getting patients in — and closing the performance gaps between individual hospitals. She said Inova has spent roughly seven years pushing to become a truly integrated system rather than a set of loosely affiliated hospitals, where a patient moving between a hospital, an ambulatory clinic and a surgery center feels one organization rather than several.
Ms. Carroll said her priority is finishing that work: standardizing the best of what each hospital already does and scaling it systemwide. She sees technology, and AI in particular, as the lever for closing those gaps — and expects healthcare to adopt it over the next decade faster than the industry ever has.
“The same tactics that got us here are not going to get us where we need to be for the next 30 years,” she said.
Ms. Carroll’s throughline is the front line. Nearly three decades with Inova, she said, taught her the same thing the charge nurse did: leaders exist to remove barriers for the people doing the work, and the fastest way to find those barriers is to ask.
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