What Are the Duties of a Hospital COO?

Large hospitals often have both a chief executive officer and a chief operating officer, or COO. Even smaller organizations may have both positions to ensure that one person is not overwhelmed with multiple responsibilities. While the CEO is generally responsible for global issues such as strategic development, dealing with the board of directors and external issues, the COO is responsible for the day-to-day operations of the hospital. However, COOs in different organizations may have different duties and roles.

The COO is commonly responsible for seeing that the organization’s strategic initiatives are carried out through its daily activities. Financial management is often a big part of the COO’s daily job duties, as hospitals operate under economic pressures in a highly competitive environment. The COO may be involved in developing an organization-wide budget, but even if she is not, she will have to live within the institution's financial parameters and ensure that all hospital departments do the same.

Quality of care, patient safety and patient satisfaction are areas that a COO must keep in mind at all times. Patient satisfaction will generate return business, while safety and high quality are two ways to improve patient satisfaction. Hospitals that receive Medicare payments must meet quality indicators and may lose funding if patients develop complications. Since 2008, Medicare has refused to pay extra costs associated with complications as falls, infections from urinary catheters or foreign objects left in the patient after surgery. The COO may be required to develop systems that prevent such events from occurring.

Physician relations are often a large part of the COO’s daily responsibilities. Physicians bring revenue to the organization by admitting patients and performing procedures or surgeries. However, physicians can also increase expenditures if their care does not meet acceptable standards and patients must stay too long in the hospital, which usually receives a flat fee regardless of length of stay. The COO is often the primary person on the administrative team who is in regular contact with physicians, building relationships, monitoring performance and taking action when there are problems.

The COO is also the primary administrative contact for employees, especially department heads. In some organizations, all or most of the department heads report directly to the COO. The COO may work with an individual department head to reduce costs, streamline services or develop new services. COOs can have a big impact on organizational culture through their day-to-day activities with both leadership and line staff. COOs also need to have an understanding of technical issues such as information management or clinical care to make effective decisions, and must spend time in all areas of the hospital to gain knowledge and insight.

The COO job is not for a newbie. The COO must be well-educated, with a minimum of a master’s degree in a field such as health science or health-care administration. Some organizations prefer that a COO have at least 10 years of management experience. Certification in management may also be preferred or required for COOs. The Bureau of Labor Statistics groups all senior leaders such as CEOs and COOs when tracking salary information; the average annual salary in this category was $176,550 in 2011.

Top executives earned a median annual salary of $109,140 in 2016, according to the U.S. Bureau of Labor Statistics. On the low end, top executives earned a 25th percentile salary of $70,800, meaning 75 percent earned more than this amount. The 75th percentile salary is $165,620, meaning 25 percent earn more. In 2016, 2,572,000 people were employed in the U.S. as top executives.