Malloy & Co. Operating Partnerships

Hospital System Operational Readiness
Risk Assessment

15 Indicators That Show Where Your Operation Is Drifting

Progress
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How to Use This Assessment

Built from 30 years of working inside hospital systems — from the clinical floor to the C-suite. Answer each indicator using the appropriate scale. When complete, enter your information to receive your personalized score and readiness profile.

Response Scales

Frequency Scale — Recurring Behaviors

1 — Never This does not occur in our organization
2 — Sometimes This occurs periodically or in some areas
3 — Often This is a consistent or widespread pattern

Yes / No — Structural Facts & Historical Events

Yes This is true of our organization
No This does not apply to our organization
Critical ×2  Weighted double — poses greatest organizational risk

Section 1 — Leadership & Organizational Structure

3 Indicators

The foundation of operational performance is clarity — in roles, accountability, and decision-making authority. When this foundation is unstable, everything built on top of it is at risk.

The CEO regularly steps into operational decisions that should be handled at the COO or director level. Critical ×2
Leadership Clarity
Accountability for operational outcomes is unclear or shared in ways that create confusion.
Accountability
There is no formal operational council or shared governance structure for non-nursing departments.
Governance
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Section 2 — Clinical-Operational Integration

3 Indicators

This is the gap most administrative leaders cannot see clearly — because few have worked a clinical floor. When clinical and operational functions are misaligned, the friction is invisible to administration but deeply felt by the people delivering care.

Clinical staff frequently work around formal processes rather than through them. Critical ×2
Process Integrity
Operational decisions affecting clinical departments are routinely made without frontline clinical input — and concerns raised by clinical staff rarely change the decision.
Decision Quality
Patient flow inefficiencies are tracked as metrics but not actively managed as operational problems.
Patient Flow
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Section 3 — Service Line Performance & Growth Readiness

4 Indicators

Growth without operational infrastructure does not scale — it fragments. The following indicators identify whether your service lines are positioned to expand or simply absorb the pressure of growth.

Service line expansion plans are regularly delayed due to operational, staffing, or infrastructure constraints.
Growth Capacity
Physician engagement scores are declining or have plateaued despite targeted improvement efforts.
Physician Relations
Capital projects are routinely delivered behind schedule or over budget. Critical ×2
Execution
The organization lacks a clear framework for evaluating, launching, or expanding new service lines.
Strategic Infrastructure
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Section 4 — Employee Engagement & Operational Culture

3 Indicators

Employee engagement is not an HR metric — it is an operational indicator. When engagement erodes, turnover climbs, patient experience suffers, and operational performance deteriorates, often before leadership recognizes the connection.

Employee engagement scores have declined or remained flat for two or more consecutive survey cycles.
Engagement Trend
Turnover in key operational or clinical roles is higher than benchmark or difficult to explain. Critical ×2
Retention Risk
Leadership development, succession planning, and knowledge transfer for departing leaders are not formalized below the C-suite level.
Pipeline Depth
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Section 5 — Compliance, Risk & Regulatory Readiness

2 Indicators

Compliance and operational performance are not separate disciplines. Organizations that treat them as separate functions often discover — too late — that their operational gaps are their regulatory exposure.

Ethics and compliance functions are siloed from operational leadership rather than integrated.
Compliance Integration
The organization has experienced regulatory citations, survey findings, or compliance concerns in the past two years linked to operational breakdowns. Critical ×2
Regulatory Exposure
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✓

Your Assessment Is Complete

Enter your information below to unlock your personalized risk score, section-by-section breakdown, and readiness profile.

Your Operational Risk Score & What It Means

Higher score = higher operational risk. Five critical indicators count double. Each section is scored independently on a 0–100 scale.

0 / 100 risk
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Complete all indicators above to see your readiness level.

About weighted scoring: Five indicators carry double weight because they represent the most measurable, externally visible, and organizationally costly risk patterns: CEO in operations, clinical workarounds, capital project execution, turnover above benchmark, and regulatory citations. Your overall score and each section score are expressed on a 0–100 scale for easy comparison.

Score by Section

Each section is scored independently. A strong overall score can mask a critical gap in one area — review each section below.

Leadership & Structure
0 /100
Clinical-Operational Integration
0 /100
Service Line & Growth
0 /100
Employee Engagement
0 /100
Compliance & Regulatory
0 /100

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