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
Frontline Staff, Workforce, Organizational Culture, Healthcare Leadership, Accountability, Change Management, Patient Safety Myrtle Roy Frontline Staff, Workforce, Organizational Culture, Healthcare Leadership, Accountability, Change Management, Patient Safety Myrtle Roy

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.

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The Executive Escalation Problem No One Talks About
Frontline Staff, Workforce, Organizational Culture, Healthcare Leadership, Accountability, Change Management, Patient Safety Myrtle Roy Frontline Staff, Workforce, Organizational Culture, Healthcare Leadership, Accountability, Change Management, Patient Safety Myrtle Roy

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.

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The Four Levels of Accountability in Healthcare Leadership
Frontline Staff, Workforce, Organizational Culture, Healthcare Leadership, Accountability, Change Management, Patient Safety Myrtle Roy Frontline Staff, Workforce, Organizational Culture, Healthcare Leadership, Accountability, Change Management, Patient Safety Myrtle Roy

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.

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Operational Failures That Quietly Create Litigation Risk
Frontline Staff, Workforce, Organizational Culture, Healthcare Leadership, Accountability, Change Management, Patient Safety Myrtle Roy Frontline Staff, Workforce, Organizational Culture, Healthcare Leadership, Accountability, Change Management, Patient Safety Myrtle Roy

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.

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Signals That a Healthcare Organization Is Losing Control
Frontline Staff, Workforce, Organizational Culture, Healthcare Leadership, Accountability, Change Management Myrtle Roy Frontline Staff, Workforce, Organizational Culture, Healthcare Leadership, Accountability, Change Management Myrtle Roy

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.

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