Of course, clinical challenges are at the heart of what has gone wrong at Parkland, with physicians also playing a role, especially with documentation issues. Some physician issues have been forwarded to a "peer review" committee, Royer says.
Another area that the hospital wants to improve is the relationship with UT Southwestern, whose medical students serve Parkland. The hospital will improve its mentoring and coaching programs, he says.
Royer emphasizes the importance of carrying out a "strong leadership program" at Parkland, as well as improved internal and external communications. He has initiated leadership and employee forums in which he eventually hopes to meet all of the hospital's 9,000 employees, including 1,600 physicians.
That's a tall order for one leader in a short amount of time, but he tries to keep it personal. When he's introduced to staff, Royer asks to be called Dr. Tom. When he left Christus, he wrote his books about leadership and teamwork. "I decided to record my 'learnings' in my quiet time," he says.
To excel at leadership, "you have to have passion. In order for me to hone my skills as a better leader, I've also become a better person, a better parent, spouse and better friend. The greatest 'learning' for me is that popularity is not parallel with good leadership." In taking on leadership in that way, "it's worth it," he says.
Even at Parkland.