Issue link: https://beckershealthcare.uberflip.com/i/1543966
12 COO The area of health system operations changing the fastest from 4 strategic leaders By Scott King Becker's asked four healthcare strategic leaders what area of health system operations is changing the fastest. Editor's note: Responses have been lightly edited for length and clarity. Question: What area of health system operations is changing the fastest right now? Chris Kane. Senior Vice President and Chief Strategy Officer, Phoebe Health (Albany, Ga.): e popular answer would be AI, but I believe that is inaccurate. Access is the area that affects every type of community and health enterprise: Urban, suburban, and rural; Population growth or decline; Hospitals, physician groups, or FQHCs. Access is an urgent complex puzzle with myriad tactics: Physician recruitment, APP optimization, GME expansion, telehealth, improved scheduling systems, etc. Many start-up companies in health care are focused on access, from virtual-first triage to in-home testing. Success requires timely pilot projects ("Let's try this") and the discipline to measure the results. Howard Whitfield. Vice President of Operations and Chief Operating Officer, UNC Health Wayne (Goldsboro, Nc.): More has to be done to strengthen health systems in the post-acute area. Most systems do not invest in post-acute services (home health and skilled facilities) due to lack of ROI. Support and resources outside the 4 walls of the hospital are minimal, fragmented, and generally lack quality. Readmissions are costly for everyone – most importantly the patient. We have to do better. Leverage AI, virtual services, and use evidence based practice to be proactive vs. reactive. Cara Koch. Associate Vice President of Indigo Operations, MultiCare Health System (Tacoma, Wa.): Revenue cycle management is undergoing one of the most dynamic shis in health system operations. e use of AI to deliver real-time eligibility and patient responsibility estimates, including claims in process, at the point of service is a true game-changer. is transparency is a triple win: it gives patients clearer financial expectations, strengthens organizational sustainability, and equips the front line to confidently collect at time of service. e impact of this technology is redefining how trust and resilience are built simultaneously. Tyler Stapp. Chief Operating Officer, Pineville Community Health Center (Pineville, Ky.): From a rural health COO perspective, workforce management and clinical operations are the areas of health system operations changing most rapidly. Hospitals must adapt to staffing shortages and evolving workforce expectations while maintaining quality, access, and financial sustainability. At the same time, clinical operations are being reshaped by care standardization, service line optimization, and increased coordination across the continuum of care. n 9 systems with dual CNO-COOs By Mackenzie Bean H ybrid chief nursing officer and COO role are gaining traction in healthcare as systems look to streamline operations and executive teams. While there is no universal approach to C-suite design, some health systems are capitalizing on the natural synergies between nursing leadership and operational management through these dual roles. Hybrid CNO-COOs can strengthen collaboration and care continuity within service lines while simplifying both strategic and operational planning. For smaller systems, the decision to merge these roles may also be driven by budget limitations and staffing constraints. Below are 9 hospitals and systems with dual CNO- COOs. Note: This is not a comprehensive list. If you have an addition, please email Mackenzie Bean at mbean@ beckershealthcare.com. 1. Traverse City, Mich.-based Munson Healthcare appointed Cristen Brandsma, BSN, RN, as COO and CNO of two hospital campuses in April 2023. 2. Amber Egyud, DNP, RN, has served as CNO and COO of Chesapeake (Va.) Regional Healthcare since 2017. 3. Dignity Health's Woodland (Calif.) Memorial Hospital appointed Kara Estenson, DNP, MSN, RN, as chief nurse executive and COO in December 2025. 4. Mount Pleasant, Texas-based Titus Regional Medical Center tapped chief nursing officer, Kathy Griffis, RN, to also serve as COO in a dual role. 5. Jean Ten Haken has served as CNO and COO of Dartmouth Health's Alice Peck Day Memorial Hospital in Lebanon, N.H., since May 2019. 6. Wilhelmina Manzano, RN, serves as group senior vice president, chief nursing executive and COO for perioperative services of New York City-based NewYork-Presbyterian. 7. Kathryn Pagliaroli, BSN, RN, serves as senior vice president, COO and CNO at Oswego (N.Y.) Health. 8. Magnolia (Ark.) Regional Medical Center named Stephanie Schmittou, MSN, RN, COO alongside her CNO role in August 2025. 9. Ascension Via Christi in Wichita, Kan., appointed Erika Troutman, MSN, RN, as CNO and COO of Via Christi St. Teresa and Via Christi Rehabilitation Hospital in July 2025. n