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.
When Culture Problems Are 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.
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 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.