Airica Powell-Steed, Ed.D, MBA, RN, CSSMBB, FACHE, FAAN, IASSC - Interim Executive Vice President and Chief Operating Officer, Loretto Hospital Network

Summary

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Episode Overview

Guest: Dr. Airica Powell-Steed, Ed.D, MBA, RN, CSSMBB, FACHE, FAAN, IASSC - Interim Executive Vice President and COO, Loretto Hospital Network
Host: Laura Deardo, Becker’s Healthcare
Date: January 10, 2026
Theme: Transformative Leadership in Healthcare Crisis—Moving Beyond Survival

This episode centers on Dr. Airica Powell-Steed’s insights into leading healthcare organizations through complex challenges—especially those tied to workforce exhaustion, financial difficulties, and maintaining the human side of healthcare. Dr. Steed shares perspectives on sustainable transformation, culture-driven change, and strategic growth for 2026 and beyond.

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Key Discussion Points & Insights

Dr. Steed’s Background and Philosophy

• 25 Years in Challenging Roles ([01:17])

  • Fourth-generation nurse and seasoned executive, specializing in safety net health systems, financially distressed organizations, and underprivileged communities.

  • Founded Breakthrough Innovation Partners to guide hospitals and public sector orgs through complex operational and cultural transformations.

    “What pulls my heartstrings is safety net health systems, highly unionized environments, financially distressed organizations and communities that historically have been underinvested yet deeply resilient.”
    — Dr. Steed ([01:25])

• Transformative Approach

  • Focuses on stabilizing, resetting, and redesigning care delivery while prioritizing mission, dignity, and long-term vision.
  • Believes true progress is more than “incremental improvement”—it’s about complete, culture-driven transformation.

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Key Initiatives & Pandemic Aftermath ([03:39])

• No One-Size-Fits-All

  • Led multifaceted transformation in environments facing severe financial strain and deep workforce exhaustion post-COVID.
  • Emphasized community engagement and complex, people-centered change.

• Long-Term Over Short-Term

  • Warned against relying on expedient cost-cutting as a strategy.

  • Instead, advocates for operational rigor, executive team stability, and quality performance.

    “It takes courage to say we cannot cut our way to health or success.”
    — Dr. Steed ([11:52])

• Results

  • Combined improved financial, operational, cultural performance, and community engagement through holistic interventions.

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Change Management that Sticks ([06:40])

• People and Culture at the Core

  • Champions trust, respect, and listening to the “muted” voices—staff and communities who often feel left out.

  • Encourages creating space for community involvement, making change happen “for them, not to them.”

    “It’s all about rebuilding a sense of trust and just respect in the people centered aspects of change management... I pride myself in opening up seats at the table for the community to have a real voice and unmute the muted.”
    — Dr. Steed ([07:08])

• Sustained Change Through Inclusion

  • Says there’s no single tactic (“no one stick of spaghetti that really sticks on the wall”)—customization and dialogue are key.

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2026 Priorities & Industry Headwinds ([08:25])

• Escaping “Survival Mode”

  • Urges transition from crisis response to sustainable, proactive leadership.

  • Identifies convergence of pressures—regulatory tightening, reimbursement erosion, workforce exhaustion, and more.

    “For many systems the question quietly being asked is no longer how will we thrive, but can we even survive all of these components? And that’s really a dangerous place to lead from.”
    — Dr. Steed ([09:39])

• Values-Anchored Leadership

  • Stresses avoiding short-term fixes (“mortgaging the future for survival”).
  • Champions long-term strategic decisions rooted in courage rather than fear.

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Courage, Consensus, and the Temptation of “Quick Fixes” ([11:13])

• Leadership Under Pressure

  • Notes that leaders in 2026 will be pushed to act quickly but warns that “speed without strategy” causes harm.

  • Emphasizes saying “no” to solutions that may be easy politically or financially but are ultimately damaging.

    “The hardest thing right now for leaders is courage and pressure under fire...It takes a lot of courage to say we cannot cut our way to health or success. It takes even more courage to really protect people, especially in environments where the workforce morale is already fragile.”
    — Dr. Steed ([11:39])

• Strategic Discipline

  • Encourages organizations to slow down, challenge assumptions, include previously excluded voices, and demonstrate prudent, anchored decision-making.

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Growth Strategies and Future Opportunities ([13:21])

• Redefining Value

  • Growth is about reimagining “how value is created—not just where revenue comes from.”

  • Investing in workforce, culture, capability, and trust as key strategic assets.

    “The greatest opportunity for growth honestly is lies in rethinking how value is created, not just in where revenue comes from.”
    — Dr. Steed ([13:26])

• Innovation through Collaboration

  • Predicts a move away from traditional M&A towards strategic collaborations and coalitions.
  • Recommends “checking titles at the door” for true, non-competitive partnerships serving community benefit.

• Aligning Clinical Excellence with Financial Stewardship

  • Leaders must stop framing clinical and financial priorities as oppositional.

• Health Equity as a Non-Negotiable

  • Integrates health equity into every strategic discussion, calling it an “anchored force” for sustained growth.

    “I like to hide the health equity pill in the applesauce because I’m never going to move away from that as a core priority for me.”
    — Dr. Steed ([15:48])

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Notable Quotes & Memorable Moments

• “Speed without strategy is how organizations really create self-inflicted wounds.” — Dr. Steed ([11:28])
• “Leadership right now in this era is not about being popular... it’s about being anchored, being disciplined, being focused and taking the courage to slow yourself down and really act more strategically.” — Dr. Steed ([12:29])
• “Growth is not going to come from chasing those shiny objects anymore and replicating what worked five, ten, fifteen years ago. It’s going to come from leaders willing to redesign care models, decision rights, cultures, and really embrace innovation in a very nifty, creative type of way.” — Dr. Steed ([15:19])
• “We can’t abandon health equity as a strong semblance of growth.” — Dr. Steed ([15:59])

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Important Timestamps

• [01:17] Dr. Steed’s healthcare background and orientation to challenging environments
• [03:39] Most important initiative in the past year—workforce exhaustion, financial stability, community engagement
• [06:40] Principles of lasting change management—the people element
• [08:25] Key challenges, headwinds, and priorities for 2026
• [11:13] Leadership challenges: Courage, resisting quick fixes, strategic discipline
• [13:21] Rethinking growth: value creation, partnerships, workforce, and health equity

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Tone & Takeaways

Dr. Steed speaks with a mix of urgency, empathy, and strategic discipline. Her emphasis is on human-centered, courageous leadership and deep transformation over superficial or expedient fixes. She advocates for a new healthcare growth paradigm, driven by investment in people, partnerships, and health equity.

This episode serves as a powerful guide for leaders facing mounting pressures—encouraging them to slow down, listen more deeply, and anchor decisions in shared values for sustainable success.

Transcript

[A]

The most important healthcare decisions don't happen in isolation. They happen when leaders come together. Becker's 16th annual meeting brings together more than 3,500 hospital and health system executives this April in Chicago. With 800 speakers from Ascension, Cleveland Clinic, Common Spirit and more, the conversations get real. Leaders will share how their scenario planning for policy shifts brief, breaking through value based care barriers and building clinical teams that translate new ideas into real world care. Join top decision makers in the room April 13th through the 16th. For the agenda and event details, visit BeckersHospitalReview.com and click on the Events tab in the upper right.

[B]

This is Laura Deardo with the Beckers Healthcare Podcast. I'm thrilled today to be joined by Dr. Erica Powell Steed, CEO of Breakthrough Innovation Partners. Dr. Powell Steed, it's a pleasure to have you on the podcast today.

[C]

I'm so excited to welcome the new year 2026.

[B]

Absolutely. Now to get us kicked off, I'm wondering, can you tell us a little bit more about yourself and your background? I know you've served in many top executive roles at hospitals and systems and so looking forward to catching up a bit with you and seeing where you're at today.

[C]

Sure, sure. So I've been a long term partner and certainly not a new face or voice to Beckers, but by way of the introduction, I'm Dr. Erica Steed, a fourth generation nurse, healthcare system executive and transformational leader spanning 25 years. So my career has really been built in the hardest places in healthcare. Really what pulls my heartstrings is safety net health systems, highly unionized environments, financially distressed organizations and communities that historically have been underinvested yet deeply resilient. That's the spaces that I've really been very fortunate to play in over the course of my career. As of the last several years, I currently lead and advise through my own company, Breakthrough Innovation Partners, where we work alongside hospitals, health systems payers and public sector organizations really navigating through a great deal of complexities. Whether it's financial pressure, regulatory change, cultural fractures or circumstances. The real focus is not just on leading and driving incremental improvement, but really helping organizations stabilize, reset and redesign how care is delivered and how people are led without losing sight of mission, dignity and long term focus. So that truly is what my organization is all about and I'm very proud to have lived through a variety of capacities over the past several years.

[B]

That's amazing to hear and you know, what a great experience to have. And then coming into this new year too, when healthcare is in Such an interesting place in the US is critical. Now I'm curious, when you think back at the last year, could you talk a little bit about the most important initiative that you led? What did you do and what were the results?

[C]

Sure, sure. My goodness. This past year I really can't believe 2025 is. But what I would say is the most important initiative wasn't a single program or a single circumstance. It really has been leading and navigating through complex multifaceted transformational journeys. So over the past year I stepped into a multitude of environments and in my current capacity as interim Chief Operating Officer, I've stepped into environments that have been really navigating through severe financial and troubling circumstances due to a variety of factors. But really some of the key symptoms I've really had to help navigate through is the severe workforce exhaustion and burnout that still has been a residual damage and harm from the COVID pandemic that really didn't fully rebound. But also really helping organizations navigate through complex people centered change and improvement and that encompasses really pulling the community in on that transformation. So it has not just been a one side or one size fits all type of efforts that I've been navigating through. On the financial sense is really helping organizations elevate quality performance, really keep the community well and out of the hospital, while also balancing the dynamic of pay for performance, really helping to stabilize executive teams and re establishing operational rigor and discipline without defaulting to very quick tempting solutions to blunt cost cut our way to health and success, which is not always the go to solution for sustainable transformation. I've really been extremely fortunate to really lead some large scale transformational turnarounds that has had a combined effect on financial performance, operational performance, cultural performance, as well as community engagement.

[B]

That's amazing to hear and you know, so critical right now. I know there's so many hospitals and systems across the country that are going through similar challenges. Especially I know you mentioned workforce transformation and thinking about how you can bring people along that human dynamic of continuing to change in healthcare, whether it's through digital transformation or some of the other initiatives. So what do you do to make sure that change management sticks?

[C]

Honestly, change management at its core is all about people and it's all about culture and it's all about rebuilding a sense of trust and just respect in the people centered aspects of change management. Every initiative, every effort, every transformational journey that I've been so fortunate to navigate through, I bring people along the way on that journey. So it's all about Getting back to the core principles of listening more than you're speaking as a leader, really winning over the hearts and minds of the heart and soul of the culture, bringing the community in. So a lot of times the community feels like change is happening to them and not for them. So I really pride myself in opening up seats at the table for the community to have a real voice and unmute the muted that is often not heard or respected in the change management process. So that is certainly not a one size fits all and it's certainly not just one stick of spaghetti that really sticks on the wall when it comes to change management. But those are some of the core principles that I really lean on and leverage as I go about this important work.

[B]

That's fascinating to hear. Thank you so much for digging a little bit deeper and great advice. Now looking ahead to 2026, what are some of the big priorities you have as well as headwinds that you're focused on?

[C]

Well, honestly, what I would say, and I know I'm not alone in my voice on this, I think the biggest priority for leaders and organizations and communities alike is moving beyond the survival mode that we've been in. And I think that we've been on this perpetual survival mode, quite honestly, well before the pandemic. But the pandemic certainly springboarded us into this. But healthcare right now is facing a convergence of pressures even more heightened, tightened regulatory tightening, reimbursement, erosion, capital constraints, political volatility, and quite honestly, and I touched on this, of the extremely exhausted workforce. So let leaders are really being put in, in a delicate balance of being able to balance all of those things simultaneously. And for many systems the question quietly being asked is no longer how will we thrive, but can we even survive all of these components? And that's really a dangerous place to lead from. But my focus right now is to avoid those short term fixes that really mortgages the future of healthcare survival and really focusing heavily on values anchored decision making that is going to preserve long term viability for healthcare organizations. So the headwinds are real, but the bigger risk is fear based leadership and those that really exercise a different level of courage and not really losing strategic nerve to execute effectively.

[B]

I love that and I think it really shows the bold strategy that you bring into place and really understanding the long view of things versus just the short quick fix as you said. And I'm curious, you know, C suite leaders across the board are facing these issues and so for some that might have the tendency to look for those quick fixes look for more cutting than, you know, really would bode well for them in the future. How do you kind of talk through that or you know, bring those leaders over to your side when you're looking at the long view, when you're thinking about the big financial issues in health care, how do you avoid that or kind of turn around that tendency and really make sure that everybody is aligned and going in the same direction? When you think about, you know, the next year and how that sets you up for the next five, ten years and more.

[C]

Yeah, I think the, the hardest thing, Laura, quite honestly is, is saying no to false solutions even when they're politically expedient, even when they're financially tempting. So the hardest thing right now for leaders is courage and pressure under fire. So in 2026, leaders are going to be under immense pressure to act more swiftly, to show movement, to reassure all the the parties that be. But speed without strategy is how organizations really create self inflicted wounds. So it really takes courage to slow those decisions down, to challenge assumptions, to bring the community in, to open up more voices at the table that have not historically been at the table and really to even challenge yourself as a leader and as an individual to, to really hone in on that voice, voice of reason and to make different decisions in a much more prudent way. It takes a lot of courage to say we cannot cut our way to health or success. It takes even more courage to really protect people, especially in environments where the workforce morale is already fragile. So leadership right now in this, in this era is not about being popular and making the popular decisions is about being anchored, being disciplined, being focused and taking the courage to slow yourself down and really act more strategically. That's going to propel us into long term success.

[B]

That's really fascinating to hear such an important reminder in mindset to have when thinking about the next 12, 24 months or so. Before we wrap up, I have one more question for you. How are you thinking about growth in the next year? So what are you excited about and what opportunities are really abreast?

[C]

You know, as I think about growth, I'm going to take a different spin on, on this as as opposed to how I would have traditionally answered this question. I think the greatest opportunity for growth honestly is lies in rethinking how value is created, not just in where revenue comes from. And that's going to be a very challenging mind shift for healthcare leaders. So organizations that will truly grow in this day and age and in this climate, with all the headwinds coming Our way are those that truly makes a real investment in workforce and culture and capability and trust. Because at the end of the day, the people are the most strategic assets that we actually have. So really drawing on people centered solutions is where the long term growth and viability is going to come from. Also, I would say in building smarter partnerships. So you're going to see a lot more innovation in the way partnerships and collaboratives and coalitions really come together. So traditional brick and mortar mergers and acquisitions are not, are not going to be the dynamic. I think that strategic collaborations is really the space for growth right now. And really checking our titles at the door and not being competitive in that collaboration because at the end of the day, we're fighting for the same populations that we're trying to drive value on. And then I would also say that we need to truly align clinical excellence with financial stewardship instead of pitting those dynamics against each other. And that is where that value growth is going to continue to prosper. But what I would say is growth is not going to come from chasing those shiny objects anymore and replicating what worked five, 10, 15 years ago. It's going to come from leaders willing to redesign care models, decision rights, cultures, and really embrace innovation in a very nifty, creative type of way. And then always for me, I like to hide the health equity pill in the applesauce because I'm never going to move away from that as a core priority for me. So really, we can't abandon health equity as a strong semblance of growth, as that anchored force that we're all chasing and moving towards doing so in the wake of all of these pressures that we're up against.

[B]

That makes a lot of sense. And you know, it's so, so critical, especially right now, when it, like you said, is tempting to move to other solutions or think a little bit more narrowly. Having that ability to strongly understand where health equity is and what healthcare could and should be in the future, especially when you look at value and what value means for patients as well as healthcare organizations, is just critical. Dr. Steve, thank you so much for joining us on the podcast today. This is been a really fun conversation and I'm looking forward to seeing you in April. I know you'll be speaking at our annual meeting and truly continuing to spotlight some of the great things that you're doing there too.

[C]

Well, I'm, I'm really excited and, and always, always a, a major fan of, of, of Beckers and you all truly contribute to really elevating the voice of, of what's needed right now and forever. So thank you for being just a tremendous partner to the healthcare community.