Executive Leadership Research Articles

How Do We Optimize Risk in Enterprise Architecture when Deploying Emerging Technologies?

Emerging Technologies which merge cyber-physical systems continue to transform businesses and digital agility in transformative ways. Importantly, most investigations around focus on either cyber risk or the risk around physical systems but it does not encompass both. However, the immediate challenge is new opportunities occurring with emerging technologies. Examples include automobiles, the Internet of Things (IoT), medical devices, and building controls. In this study we will focus identifying risk as an optimization not a minimization problem and how to develop a practical approach for executives and boards to use in the oversight of cyber physical systems. Based on interviews with executive leadership teams and boards of directors we explored the over-arching research question: How can we apply a risk-based approach to cyber-physical security and what questions should business leaders be asking? The research methodology used a survey instrument and multiple qualitative methods involving business leaders from 60 companies and 80 business leaders from September 2018 – September 2019. Based on this analysis, we developed an extended framework for executives, as well as questions and process for boards to consider as part of their oversight. The Extended Risk-Based Approach equips boards and executives as they begin to develop their thinking around enterprise cyber physical risk.

Academic Radiology in the United States: Defining Gender Disparities in Faculty Leadership and Academic Rank

Female physicians in academic medicine have faced barriers that potentially affect representation in different fields and delay promotion. Little is known about gender representation differences in United States academic radiology departments, particularly within the most pursued subspecialties. To determine whether gender differences exist in United States academic radiology departments across seven subspecialties with respect to academic ranks, departmental leadership positions, experience, and scholarly metrics. In this cross-sectional study from November 2018 to June 2020, a database of United States academic radiologists at 129 academic departments in seven subspecialties was created. Each radiologist's academic rank, departmental leadership position (executive-level - Chair, Director, Chief, and Department or Division Head vs vice-level - vice, assistant, or associate positions of executive level), self-identified gender, years in practice, and measures of scholarly productivity (number of publications, citations, and h-index) were compiled from institutional websites, Doximity, LinkedIn, Scopus, and official NPI profiles. The primary outcome, gender composition differences in these cohorts, was analyzed using Chi2 while continuous data were analyzed using Kruskal-Wallis rank sum test. The adjusted gender difference for all factors was determined using a multivariate logistic regression model. Overall, 5086 academic radiologists (34.7% women) with a median 14 years of practice (YOP) were identified and indexed. There were 919 full professors (26.1% women, p < 0.01) and 1055 executive-level leadership faculty (30.6% women, p < 0.01). Within all subspecialties except breast imaging, women were in the minority (35.4% abdominal, 79.1% breast, 12.1% interventional, 27.5% musculoskeletal, 22.8% neuroradiology, 45.1% pediatric, and 19.5% nuclear; p < 0.01). Relative to subspecialty gender composition, women full professors were underrepresented in abdominal, pediatric, and nuclear radiology (p < 0.05) and women in any executive-level leadership were underrepresented in abdominal and nuclear radiology (p < 0.05). However, after adjusting for h-index and YOP, gender did not influence rates of professorship or executive leadership. The strongest single predictors for professorship or executive leadership were h-index and YOP. Women academic radiologists in the United States are underrepresented among senior faculty members despite having similar levels of experience as men. Gender disparities regarding the expected number of women senior faculty members relative to individual subspecialty gender composition were more pronounced in abdominal and nuclear radiology, and less pronounced in breast and neuroradiology. Overall, h-index and YOP were the strongest predictors for full-professorship and executive leadership among faculty. ● Though women comprise 34.7% of all academic radiologists, women are underrepresented among senior faculty members (26.1% of full professors and 30.6% of executive leadership) ● Women in junior faculty positions had higher median years of practice than their male counterparts (10 vs 8 for assistant professors, 21 vs 13 for vice leadership) ● Years of practice and h-index were the strongest predictors for full professorship and executive leadership.

Forecasting uncertainty: Cindy March at Veracity

Study level/applicability This case is appropriate for use in undergraduate and MBA courses. Subject area This case can be used in courses in business ethics, leading teams and organizations or business strategy. The focus of the case aligns well with discussions of managing up, navigating changes in top leadership and conflicts between executive vision and future company growth. Instructors that choose to emphasize the ethical approach could assign this case to explore tradeoffs between loyalty to current and future bosses. Case overview Associate Director of Forecasting Cindy March faces a multi-faceted dilemma as biotech firm Veracity’s acquisition date by pharmaceutical giant Makhola approaches. After a new competitor enters the market, March expects Veracity drug Sangren’s future revenue to drop to $600m in 2019, but the outgoing Veracity CEO refuses to accept a forecast of less than $700m. March suspects that the CEO is intent on handing over a financially successful company and is overly optimistic about Sangren’s ability to maintain market share. In two weeks, March is due to present a 2019 Sangren forecast to incoming Makhola leadership, who she anticipates becoming her direct boss after the acquisition. Should March present the inflated forecasts and accept the poor reflection on her professional abilities or should she refuse to present numbers she does not believe in? Expected learning outcomes By analyzing and discussing the case, students should be able to:Evaluate the potential business and ethical conflicts arising from decision-making based on both data and intuition. Synthesize an appropriate strategy for navigating tradeoffs between current and future leadership.Analyze the gender dynamics of male-dominated executive leadership structures and strategies for female employees to combat gender biases. Supplementary materials The Behavioral Science Guys, 2015. One Simple Skill to Curb Unconscious Gender Bias. YouTube. https://www.youtube.com/watch?v=SEHi4yauhu8&amp;ab_channel=VitalSmartsVideoTeaching Notes are available for educators only. Please contact your library to gain login details or email support@emeraldinsight.com to request teaching notes. Subject code CSS 6: Human resources.

“If you really think it's that important—show me, don't tell me!”

Abstract“Action speaks louder than words but not nearly as often.” Mark Twain: Effective process safety messaging supports, represents, and reinforces a strong process safety culture. However, no communication program or slogan can create a strong process safety culture. Organizations must invest the necessary time and resources to support process safety from the front lines to the board room. In order to establish, sustain, and improve process safety performance, organizations must identify and address situations that contradict their expectations and communication related to process safety. Employee engagement and commitment are only possible when sufficient incentives are provided. In other words, people will put the most effort into the activities that provide the most reward. Actions, particularly financial decisions, always speak much louder than words. Does the executive leadership have a long‐term strategy for investing in process safety? Is a demonstrated commitment to process safety necessary for career advancement? Are leaders rewarded for properly managing risk even when their decisions might have a short‐term negative impact on production? This paper will provide examples of situations that contradict an organization's process safety messaging and suggest best practices to address those situations.

Implementation strategies in the context of medication reconciliation: a qualitative study

BackgroundMedication reconciliation (MedRec) is an important patient safety initiative that aims to prevent patient harm from medication errors. Yet, the implementation and sustainability of MedRec interventions have been challenging due to contextual barriers like the lack of interprofessional communication (among pharmacists, nurses, and providers) and limited organizational capacity. How to best implement MedRec interventions remains unclear. Guided by the Expert Recommendations for Implementing Change (ERIC) taxonomy, we report the differing strategies hospital implementation teams used to implement an evidence-based MedRec Toolkit (the MARQUIS Toolkit).MethodsA qualitative study was conducted with implementation teams and executive leaders of hospitals participating in the federally funded “Implementation of a Medication Reconciliation Toolkit to Improve Patient Safety” (known as MARQUIS2) research study. Data consisted of transcripts from web-based focus groups and individual interviews, as well as meeting minutes. Interview data were transcribed and analyzed using content analysis and the constant comparison technique.ResultsData were collected from 16 hospitals using 2 focus groups, 3 group interviews, and 11 individual interviews, 10 sites’ meeting minutes, and an email interview of an executive. Major categories of implementation strategies predominantly mirrored the ERIC strategies of “Plan,” “Educate,” “Restructure,” and “Quality Management.” Participants rarely used the ERIC strategies of finance and attending to policy context. Two new non-ERIC categories of strategies emerged—“Integration” and “Professional roles and responsibilities.” Of the 73 specific strategies in the ERIC taxonomy, 32 were used to implement the MARQUIS Toolkit and 11 new, and non-ERIC strategies were identified (e.g., aligning with existing initiatives and professional roles and responsibilities).ConclusionsComplex interventions like the MARQUIS MedRec Toolkit can benefit from the ERIC taxonomy, but adaptations and new strategies (and even categories) are necessary to fully capture the range of approaches to implementation.

The Reality for Minorities Exploring Nurse Executive Leadership.

Practices to increase diversity in nursing have had little effect at the executive leadership level. Lack of diversity in leadership threatens efforts to improve patient care and reduce disparities. This article advocates for formal mentorship as an evidence-based pathway to expand diversity in nurse executive leadership.

FORMED IN THE CRUCIBLE OF CRISIS: MY APPROACH AND INSIGHTS ON LEADING PFIZER’S EXECUTIVE LEADERSHIP TEAM

AbstractThe author details his experience as chief executive officer (CEO) of Pfizer, a top five global pharmaceutical company, and in particular his working with the company’s Executive Leadership Team (ELT). He details the company’s turnaround from a period of crisis during the previous leadership regime and outlines four principles that led to its success. The author contends that these principles can work for other executives, either in corporations, or elsewhere. In his words, they are #1: Build trust on the ELT. #2: Align on a fully shared view of the strategic business challenge and needed actions, uniting the ELT. #3: Link the business challenge to needed culture change. #4: Keep the ELT focused on enterprise‐level decisions and true cross‐divisional collaboration opportunities. Each principle is described in detail, revolving around the author’s experience with his Pfizer ELT. For instance, within principle #1, he writes, “How the CEO responds to mistakes can build or diminish trust, especially but not limited to the big mistakes.” Within #2: “My goal was to build a common understanding of our key challenges and from there, set strategy and a game plan for creating a company we could once again be proud of.”

Systemic leadership development: impact on organizational effectiveness

PurposeThis study aims to examine the impact of leadership development programs on organizational outcomes and organizational effectiveness.Design/methodology/approachUsing a grounded theory approach, semi-structured interviews were conducted with 15 executive leaders from aviation firms in Brazil with employees participating in a leadership development program. NVivo12 was used for coding and managing the data. Thematic analysis was performed to determine themes and categories.FindingsThe leadership development program was found to influence organizational level outcomes identified as themes of internal impact, external impact, skill development and capacity. The interviews also found that executive leaders perceived the leadership development program to impact organizational effectiveness. Connections to human capital, social capital and collective leadership were found as outcomes of the leadership development program contributing to organizational effectiveness.Research limitations/implicationsThe findings are dependent upon the executive leaders’ interviews and are limited sample size. The protocol of subjective inter-coder reliability was followed supporting the credibility and dependability of the findings; however, researcher bias may still be present in qualitative studies. Generalizability outside of the Brazilian aviation context is cautioned until further studies in additional contexts and industries are completed.Practical implicationsThe findings of this study support leadership development programs as impactful on organizational outcomes and effectiveness. Incorporating leadership development programs as part of human capital management strategies supports organizational effectiveness through increased collective leadership capacity, human capital development and social capital.Originality/valueA large amount is known regarding the outcomes for individuals as a result of leadership development programs with less examination on the contribution to organizational level outcomes and organizational effectiveness. This study aids in bridging this gap.

Practice transformation at scale through a microsystems quality improvement (QI) approach.

e18667 Background: How oncology providers should implement practice transformation for value-based care is unclear, particularly at scale. Organizational size enables efficient “top down” approaches, but also presents challenges such as physician engagement. Dis-economies of scale can be acute in oncology due to physician autonomy and coordination costs. We hypothesized that organizational change based in sense-making models that enhance physician engagement and use a decentralized, iterative microsystems approach will enable practice transformation to scale. Methods: Florida Cancer Specialists &amp; Research Institute (FCS) is a physician led 250-oncologist statewide practice, with regional variation in disease state/mix, patient cohort, etc., making a purely top-down approach to organizational change infeasible. FCS prototyped a transformation strategy starting in June 2017 based on sharing interpreted data with physician and executive leadership. Later implementation directly engaged physicians in a microsystems quality QI strategy focused on regional performance. Interventions targeted disease, health service utilization, location, and individual physicians. Performance was evaluated using data from Medicare’s Oncology Care Model (OCM) and assessed using the one-sided risk target (4% below benchmark). We analyzed 70,239 performance period (PP) episodes at FCS across 35,116 patients. Results: In the pre- intervention period (90% of PP1 episodes, completed by June 2017), FCS was 5.8% above target. Performance was 10.9% above target for the remainder of PP1 (10% of PP1 episodes), then improved to 0.3% above target in PP2 and PP3, and below target by 0.9%, 0.8%, and 0.75% in PP4, PP5, and PP6. Early QI efforts focused on performance in lung cancer, which was 2.5% over target in PP1; it improved to 2.1% under target in PP6. Later regional QI sessions targeted cancer, utilization and providers. Pre-intervention, all 18 regions were above target; by PP6, 11 out of 19 regions were below target. Relative to the pre-intervention period, per-episode inpatient costs increased by 12.1% for the remainder of PP1 and increased by 4.3% and 1.3% in PP2 and PP6; inpatient costs decreased in PP3, PP4, and PP5 by 3.8%, 2.4% and 4.8%. Conclusions: Practice transformation in oncology can achieve scale through models of organizational change that foster physician engagement. Data, when clinically contextualized, is a foundational tool in the sense-making process. Scale can develop through an additive microsystems approach in which QI units are de-centralized, accountability is defined, and iteration becomes part of organizational culture. [Table: see text]

Reconsidering Budgeting after the COVID-19 Outbreak

The financial field is experiencing unprecedented changes, as the effects of the COVID-19 outbreak are unraveling. One of the main challenges the managers have to face is the elaboration and implementation of the budgets. During 2020, companies worldwide had to continuously adjust the budgets which were already approved before the pandemic. But, as everyone understood that the world is not facing just a temporary situation, executive leaders had to also reconsider their budgeting process, taking into consideration the uncertainties of the future. It was clear that the traditional way of developing a budget, based on historical information, was no longer relevant and a new process should be implemented. Therefore, the aim of this paper is to put into discussion which would be the best alternative to the traditional budgeting process. Based on the thorough analysis of the reports published by relevant organisms and firms, the authors concluded that the best alternative would be the zero-based budgeting technique. The paper presents the benefits of this method, but also a guideline regarding the implementation of this process.

StateChurch: Bringing Religion to Public Higher Education

Religion undeniably impacts life in modern society in numerous ways. In the U.S., discussions about religion in public life often start at the First Amendment of the U.S. constitution as fundamental to the separation of church and state. Public higher education does not necessarily share established associations with any religion, but is not free from religious influence. Although Christian influences are undeniably present on public campuses, educators hesitate to discuss religion and spirituality due in part to a pedestrian understanding of the establishment clause and epistemologies that artificially equate secularism with intellectualism. This paper examines case studies conducted at five public U.S. institutions. Focus groups and interviews highlight what different public campuses are doing to address religious diversity, and how they are succeeding or failing to accommodate the needs of students. Findings indicate that executive leaders’ attitudes towards religious diversity on campus are essential for sustained interfaith efforts, but fell short without bottom-up buy-in. Faculty in particular served as key bottom-up leaders for interfaith motivation on campus with students often feeling most comfortable exploring different worldviews within the classroom. This study provides reasonable and responsible pathways toward helping locate religion within public education, and substantiating interfaith ideas as necessary for an informed and responsible global citizenry.

Gender Disparity in Surgical Society Leadership and Annual Meeting Programs

Prior work suggests women surgical role models attract more female medical students into surgical training. We investigate recent trends of women in surgical society leadership and national conference moderator and plenary speaker roles. Gender distribution was surveyed at 15 major surgical societies and 14 conferences from 2014 to 2018 using publicly reported data. Roles were categorized as leadership (executive council), moderator, or plenary speaker. Data were cross-checked from online profiles and by contacting societies. Logistic regression with Huber-White clustering by society was utilized to evaluate proportions of women in each role over time and determine associations between the proportion of women in executive leadership, and scientific session moderators and plenary speakers. The proportion of leadership positions held by women increased slightly from 2014 to 2018 (20.6%-26.6%, P = 0.23), as did the proportion of moderators (26.2%-30.6%, P = 0.027) and plenary speakers (26.2%-30.9%, P = 0.058). The proportion of women in each role varied significantly across societies (all P < 0.001): leaders (range 0.0%-52.0%), moderators (12.5%-58.8%), and plenary speakers (11.3%-60.0%). Three patterns of change were observed: eight societies (53.3%) demonstrated increases in representation of women over time, four societies (26.6%) showed stable moderate-to-good gender balance, and three societies (20.0%) had consistent underrepresentation of women. There is significant variability in the representation of women at the leadership level of national surgical societies and participating at national surgical conferences as moderators and plenary speakers. Over the past 5 years some societies have achieved advances in gender equity, but many societies still have substantial room for improvement.

Instructional reform and multiple institutional logics: insights from executive leadership in English Multi-Academy Trusts

ABSTRACT The systemic changes in the education policy landscape in England under the academies reform movement have nurtured a growing prevalence of educational organisations such as Multi-Academy Trusts (MATs) operating as meso-level institutional actors that shape the implementation of policies and mediate between social structures and individual contexts and environments. This paper presents findings from an analysis of instructional improvement efforts in two MATs drawing on data from interviews with 13 executives and school leaders. Insights from neo-institutional theory provide an important lens for examining the ways in which logics of state, market and community influence executive leaders’ decisions and practices towards system-wide instructional reform. Findings demonstrate the different ways in which executive leaders perceived these logics influencing their actions and how school leaders experienced the expectations from the executive leaders in the wake of multiple accountability demands. The contextual analysis of institutional logics provides new knowledge on the perceived impact of the macro level policy development and implementation at the meso- and micro-level structures, beliefs and practices revealing the complexity of instructional reform.

Influence of chief executive officer servant leadership on middle managers' voice behavior

On the basis of social learning theory, we explored the mechanism through which chief executive officers' use of the servant leadership style affects middle managers' voice behavior. We analyzed data obtained from a sample of managers of firms in the energy industry in China. We found that chief executive officers' servant leadership had a positive influence on organizational collective promotion focus through its effects on top management team servant leadership. Further, organizational collective promotion focus was positively correlated with middle managers' voice behavior through the mediator of middle managers' promotion focus. Finally, a promotion focus motivated middle managers to speak out more often in their organizations. Theoretical and managerial implications are discussed.

Wells Fargo: An Examination of a Corporate Scandal and the Economic Impact on the Value of the Stock

Throughout the past 20 years, there has been an uptick in corporate scandals (Harrison & Wicks, 2021). In light of recent scandals that are part of our daily news feed, there is an impetus to do more research on why and how executive leaders continue to perpetuate these misdeeds and what impact, if any, these scandals have on the overall financial status in relationship to the stock activity Wells Fargo (WFC) is one of the companies that was engulfed in massive scandal (Cavico & Mujtaba, 2017) and will be the main spotlight for this paper. This paper will highlight and draw parallels between WFC fake account scandal and the effects that this activity had on their stock activity before, during, and afterward. An in-depth analysis is needed to see if there are any correlations between how a power-house company, such as WFC falls from grace to greed, and what economic impact the shameful conduct has on the company’s stock prices. The theoretical analysis further seeks to investigate whether there is a causal relationship between corporate governance transgressions and the negative effects on large-scale stock performance. This paper will attempt to show how the market reacted to the predacious behavior of WFC.

Leadership challenge: lateral systems integration for healthcare

PurposeGovernment imperatives that drive integrated care are challenging corporate executive leadership. Conspicuous by its absence in both government's imperatives and the literature, is any reference to corporate executive leadership in transitioning a hierarchically oriented health system to a laterally integrated health system referred to, in this paper, as an integrated health system. This lack of reference to executive leadership involvement conveys either significant consequences or opportunities for corporate healthcare executives. The purpose of this qualitative, multi-case study is to explore corporate executive leadership in transitioning a hierarchically oriented health system to an integrated health system.Design/methodology/approachBetween December 2017 and February 2018, a qualitative methodology and multi-case study design facilitated one hour telephone interviews with 11 presidents and four senior vice presidents. Critical case sampling was used to select the study sample from a target population of 246 corporate healthcare executives representing Ontario's major acute healthcare organizations/systems.FindingsCorporate healthcare executives possess the requisite skills and knowledge to transition a hierarchically oriented to a laterally integrated the health system but are constrained by an undefined partnership role with government and fear of government changes.Originality/valueThis paper provides corporate executive leaders with a systematic leadership approach to organizational readiness, in transitioning to an integrated health system. Features and outcomes of the approach are illustrated.

A Model Development of Administrators Leadership Integrating Garāvāsadhamma IV in Primary Schools under Bangkok Metropolitan Administration

The purposes of this research were 1) to study the leadership of primary school administrators, 2) to study theleadership styles of administrators integrating Garāvāsadhamma IV in primary schools, 3) to propose the leadership styles ofadministrators integrating Garāvāsadhamma IV in primary schools. Research tools used in the research were questionnairesdistributed to 390 administrators and teachers in primary schools under Bangkok Metropolitan Administration, interview formby interviewing 24 key informants, and questions for focus group discussion with 9 experts. The researcher collected the dataand analyzed data consisting of 1) document analysis using content analysis, quantitative data analyzed using percentage,frequency, mean, and standard deviation. Data from interview and focus group discussion were analyzed by using contentanalysis. Results indicated that leadership of primary school administrators under the Bangkok Metropolitan Administrationconsisted of 3 aspects which were 1) vision (Chakkuma), 2) knowledge and ability (Withusu), and 3) Human relations(Nissayasampanno), and overall was in a high level. Considering in each aspect showed that it was at high level in all aspects.Leadership styles of administrators integrating Garāvāsadhamma IV in Primary schools under Bangkok MetropolitanAdministration consisted of the leadership principles of the administrators of primary schools. Garāvāsadhamma IV is fair forpeople to live together, honesty with one another, self-training, patience, tolerance, sharing, generous, the qualities of those whocan create honor, create wisdom, and create wealth and building a group of friends and family to succeed with their ownperseverance. Garāvāsadhamma IV consists of 4 principles which are (1) truth, (2) emotional control, (3) patience, and (4)sharing. Leadership styles of administrators integrating Garāvāsadhamma IV in primary schools under the Bangkok MetropolitanAdministration was called L G S Model, there will be 3 important points which are: 1) Leadership (L), Leadership of theadministrators of primary schools was shown in physical behavior various words of leaders that colleagues or subordinatesworking together to achieve the goals set in 3 ways, which were (1) vision (Chakkuma), (2) knowledge and ability (Withusu),and (3) have human relations (Nissayasampanno). 2) Garāvāsadhamma IV (G) is justified for executive leadership in primaryschool under Bangkok Metropolitan Administration, there are 4 factors which consisted of truth, emotional control, patience,and sharing. 3) School (S), school administration was the operation in all 4 aspects of the school, which were (1) academicadministration, (2) budget administration, (3) human resource management, and (4) general administration.

Tone From the Top: The Role of the General Counsel in the Prevention of Harassment and Abuse in International Sports.

To prevent harassment and abuse in sports, the consensus is that an essential factor is “tone from the top” of the organization. It is key as a catalyst and sustainer of change, whether in the corporate or sports world. An organization's general counsel is one of the go-to top advisors for executive leadership regarding laws and regulations. Additionally, they serve as advisors for issues in other areas, such as public policy, ethical and legal risks, and human rights. With their leadership, general counsels can play a vital role in the prevention of harassment and abuse in an organization. The guidance and leadership of the general counsel should facilitate reviewing and strengthening of the organization's policies and procedures and other strategies helping to prevent and address issues of harassment and abuse. Legal issues become more complex the more global the organization, so more complex strategies are needed to tackle these issues successfully.

Today's Advanced Practice Leader: Value Contribution to Healthcare Systems and Delivery of Accessible, High-Quality Patient Care.

This month's column highlights organizational, practice, and patient care advantages to adding advanced practice leaders to health systems' leadership teams and ideal characteristics of effective, executive advanced practice leaders.

Operations (Management) Warp Speed: Parsimonious Design for Rapid Deployment of Hospital Prediction and Decision Support Framework during a Pandemic

At the onset of the COVID-19 pandemic, hospitals were in dire need of data-driven analytics to provide support for critical, expensive, and challenging decisions. Yet, the majority of analytics being developed were targeted toward state- and national-level policy decisions, with little availability of actionable information to support tactical and operational decision making and execution at the hospital level. To fill this gap, we developed a multi-method framework leveraging a parsimonious design philosophy that allows for rapid deployment of high-impact predictive and prescriptive analytics in a time-sensitive, dynamic, limited data environment such as a novel pandemic. Our framework integrates disease progression models tailored to data availability during different stages of the pandemic with a stochastic network model of patient movements among units within individual hospitals to forecast time-varying patient workload and demand for critical resources. Both components employ adaptive tuning to account for hospital-dependent, time-varying parameters that provide consistently accurate predictions as changes in system dynamics are learned over time. The product of this research is a workload prediction and decision support framework customized to individual hospital that specifically targets actionable information based on hospital needs. Yet, by design, our framework is portable across hospital data-systems and easily implementable for expeditious expansion. This work was contextually grounded in close collaboration with IU Health, the largest health system in Indiana with 18 hospitals serving over 1 million residents. Since April 2020, we have implemented our framework to support decisions from operational to strategic made by multiple departments at IU Health as well as the executive leadership team during the course of the COVID-19 pandemic.