As health systems grow and the needs of patients evolve, organizations are creating new C-suite roles to match.
The moves are part of a wider restructuring wave: amid shifting priorities and systemwide realignments, hospitals and health systems across the country have cut, combined and expanded C-suite roles throughout the past few years.
The common thread among the inaugural appointments, leaders say, is complexity — growth that has outpaced existing governance structures, workforces that have expanded faster than the leadership models built to support them and strategic partnerships requiring dedicated executive alignment. Becker’s connected with eight leaders who shared the key drivers behind inaugural appointments at their organizations and the gap each role fills.
Growth
Several systems pointed to expansion, including the acquisition of community hospitals and the construction of new facilities, as the primary catalyst. Charlottesville, Va.-based UVA Health tapped longtime physician leader, Reid Adams, MD, as its first system-wide chief medical officer in February, following the full acquisition of three community hospitals in 2021 and the expansion of primary and specialty care clinics across Virginia. The move was designed to bring consistent, high-quality care to patients throughout the state, connecting community locations more tightly to the academic medical center in Charlottesville.
UVA Health CEO Mitchell Rosner, MD, said the strategic vision to evolve as an expanded integrated health system made unified clinical leadership essential.
“This role will support more streamlined decision-making, strengthen collaboration across locations and ensure our resources are organized around the needs of patients and families across Virginia,” he said.
Beaufort (S.C.) Memorial similarly pointed to physical growth as the driver when it named Courtney Smith its inaugural COO and vice president of operations in April. The hospital is preparing to open a second facility in the fast-growing South Carolina Lowcountry, and President and CEO Russell Baxley said expanded operational leadership became necessary to manage that transition.
“By continuously improving processes, removing barriers and maximizing resources, we strengthen the organization and create the capacity for continued growth in our community,” Ms. Smith said.
Integration
At Rochester (N.Y.) Regional Health, the driver was less about geography and more about alignment. The system appointed Leslie Wong, MD, as inaugural chief clinical officer in April, bringing together the provider enterprise, clinically integrated network, graduate medical education, and quality and safety functions under a single leadership structure.
Dr. Wong said the healthcare environment, which is increasingly shaped by value-based care, workforce demands and the need for consistent outcomes, required those functions to operate with shared priorities and accountability. The role was created to bridge traditional silos among clinical operations, physician leadership, quality and safety, medical education and network development, he said.
“While healthcare organizations have historically separated many of these functions, today’s environment requires a more integrated approach to ensure consistency, efficiency and accountability across the continuum of care,” he said. “Bringing these functions under the chief clinical officer unifies leadership and accountability to ensure coordinated, patient-centered care.”
Dr. Wong expects that impact to surface in four areas: stronger care coordination in patient outcomes; deeper physician and provider engagement with system strategy; more consistent clinical integration and clearer accountability organizationally; and better alignment across the provider enterprise, network and academic programs to support growth in value-based care.
Nursing alignment and workforce scale
For two systems, a rapidly expanding nursing workforce and the need for unified strategy prompted the creation of a chief nurse executive role for the first time. Birmingham, Ala.-based UAB Health System named Terri Poe, DNP, RN, to the role in January.
Dr. Poe said the organization’s continued growth in size and complexity made unified nursing leadership across the academic and community health system a strategic necessity, not just an operational one.
“As our organization continues to grow and evolve, this role fills the need for alignment of nursing priorities across all care settings while advancing professional practice and operational excellence,” Dr. Poe said. “The impact over time will be standardization of care, best practice implementation, and the opportunity to maximize nursing practice across the state.”
Houston-based University of Texas MD Anderson Cancer Center made a similar move in April, appointing Kim Slusser, PhD, RN, as its inaugural chief nurse executive. MD Anderson’s nursing workforce exceeds 6,000 — spanning care, research, education, prevention and leadership — and Rosanna Morris, executive vice president and chief clinical operations officer, said the scale and specialization of that workforce had outgrown existing structures.
“As the role of nursing has continued to grow and evolve, we saw an important opportunity to be more proactive and strategic in how we support, align and elevate that work,” Ms. Morris said. “This role was created to provide health system-level leadership for nursing and to ensure our nurses are positioned to have the greatest possible impact on patient experience, safety and quality.”
The new role is expected to yield new professional practice models, strengthen recruitment and retention and create long-term career pathways. Ms. Morris said it would also ensure nursing leadership is directly aligned with organizational strategy and MD Anderson’s broader commitment to exceptional cancer care.
APP workforce evolution
New Orleans-based LCMC Health took a different approach to workforce leadership, creating an office of advanced practice in May and appointing Meghan Kirkland as inaugural chief of advanced practice. The move followed marked growth in the system’s advanced practice provider workforce — growth that, over time, produced different processes across departments.
The new office is designed to standardize management, promote clinical excellence and position APPs not as operational resources but as fundamental strategic assets, Ms. Kirkland said.
“The chief of advanced practice role represents an important shift in utilizing APPs not just as operational resources, but as fundamental strategic assets,” she said. “By creating a centralized vision of advanced practice at LCMC Health, we can streamline processes to better support the workforce, strengthen retention and expand access. With the increasing demands facing healthcare, centralized organization of APPs allows for top of license practice, which translates into better outcomes, improved access and a more seamless experience for the patients and communities we serve.”
New partnership structure
Springfield, Mo.-based St. Louis Children’s at CoxHealth appointed Matthew Adler, MD, PhD, as its inaugural pediatrician-in-chief and chief medical officer in March. The role emerged from a joint venture between St. Louis Children’s Hospital and CoxHealth that also drew on pediatric expertise from St. Louis-based WashU Medicine. Sarah Becker, vice president and administrator of Southwest Missouri at St. Louis Children’s at CoxHealth, said the three-way collaboration created a clear need for dedicated medical leadership to ensure alignment and consistency.
“The role was designed to provide that leadership — ensuring care delivery reflects the high standards of St. Louis Children’s Hospital, CoxHealth and WashU Medicine, while building a foundation for a strong medical staff,” Ms. Becker said. “The impact is already being seen in closer coordination across care teams and aligned strategic vision to expand nationally recognized pediatric expertise to children and families across the region.”
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