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Message from Doug Hawthorne


TO: Texas Health Resources Physician Leadership Council, Entity Chiefs of Medical Staffs

FROM: Doug Hawthorne, FACHE, Chief Executive Officer and Dr. Glenn Hardesty, Chairman, Physician Leadership Council

DATE: Wednesday, March 07, 2012 12:16 PM 

Texas Health Resources has reached a key crossroads in its journey to transform the delivery of health care to the people we are privileged to serve.  We have made tremendous progress in the first half of our 10-year climb up Transformation Mountain.  However, our industry as we know it today is under unprecedented pressure; we acknowledge that significant change is necessary to equip us for the future.

I want to share with you today our vision for a transformational advancement of Texas Health Resources’ leadership and governance.  This important leadership evolution is designed to move us away from operating in silos – where physicians, hospitals, home-health agencies and other care providers each deliver care in our respective settings and sometimes lack coordination and communication.  This change will significantly advance us toward patient-centered, coordinated care across the continuum, delivered with higher quality and in more cost-effective settings.  While our nation’s leaders continue to work toward solutions, Texas Health Resources must chart its own course, understanding that true reform happens locally, led by those directly giving and receiving care.  So as we lead change, we move from being a hospital-centered system to become: 

  • A well-connected and coordinated system of health delivery that strives to help people be healthy and well in addition to expertly treating disease and injury;
  • An organization committed to explicitly collaborating and integrating across all access points of care across the continuum, both those we own and those with whom we partner;
  • A health care system that excels at managing the health of groups of individuals (“population health management”) through the development and use of individual care plans that treat the whole person and emphasize prevention, well-being and ongoing medical care.

Shared, collaborative leadership

Texas Health Resources continues to grow and transform care delivery, and, as I’ve shared previously, we must evolve our leadership model to stay in step with the future of our north Texas market and industry.  This advancement of our leadership furthers our vision of joining with physicians to become the health care system of choice and honors our commitment to continually improve the quality of care.  Advancing more clinical executive leadership at several key points throughout the organization is a critical component of our future.

Our new leadership model

We will employ a dyad model that emphasizes both operations and clinical excellence.  The dyad approach has been successfully utilized at other progressive healthcare systems; it is a two-pronged approach to the integration of clinical and healthcare operations.  This will include a new Chief Operating Officer (COO) and a new Chief Clinical Officer (CCO) reporting to me.  The dyad model is a key element in bringing about consistent, high-quality care delivered in the most appropriate setting.

The system COO and CCO will lead the formation of three zones within Texas Health Resources – North, Southeast, and Southwest.  Each zone was carefully organized after thorough analysis and opportunity assessment.  The vision for the zones is to be people-centric and organized around geographies where people live, work, worship, go to school, and seek health care services.  Each zone will consist of all critical elements of Texas Health Resources within the respective geographic area: physicians, wholly-owned hospitals, joint ventured hospitals, diagnostic and health centers, ambulatory surgery centers, and pre- and post-acute services.  Physicians will practice in each of the three zones in their current settings.  We will actively reach out within and across zones to work in a collaborative fashion with other health care partners who share our vision of excellence and commitment to seamless care delivery.

For a zone map, click here.

The dyad model will extend to the zones, with operations and clinical leaders jointly overseeing each zone, reporting to the system COO and CCO, respectively.  While the zones are defined geographic areas, zone borders should not be viewed as boundaries that cannot be crossed.  For instance, there is no reason a patient could not be referred to another zone for services based on the existence of a system-wide service line such as heart and vascular, or based on the patient’s individual needs or a physician’s preferences.

An organizational chart detailing the zone model and reporting relationships can be found here.

Our system of governance will also evolve.  While the Texas Health Resources board will continue to be responsible for operational and financial strategies and success measures, Zone boards will be created to oversee the alignment of our wholly-owned and joint-ventured entities, physicians, continuum of care partners and community organizations to improve the value we deliver to the communities we serve.  Hospital community boards will continue to concentrate on overseeing their respective acute care hospital’s local quality, safety, service, credentialing, community health, advocacy and philanthropy.

Further explanation of system, zone and hospital board responsibilities can be found here.

Next steps

It is our intent to fully complete these advances by January 1, 2013 with incremental activities occurring throughout the remainder of 2012.  It will take time to determine who will fill these important posts.  We are blessed with outstanding operational and clinical leadership talent, and it is our intent to advance people from within Texas Health Resources wherever possible.  Watch for additional communications in the coming weeks and months about the selections, as well as the addition of new collaborative relationships and how we will manage populations of people to become healthier. 

We have made significant progress, for which we should be very proud. But we have more tough work ahead.  You, our employees, volunteers and our loyal physicians, remain our most valued assets.  Thank you for the key role you play in transforming the way we care for our patients and delivering our Mission, Vision, Values and Promise.

Send your questions to  I will work to address your questions in future communications and in a special Texas Health Now videoconference at 10 a.m. March 19.


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