For generations of physician and nurse leaders, good care was measured by presence: a full roster, a fully staffed floor and a patient in a hospital bed. That definition is shifting fast as virtual nursing, AI-supported workflows and team-based care models give clinical executives new ways to protect quality without stretching their people thinner.
Becker’s asked chief medical officers and chief nursing officers from hospitals, health systems and academic medical centers across the U.S. which once-core strategic assumption their team has fully let go of as that equation stopped holding up.
Every executive featured in this article will speak on panels at Becker’s CMO+CNO Summit at the 14th Annual CEO + CFO Roundtable, taking place November 2-5, 2026, in Chicago. Attendees will have the opportunity to hear these and other health system leaders discuss the challenges shaping strategy for the year ahead, from workforce retention, AI integration, to OR operations.
Registration is open now for the 14th Annual CEO + CFO Roundtable. Register here to secure your spot and join the conversation with the executives featured below.
If you would like to join as a speaker or a reviewer, please contact Mariah Muhammad at mmuhammad@beckershealthcare.com or agendateam@beckershealthcare.com.
For more information on sponsorship opportunities, please contact Jessica Cole at jcole@beckershealthcare.com.
Question: What once-core strategic assumption has your team fully abandoned?
Kyle W. Trecartin, MD. Chief Medical Officer of Beth Israel Deaconess Hospital–Plymouth (Mass.): Our team has abandoned the belief that healthcare organizations can afford to be reactive. For decades, hospitals have been designed to respond to events after they happen: an emergency department surge, a staffing shortage, a patient safety event, or a preventable readmission.
Today, we’re focused on anticipating challenges before they occur. Improved access to data and advanced analytics allows us to identify operational pressures before they become crises. A strong culture of safety encourages us to proactively identify risks and redesign processes before harm occurs. By studying trends in care transitions and understanding where patients struggle after discharge, we can create stronger communication pathways, reduce avoidable readmissions, and improve outcomes. Similarly, greater care standardization reduces unnecessary variation, improves reliability, and creates capacity to absorb unexpected demand.
Success in healthcare is no longer defined by how effectively we respond to problems. It’s increasingly defined by how often we’re able to prevent them.
Sunil Patel, MD. Chief Medical Officer of Prime Healthcare (Ontario, Calif.): We have abandoned the assumption that all growth is good growth.
Healthcare organizations historically celebrated growth almost reflexively. More procedures, more physicians, more service lines and more volume were generally viewed as signs of success. But even growth that is profitable on a standalone basis may not be strategically valuable.
Today, we are much more disciplined about asking whether growth fits the broader hospital and market strategy, strengthens a service line where we can truly differentiate, and deserves the organizational resources required to execute it well.
Leadership bandwidth is finite. Capital is finite. Clinical talent is finite. Operational capacity is finite. If an organization tries to grow 10 priorities simultaneously, it can easily end up executing none of them exceptionally well.
For us, the objective is not simply to grow. It is to identify the areas where we can create distinctive clinical value, build the necessary infrastructure around them, and concentrate leadership attention there.
Growth for growth’s sake creates complexity. Strategic growth creates value.
Amber Price. Enterprise Chief Nursing Officer of Sentara (Norfolk, Va.): Our team has moved away from medication scan rates as a measure of success and safety. Our RCA process consistently demonstrated that scan rates are not reflective of adherence to medication administration protocols. While the medication may have in fact been scanned, it may not have occurred prior to administration. Normalized deviance has been identified as a primary cause of medication errors. Normalization of deviance in healthcare happens when medical teams routinely break safety rules or take shortcuts, and because nothing bad happens right away, the unsafe shortcut becomes the normal way of working. We have shifted to monitoring when scanning occurs, not if scanning occurred. This has led to new use of virtual verification and ongoing remote auditing. We are using our virtual hospital and existing FTE to normalize support and surveillance of medication administration protocol adherence.
Megan Isley, DNP, RN. Chief Nursing and Quality Executive of Adena Health (Chillicothe, Ohio): One assumption we’ve moved away from is that a single healthcare strategy can work equally well across every community we serve. In rural healthcare, the needs of the community have to drive the model, not the other way around. What works in one market may look very different in another based on access, workforce, transportation, economic conditions and the resources already available locally. At Adena Health, that has pushed us to listen differently, build stronger community partnerships and think more creatively about how and where care is delivered. Sometimes the answer is expanding traditional services, and other times it is bringing care closer to patients through schools, community partnerships or new models of access. The goal is not to make every community look the same. It is to make sure each community has the right resources and relationships to keep high-quality care as close to home as possible.
Amy Buckingham, DNP, MSN, RN. Patient Care Executive of Adventist Health North Coast Service Area (Roseville, Calif.): One strategic assumption I’ve moved away from is the belief that the best solutions come from leadership.
As we’ve continued to build on our foundation of High Reliability, I’ve learned that the people closest to the patient are often the ones who see risks first and know what needs to change. We evaluate every event or near miss as an opportunity to learn and strengthen our care delivery model.
Whether we’re addressing workplace violence, supporting patients in behavioral health crises, or navigating workforce challenges, our frontline nurses and caregivers bring insight that cannot be replicated in a boardroom.
My role has shifted from providing answers to creating an environment where people feel safe speaking up, solving problems, and leading change.
Some of our most meaningful improvements have come from nurses who identified barriers, raised concerns, and worked collaboratively to develop better solutions.
When we trust and empower those closest to the work, we not only improve safety and outcomes, we strengthen engagement, resilience, and accountability.
To me, High Reliability is ultimately about ensuring every caregiver has both the confidence and support to make care safer and better for our patients every day.
