Chief Operating Officer — Care-Delivery Network

The mandate

A multi-site care network has documented strong individual practice but weak control across transitions. Patient identity is verified differently by site, deterioration signals enter inconsistent escalation paths, and discharge tasks may close before medicines, equipment or follow-up are confirmed. The board needs a Chief Operating Officer who can turn safety requirements into ordinary, repeatable work.

Approximately 1,400 employees and material partners support ambulatory, procedural, post-acute and home-linked services from Boston across the wider US region. The COO owns operations, sites, access, workforce deployment, facilities, service performance and operational improvement, reporting to the Group Chief Executive or nominated sponsor. Clinical leaders own professional standards; the COO makes the operating environment dependable enough to meet them.

Identity control will be rebuilt at every transition, not only registration. Teams must verify the correct person, order, specimen, medicine and destination before hand-off. The COO will define hard stops, permitted exceptions and rapid resolution. Workarounds such as handwritten labels or locally maintained lists require explicit risk assessment and retirement evidence.

Deterioration response needs an end-to-end design. Observation, patient contact, virtual message or caregiver concern may reveal change outside a traditional bedside setting. The operating model will specify who reviews, how quickly, which clinician can act and what happens when the first contact is unavailable. Escalation performance must be tested through cases rather than training completion.

Discharge is a coordinated clinical operation. Medicines, transport, equipment, instructions, test results and receiving care should be confirmed according to pathway. The COO will introduce readiness gates and exception ownership while avoiding unnecessary delay. A patient physically leaving the facility is not the definition of a completed discharge.

Daily management will focus on active risk. Site teams should see patients awaiting critical review, identity exceptions, transfer delays, fragile rosters and overdue follow-up. Meetings will require a named decision and deadline. Historical dashboards that explain yesterday without protecting today's patients will be retired.

Standardisation must preserve legitimate pathway variation. A day procedure and a home transition will implement controls differently, but the safety objective and evidence should remain comparable. The COO will use clinical and frontline design teams, validate changes in normal workload and prevent local preference from being presented as clinical necessity.

Workforce conditions drive reliability. Vacancy, premium labour, supervision and fatigue will be linked to control performance. The COO will set minimum skill mix by service and shift, establish escalation before unsafe coverage begins and develop cross-site capability. Cost reduction will follow a safer roster design, not precede it.

Capacity and safety will be balanced. Adding appointments may overload diagnostics, recovery or follow-up. The COO will model pathway capacity and introduce release rules so front-end growth cannot create hidden downstream queues. Productivity changes will carry balancing measures for rework, escalation and patient experience.

Facilities and equipment controls need operational ownership. Preventive maintenance, temperature, emergency power and clinical consumables may be managed by suppliers, but accountability remains with the network. The COO will classify critical assets, test contingencies and ensure failures trigger patient-pathway decisions, not only engineering tickets.

Third-party partners include transport, home services, pharmacies and staffing agencies. Service agreements will define safety-critical information, acceptance and escalation. Vendor scorecards should include missed hand-offs and clinical consequence. Persistent underperformance will lead to remediation, alternative provision or managed exit.

Incident learning will distinguish immediate containment from sustained control. Actions need an owner, due date, effectiveness measure and evidence under normal conditions. The COO will personally review repeated themes that cross sites and ensure local teams receive usable learning rather than lengthy central reports.

The incoming executive must preserve continuity during leadership transition. The incumbent's active remediation commitments will be mapped, but none will be accepted untested. The COO will communicate clearly with staff, regulators and partners about what remains in place, what is changing and how confidence will be earned.

What you will own

• Network operations and safety-control implementation.
• Identity, deterioration, discharge and transfer processes.
• Site leadership, workforce deployment and daily management.
• Capacity, productivity and patient-flow balance.
• Facilities, equipment and third-party continuity.
• Incident action and effectiveness verification.
• Operational regulator and partner relationships.
• Operations talent and succession.

The first 12 months

In the first 30 days, observe priority pathways on every shift, identify uncontrolled transitions and secure immediate safeguards. Reconcile the inherited remediation plan against actual operations.

By month five, establish common control objectives, pathway-specific implementation and active-risk daily management. Complete live tests of deterioration, discharge and continuity arrangements.

At twelve months, reduce overdue high-risk discharge actions by 70%, cut identity-related near misses by 50% and achieve 95% timely escalation of defined deterioration signals. All critical services should meet approved skill-mix standards on 90% of shifts, and 95% of serious actions must pass effectiveness verification by their agreed dates.

What the sponsor will examine

• Controls operating through busy and after-hours periods.
• Identity uncertainty producing a visible stop.
• Deterioration reaching an authorised decision-maker.
• Discharge closing only after essential continuity.
• Capacity released without downstream hidden queues.
• Incident actions surviving normal operating pressure.

The person

You bring 28+ years in healthcare operations, including COO or regional operating accountability across multiple US sites. Your record includes implementing patient-safety controls during a quality recovery, managing a workforce above 1,000 and personally leading through material service disruption.

Candidates must demonstrate how clinical standards became observable operating routines and how ineffective local workarounds were removed safely. Board and regulator exposure is expected. This permanent role is onsite in Boston with frequent presence throughout the network.

Compensation and terms

Base compensation is USD 500,000–750,000 plus annual incentive and long-term participation linked to safety controls, flow, workforce reliability, service continuity and leadership. The permanent onsite Boston appointment reports to the Group Chief Executive or nominated executive-committee sponsor. Replacement is urgent while remediation remains active.

Confidentiality

The network, patients, sites, practitioners, incidents, controls, partners and transition circumstances remain confidential. Further detail follows conflicts and signed confidentiality. Applicants must not contact providers, staff or regulators to infer the organisation.