Insights on Healthcare Operations & Leadership
Essays on healthcare operations and leadership, written from inside the work. Myrtle Roy examines access, accountability, workforce performance, and the operational realities that determine whether a health system holds under pressure — drawing on more than two decades from the emergency department floor to multi-site regional leadership, and on the Anchor/Flounder framework that runs through all of it.
When Culture Problems Are Actually Governance Problems
Leadership replacement rarely fixes culture. Myrtle Roy on the four governance dimensions — oversight clarity, performance visibility, executive accountability, and leadership autonomy — that determine whether a healthy culture is even possible.
The Executive Escalation Problem No One Talks About
Healthcare organizations have escalation processes on paper. Serious problems still routinely stall before reaching leadership. Myrtle Roy on why the gap persists — and what it actually takes to close it.
The Four Levels of Accountability in Healthcare Leadership
Accountability in healthcare isn’t one thing. Myrtle Roy on the four interdependent levels — individual, team, organizational, and system — and why all four must function together for a healthcare organization to perform safely and well.
Operational Failures That Quietly Create Litigation Risk
Healthcare litigation rarely results from a single mistake. Myrtle Roy on the five operational failures — culture, workforce conditions, communication, escalation, and management — that quietly compound into legal exposure.
Signals That a Healthcare Organization Is Losing Control
Decline in healthcare organizations is gradual and visible — if you know where to look. Five warning signs that surface in communication and daily operations long before dashboards reflect them.
Why Most Healthcare Culture Initiatives Fail
Most healthcare culture initiatives are well-intentioned. Most of them don't work. Not because of poor effort — because of four execution failures that appear consistently across health systems.
The Quiet Signals That Culture Is Failing
Culture failure doesn't announce itself. It builds through small, repeated behaviors that are easy to dismiss — until the damage is already done. Four signals that appear long before results are affected.
The Quiet Collapse of Accountability in Healthcare
Healthcare's accountability problem didn't arrive with the pandemic. It was already there — and the conditions that produced it are still in place. Four warning signs, what they mean, and what rebuilding actually requires.