1. Knowlton, Leslie


Nurses rise to the top at Orlando Regional Healthcare.


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Unlike most large health care systems, at which top management has little or no direct contact with patients, the eight-hospital Orlando Regional Healthcare (ORH) boasts several leaders who launched their careers as nurses. In fact, more than a quarter of ORH's top executives are nurses with patient-care experience who are now heading hospitals or corporate departments in both traditional and nontraditional nursing areas.


Many of the executives began decades ago at the bedsides of Orange Memorial Hospital, precursor to the system that now includes Orlando Regional Medical Center, Arnold Palmer Hospital for Children, Winnie Palmer Hospital for Women and Babies, and M. D. Anderson Cancer Center Orlando. In addition to vice president of nursing, other top corporate positions held by nurses at ORH include executive vice president, vice president of human resources, and senior vice president of finance and administration. Other nurse leaders are presidents, executive directors, and chief operating officers of the system's hospitals and cancer center. And the list goes on.


"Nurses tend to be very team-oriented people, which gives them the propensity to be good executives," says John Hillenmeyer, ORH's president and chief executive officer. "They weren't picked because they were nurses, but that was the platform where they really demonstrated their capabilities as executives."


Hillenmeyer, who has been with ORH for more than 25 years, says that from its beginning the system fostered a culture that particularly valued patient care. Because of their clinical work, nurses have a deep understanding of patient-care issues and how those issues drive management decisions. "These people have all taken the larger view," he says, "and that's why they're successful."


Anne Peach, MSN, RN, is ORH's vice president of nursing and chief operating officer at M. D. Anderson Cancer Center Orlando. She says that the nurses who have become their top executives have obtained advanced degrees in a number of areas, including nursing, finance, business, and health care administration, but it's the shared background in nursing that enables them to bridge differences and understand each other's needs. "It creates a different culture," Peach says. "Our discussions really center on what's in the best interest of the patient, and there's a big focus on the team."


Peach was a clinical nurse specialist at the University of Medicine and Dentistry of New Jersey before moving to Orlando in 1991. After working at ORH as an educator, she became director of corporate education. In 1994 she was invited to apply to run ORH's Orlando Regional Sand Lake Hospital (now Dr. P. Phillips Hospital). "I was kind of in shock," she recalls with a laugh. "But ORH provided me with support and structure, and after a few years I earned my wings." In 2000 she became chief operating officer at M. D. Anderson, and in 2005 was named ORH's vice president of nursing.


Nancy Dinon, MBA, BSBA, ASN, vice president of human resources at ORH, is a leader in an area that few nurses are. Dinon started her career in 1977 as a pediatric nurse at Orange Memorial but quit in 1984 to attend school full-time, earning degrees in business administration. In 1987 she accepted a job in risk management at Orlando Regional Medical Center.


"This is where I began tying together all the business knowledge I had accumulated over the previous few years," says Dinon. In 1988 she returned to the clinical setting as a nurse manager for pediatrics. Later she moved to ORH's St. Cloud Hospital as administrator of ancillary services and eventually became associate executive director. By 1996 she'd been promoted to her current position.


Like Peach, Dinon says that a shared background in nursing gives leaders a common language. "Most important, we share a nursing heart. Being a nurse is at the core of it all," she says.


Kathy Ann Swanson, MS, MBA, BSN, RN, senior vice president of ORH and president of Winnie Palmer Hospital for Women and Babies, also started her career at Orange Memorial in 1977, as a neonatal nurse. In 1989, after a series of promotions and a year before she completed her bachelor's degree, she became director of nursing for pediatric services at Arnold Palmer Hospital for Children.


"Once that happened, a whole new set of doors opened," Swanson says. She next held a series of administrative positions, all while earning master's degrees in health services administration and business administration. In 2005, after being promoted to chief nursing officer at ORH and vice president at Arnold Palmer Hospital, she became an ORH senior vice president and president of Arnold Palmer. Last year she stepped into the position of president of the new Winnie Palmer Hospital.


Swanson encourages nurses to get dual degrees. "You never know what opportunities are going to come your way," she says. "It's good to keep your options open."


Steve Harr, MBA, BS, is ORH's senior vice president of finance and administration. He began as a critical care nurse at Orange Memorial in 1974 and earned a bachelor's degree in respiratory therapy. After becoming an assistant director of nursing, he quickly realized he was "relatively unprepared for the new expectations," so he went back to school to earn an MBA.


Harr went on to become executive director at Arnold Palmer Hospital and held two other top-level positions before reaching his present position in 2005. One of his primary duties, he says, is translating between the financial and clinical sides of ORH.

Figure. Standing wit... - Click to enlarge in new windowFigure. Standing with ORH's president and chief executive officer, John Hillenmeyer, are five top executives in the ORH system who started out as nurses. From left: Steve Harr, Kathy Ann Swanson, Nancy Dinon, Hillenmeyer, Sherrie Sitarik, and Anne Peach. 'Most important, we share a nursing heart,' says Dinon.

"It was not a conscious decision to be where I am today," he says. "I think all of us went into the clinical side because we enjoyed it, and then kind of drifted into other roles."


SherrieSitarik, MS, BSN, RN, is ORH's executive vice president and president of Orlando Regional Medical Center-Lucerne Hospital. Sitarik began her ORH career in 1978 in Orange Memorial's neonatal ICU. By 1986 she was director of nursing for pediatrics. In 1989 she accepted the role of administrator for patient care at the just-opened Arnold Palmer Hospital. After receiving her master's degree in 1993, she became its executive director, as well as vice president at ORH.


"I loved being at the bedside," she says. "But after I filled in as interim head nurse, I found I actually enjoyed management. As you progress through management you have the opportunity to make a difference in broader areas, which is very rewarding."


Her advice to nurses seeking to be leaders? "Follow your passion. Look outside of your area. Get on committees that give you exposure and knowledge. Being a nurse provides such a wonderful foundation for pursuing other opportunities."


Leslie Knowlton