The hospital system hired the consulting firm Alvarez & Marsal Healthcare Industry Group to guide it through the systems improvement agreement process. A 300-page gap analysis report prepared by A&M detailed ongoing deficiencies, including systemic issues in the role and organizational structure of nursing and nursing practices. Royer has said that about 75% of Parkland's problems involve inconsistent nursing practices across the system.
Royer took over Parkland at a time of his life when other physicians his age would be fishing, playing with the grandkids, or soaking in the sun. In 2011, the surgeon had just stepped down from being president and CEO of Christus Health, where he held the top job for 14 years. Previously, he served as Chairman of the Board of Governors of the Henry Ford Medical Group and Senior Vice President of Medical Affairs of the Henry Ford Health System in Detroit from 1994 to 1999.
Royer says he wants to help Parkland plan for his successor as well. "Obviously, to create permanency (the hospital) needs to recruit a permanent CEO and a person who is a lot younger than I am. I am willing to help train that person, and help in transition."
Before taking over as the interim CEO at Parkland, Royer says he was in the midst of "semi-retirement, doing some speaking and working on a book." He says he essentially completed the unpublished book, named "Dr. Tom's Learnings," about his views on leadership, when the opportunity presented itself to take over the interim role at Parkland. While Royer used the word "opportunity," some would choose a different word for jumping at the chance at being interim CEO at Parkland.