Mark Solazzo, executive vice president and COO of New Hyde Park, N.Y.-based Northwell Health, recently shared with Becker’s that after three decades with the 28-hospital health system, he will retire at the end of the year. Among his accomplishments, Mr. Solazzo is credited with driving a major cultural transformation at Northwell after realizing the COO role should be “90% people” and that “culture changes everything.”

Looking back at his time with Northwell, Mr. Solazzo recalled how the system evolved into a top-tier organization.

“Thirty years ago, Northwell was a very, very different place. It was then North Shore University Hospital, [which] just joined one other hospital, forming the North Shore Health System back in the mid-90s. And it … had great aspirations, but no structure,” Mr. Solazzo said. “It had no physiology of a health system. Our job was to figure out … how to continue to grow into the vision that the fledgling organization had.”

Over time, Mr. Solazzo said he came to learn that effective healthcare operational leadership is more about people than budgets. In his early days with the system, he occupied himself with meeting financial marks and “looking for strategic opportunities.”

Mr. Solazzo later realized that the job should be “90% people.”

“What you have to do is really develop the people around you, find the best, make certain they continue to develop and shine, and develop a culture for the whole organization to make certain that everybody feels valued,” he said.

Mr. Solazzo considers the culture shift and the sense of “systemness” he helped establish at Northwell to be one of his greatest accomplishments.

“It means having small meetings with team members all the time. … It means making certain that everyone feels valued throughout the organization,” Mr. Solazzo said, defining what constitutes building a valuable culture. “And as you grow and get large, which we are very large now, the effort multiplies. And so, it has to be a conscious effort to constantly nurture the culture, because the culture will get you through rough times,” he added.

“The other important thing that I think I’m very proud of is the degree of ‘systemness’ that we created here. This isn’t a collection of entities. It’s not a collection of hospitals and ambulatory facilities across the Northeast. It’s an integrated, true physiological entity in which we all work together, and you can’t distinguish one piece from the other if you pull a thread, it has implications throughout the system,” he said.

As health systems have evolved, so has the COO role, Mr. Solazzo noted.

“When I became COO, it was about really managing a budget. You develop the budgets for the entities, and then you drove that throughout the year. [The COO role] has become much more strategic, much more pivotal … in looking forward five to 10 years … it’s not year to year, it’s not quarter to quarter, month to month. It’s now looking out five years,” Mr. Solazzo said. “What are we putting in place that will make this organization thrive?”

When asked what challenges Mr. Solazzo foresees healthcare leaders facing in the years ahead, he offered advice that he believed may serve younger C-suiters well.

“I don’t see challenges. I see opportunities,” he said. “Because if I look back over the decades that I’ve been here, all the CEOs in healthcare have faced enormous challenges. … We’ve seen an amazing amount of mergers and acquisitions. We’ve dealt with consumerism, government regulation, aging population, technology, cybersecurity, a pandemic, shortages of staff.

“When people start worrying about the [One] Big, Beautiful Bill [Act], or how are we going to face the next pandemic? To me, that is an opportunity to take advantage of the situation. How can we be stronger? How can we be ready five to 10 years from now? How can we come out of these things stronger, more agile, with an ability to serve our patients better, think more strategically, act more locally,” he said.

For future healthcare leaders, Mr. Solazzo’s parting advice centers on empowering team members at every level.

“It’s just not the C-suite,” Mr. Solazzo said. “It’s the housekeeper, it’s the nurse, it’s the therapist, every one of the team members throughout this organization, we’re 104,000 strong now, who make us who we are. That’s why I say you can’t supervise 104,000 team members, what you can do is create an environment, a culture of excellence, of caring, of dedication, and of passion,” he said.

Mr. Solazzo noted the number of tasks a COO is involved with can seem insurmountable, but he believes letting staff know which ones are the most crucial to the organization, patients and the community is key.

“If you don’t purposely cut out some time to deal with those more substantive, long-term issues, you’re never going to reach the heights you can as a leader. So, my advice is to purposely make the time to connect with all of your team members and walk the walk, talk the talk,” he said.

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