Malloy & Co. Operating Partnerships

Malloy & Co. Operating Partnerships

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Malloy & Co. Operating Partnerships

The Health System
Operational Quality Assessment

25 indicators · 15 minutes · An honest look at whether your operational infrastructure can sustain the performance your strategy demands

The gap between strategy and performance is almost always an operational infrastructure problem.

Most health systems have a clear strategy. Few have the operational infrastructure to reliably deliver on it. This assessment reveals where the gaps are — before they show up in margin reports, board conversations, or physician attrition.

Built from 30 years inside health systems, across four hurricanes, a pandemic, and dozens of service line transformations, these 25 indicators reflect what actually separates organizations that execute from those that don't.

Rate each indicator based on your organization's actual state — not your aspirations or your most recent board presentation

CRITICAL indicators are the ones most commonly driving margin leakage and leadership credibility gaps

Your results and priority recommendations appear after all 25 are answered

Rating Scale

1 - Strong

Operating well; a genuine organizational strength

2 - At risk

Present but inconsistent; vulnerable under pressure

3 - Critical Gap

Absent or broken; actively costing performance now

Section 1 — Accountability & Governance

High-performing health systems have unambiguous ownership of every critical metric. Operational drag almost always traces back to unclear accountability.

Every major initiative has a single named owner with defined milestones — not shared accountability distributed across a committee. *

1 - Strong

2 - At risk

3 - Gap

CRITICAL

Decision rights are clearly understood — people know what they can decide independently versus what requires escalation to leadership. *

1 - Strong

2 - At risk

3 - Gap

Leadership meetings produce documented decisions and assigned follow-through — not just status updates that reset the next week. *

1 - Strong

2 - At risk

3 - Gap

There is a functioning operating cadence — weekly and monthly rhythms that keep initiatives from losing momentum between leadership reviews. *

1 - Strong

2 - At risk

3 - Gap

Underperformance is addressed directly and quickly — there is no organizational tolerance for persistent unresolved performance gaps. *

1 - Strong

2 - At risk

3 - Gap

OQA Section 1 Score

Section 2 — Operational Efficiency

Operational efficiency determines whether your margins can support your strategy. The numbers in the dashboard rarely capture the full picture of where drag is concentrated. accountability.

Service line leaders have clear visibility into their contribution margin and understand the specific levers that drive it. *

1 - Strong

2 - At risk

3 - Gap

Throughput metrics — OR utilization, LOS, bed management — are tracked in real time and owned by identifiable leaders with authority to act. *

1 - Strong

2 - At risk

3 - Gap

Staffing models are reviewed regularly against actual patient volumes — not carried forward from prior years with minimal adjustment. *

1 - Strong

2- At risk

3 - Gap

Supply chain and purchased services spend is actively managed with defined targets, named accountability, and regular variance review. *

1 - Strong

2 - At risk

3 - Gap

Your organization has reduced costs in the last 12 months without proportional reductions in quality, safety, or service line volume.

1 - Strong

2 - At risk

3 - Gap

OQA Section 2 Score

Section 3 — Physician Alignment & Engagement

Physician alignment is not a nice-to-have. It is the mechanism through which volume, quality, and cultural performance are ultimately delivered.

Physicians in key service lines — surgical, CV, procedural — view leadership as operational partners, not obstacles to be worked around. *

1 - Strong

2 - At risk

3 - Gap

Physician compensation models are aligned with current organizational performance priorities — not legacy structures that reward activity regardless of outcomes. *

1 - Strong

2 - At risk

3 - Gap

There is a functioning joint operating committee or equivalent structure where physicians and administrative leaders resolve conflict and make decisions together. *

1 - Strong

2 - At risk

3 - Gap

Physician engagement scores have improved or held steady in the last 12 months, and leadership understands the primary drivers of dissatisfaction. *

1 - Strong

2 - At risk

3 - Gap

Leadership can name the physicians whose alignment is critical to the next 12 months of performance — and has an active plan to maintain it. *

1 - Strong

2 - At risk

3 - Gap

OQA Section 3 Score

Section 4 — Quality & Safety Infrastructure

Quality and safety infrastructure is only as strong as the organizational will to act on what it surfaces — and the systems that make that action possible.

Quality and safety data is reviewed at the executive leadership level — not just quality committees — and drives resource and priority decisions. *

1 - Strong

2 - At risk

3 - Gap

Near-miss and adverse event reporting rates suggest a psychologically safe culture — not systematic underreporting driven by fear of consequences. *

1 - Strong

2 - At risk

3 - Gap

Core quality measures — readmissions, HAIs, HCAHPS — are benchmarked against peer organizations, not just tracked against internal prior-year trends. *

1 - Strong

2 - At risk

3 - Gap

Peer review and credentialing processes are functioning, timely, and not primarily defensive — they are genuinely improving practice. *

1 - Strong

2 - At risk

3 - Gap

Clinical and operational leadership are aligned on which quality gaps pose the greatest organizational risk — and there is a shared, resourced plan to close them. *

1 - Strong

2 - At risk

3 - Gap

OQA Section 4 Score

Section 5 — Strategic Execution

Strategy execution is where most health systems lose margin, credibility, and talent. The gap between planning and delivery is where the COO earns their seat.

Your organization's top three strategic priorities are known — and measurably advancing — at every level of leadership, not just in board presentations. *

1 - Strong

2 - At risk

3 - Gap

Capital projects are consistently delivered on time and within budget — or variances are surfaced early and managed proactively, not discovered at completion. *

1 - Strong

2 - At risk

3 - Gap

Service line growth initiatives have produced measurable volume or margin improvement in the last 18 months — not just launch activity and planning documents. *

1 - Strong

2 - At risk

3 - Gap

The leadership team is energized by the organization's direction — not quietly managing burnout, disillusionment, or fatigue from repeated stalled initiatives. *

1 - Strong

2 - At risk

3 - Gap

If the CEO or COO stepped back for 30 days, the operational infrastructure would sustain performance — without degradation or leadership paralysis. *

1 - Strong

2 - At risk

3 - Gap

OQA Section 5 Score

OQA Total Score

Enter your details to receive your full operational quality breakdown, section scores, and Kelly's recommended priority actions for your specific profile.

Full Name *

Organization *

Title *

Email *

Your information is confidential and will not be shared. Kelly may follow up with resources specific to your results.

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