Ninfa M. Saunders, DHA, RN, FACHE, is president and CEO of Navicent Health, formerly known as Central Georgia Health System and the Medical Center of Central Georgia in Macon. Previously, she was president and chief operating officer (COO) of Virtua Health in southern New Jersey. From 1995 to 2002, she was COO of Dekalb Medical Center in Decatur, Georgia, and from 1980 to 1993 was director of nursing resources at Emory University Hospital in Atlanta. From 1974 to 1980, she held various positions at St. Barnabas Medical Center in Livingston, New Jersey.Dr. Saunders has served on the Governor's Georgia Cancer Coalition and holds academic appointments as dean's professor at the Mayers School of Business, as distinguished faculty at Emory University, and as an associate professor at Rutgers University. She is a Fellow of ACHE and serves on the board of directors for the American Hospital Association as the chair of the Institute for Diversity in Health Management. She also has served on the board of the American Heart Association.Awarded the 2011 Woman of Distinction award from the New Jersey Go Red for Women public awareness campaign from the American Heart Association, Dr. Saunders was also honored with the 2012 American Red Cross Citizenship and Good Neighbor award for her dedicated service to healthcare. The 2013 recipient of the Georgia Diversity Council's Most Powerful and Influential Woman award, she was most recently named the 2014 CEO of the Year by the Georgia Alliance of Community Hospitals.Dr. Saunders earned her doctorate in healthcare administration from the Medical University of South Carolina, an MBA degree from Emory University, an MSN degree from Rutgers University, and a BSN degree from Concordia College in Manila, Philippines. She holds a Black Belt in Six Sigma from the University of Michigan College of Engineering.Dr. O'Connor: Reflecting on the differences between the job of CEO and that of COO, how should a COO best prepare to become a CEO? What do you see as the most important behavioral competency a CEO needs to possess in order to succeed in today's healthcare environment?Dr. Saunders: When I think about our work as leaders in healthcare, I think about three simple yet comprehensive aspects: strategy, operations, and people-with people being the most important. A COO should focus on all three, but his or her main job is to translate the strategy of the organization as defined by the CEO into an implementable, workable framework. In other words, the work of the COO is translation and execution. How should the strategy be executed? What areas need to be modified and strengthened? Once these questions have been answered, the COO and CEO must be prepared to reframe the tactics and approach to meet the expected outcomes for the organization.A CEO is also closely involved with the areas of strategy, operations, and people, but here is the difference: The CEO must have the ability to put concepts together, such as the organization's vision and how it relates to the mission, the community served, and the people surrounding him or her, and to develop a model that integrates all of these variables into a platform of strategic imperatives that can be translated into the organization for implementation. Equally important is that, as those tenets cascade to the employee base and to the community and are brought back to the CEO through various avenues, such as the COO, the C-suite, employees, the community, or patients, the CEO must constantly be willing to adjust and recalibrate. This recalibration requires flexibility to ensure that the organizational agenda is relevant. CEOs have the best job, and also one of the most challenging jobs, in the healthcare organization. They are in charge, and while at the helm they must demonstrate operational competencies to achieve process integration and success. Some of those competencies include (1) building a guiding coalition to assess the strategic imperatives that you have planned for the organization; (2) gaining credibility; and (3) advancing a common understanding of what it is you are doing, why you are doing it, and what the value proposition is for all key stakeholders. …