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Aligning for Excellence and Care

March 28, 2022

To the YSM Community:

Today, as we mark a leadership transition at Yale New Haven Health System (YNHHS), we write as dean of Yale School of Medicine (YSM) and chief executive officer of YNHHS, to affirm our shared commitment to align further our two institutions to realize our full potential as one of the nation’s top academic health systems.

In 1965, a formal affiliation agreement codified the long-standing relationship between YSM and Yale New Haven Hospital (YNHH). In 1999, a second affiliation agreement further established the relationship between YSM and YNHHS. Since then, the health system has grown significantly, adding delivery network hospitals, each with its own history, board, and culture.

We recognize that the relationship between YSM and YNHHS has not always been easy. It has often been transactional. Yet, we also believe that a more robust partnership—one based on trust and shared strategic decision-making—will benefit not only the school and health system, but also our patients and our communities.

When we come together as an academic health system, we provide better routine care, diagnostic accuracy, and cutting-edge therapies to our patients. Never was this more evident than during the COVID pandemic, when YNHHS achieved one of the country’s lowest mortality rates among COVID patients. In addition, together we serve those who may not otherwise have access to care. Academic health systems comprise five percent of hospitals in the United States but provide 30% of indigent care.

YNHHS hospitals and care venues serve as clinical medicine learning sites, providing training for our medical students, as well as 900 residents and 400 fellows affiliated with YSM’s clinical departments. YSM provides infrastructure for research, including clinical trials, informatics using the electronic health record, and research in genetics, precision medicine, and drug development through the creation of biorepositories of clinical samples.

To achieve our goal of being one of our nation’s premier academic health systems, we must:

  • Create an environment in which the chairs and chiefs of the clinical departments work collaboratively with service line leaders and hold responsibility and authority for the quality of care in their specialties and subspecialties across the system
  • Develop a common strategic plan that we can implement with agility and efficiency
  • Capitalize on the excellence and expertise that our faculty bring, not only to the care of critically ill patients, but also to the assurance of care consistency and the reduction of health inequities
  • Embrace the lessons of teamwork, collaboration, and spirit of innovation that we learned during the COVID-19 pandemic

During the coming weeks and months, we will be restructuring meetings to enhance shared strategic decision-making and execution at all levels of our YSM/YNHHS collaboration. We also recognize the need to eliminate duplication and competition between our two institutions, including between our practice plans. We must standardize and rationalize funds flow between and within our institutions, make financial transactions transparent, tie decision-making regarding investments to our joint strategic goals, align incentives with desired outcomes, and promote our academic mission. As we embark on rethinking our future, we have engaged the Chartis Group, a consulting firm that has worked with many of our peers to increase alignment. They have been meeting with leaders and gathering data as they prepare to advise us.

The path ahead will not be easy. It will require a change in our current culture and an investment in the development of real trust. It will require a willingness to take risks for the betterment of our academic health system. It will require constant communication. We will make mistakes, and when this happens, we need to allow each other some leeway.

Our aspiration to be one of our nation’s premier academic health systems mandates better alignment and we cannot afford to fail. External forces, including health care consolidations, workforce shortages, and increased emphasis on value and access, require that we think strategically and creatively and then rapidly and nimbly execute.

We are committed to transparent and frequent communication, and we welcome your questions and feedback. Please reach out to either or both of us to share your thoughts and ideas. We thank you in advance for your support and leadership.


Nancy J. Brown, MD
Jean and David W. Wallace Dean of Medicine
C.N.H. Long Professor of Internal Medicine

Christopher M. O’Connor, FACHE
Chief Executive Officer of Yale New Haven Health System