As part of an ongoing restructuring, SSM HealthCare-St. Louis has dismissed 75 members of its management team, including all hospital chief operating officers and vice presidents. After taking over in 2007, Chief Executive Jim Sanger reorganized the hospital system into north and south geographic regions and by areas of patient care. During the reorganization, system leaders realized the hospitals needed more consistent practices to improve patient care and efficiency. SSM hopes eliminating most top management positions at individual hospitals will reduce redundancy and help the transition, and Sanger thinks fewer people making decisions will lead to more consistent decision-making.