Describe your journey from bedside nurse to CEO.
Parrinello: I always loved science, anatomy and physiology, so while in high school I decided I wanted to be a nurse. I started college at the University of Rochester as I was drawn to its nursing program with the goal of becoming a nurse practitioner. While earning my graduate degree, I worked at the hospital and took various leadership roles in nursing. I realized I loved shaping change and improving how we deliver care. I eventually earned a PhD in educational administration to prepare for broader leadership roles in healthcare.
One pivotal moment was during a major hospital reorganization in the 1990s, when I was the lead nurse on an interdisciplinary team tasked with transforming care delivery amid budget cuts. That led to my first operational leadership role. From there, I served as chief operating officer for many years before being asked to become CEO in 2024.
Spisso: I’ve truly worked every rung of the career ladder. I began as a critical care nurse at the University of Pittsburgh, Presbyterian Hospital then moved to University of California, Davis where I spent 12 years and progressed to associate director of nursing. After moving to Seattle, I joined the University of Washington Harborview Medical Center as chief nursing officer. I spent 22 years at UW after CNO, became COO, then executive director and CEO, and finally chief health system officer for UW Medicine Health System. I was later recruited to UCLA in 2016 as president, UCLA Health and CEO, UCLA Hospital and Clinic System.
Throughout my career, I understood the importance of inclusion, having a voice, mentorship and the significance of being part of a team that was making performance improvements. So, I work hard to bring that visibility to my teams by being open and inclusive and encourage those closest to patient care to share their expertise and ideas.
What makes you excited to come to work each day?
Parrinello: Being part of an academic medical center means we provide everything from primary care to the most complex treatments and procedures. I’m energized by helping to bring clinical trials and new therapies to patients’ bedsides — especially when we are first in the region providing these therapies. It’s fulfilling to watch our teams build specialized programs, attract top talent and improve care for communities in upstate New York and northern Pennsylvania.
Spisso: My mom was a school principal — one of the first women in her role — and I had three aunts who were nurses. Watching them, I saw how respected they were, and I wanted to help people the same way. I’m inspired by how our physicians and staff change lives, often under immense pressure. Patients come to UCLA with some of the most critical injuries and illnesses. Our teams provide not only exceptional care, but also compassion. Even when the outcomes aren’t ideal, our staff show up with kindness and dignity. We’re a patient-first culture.
Organizational culture is key to attracting and retaining top employees. What makes your organization’s culture unique?
Spisso: Our culture at UCLA Health is built around excellence and respect. Patients expect top-tier care here, but what they remember most is how they were treated. We emphasize service excellence and spend a lot of time building culture through quarterly retreats and ongoing training that help staff reconnect with purpose and build resilience.
As one of the largest tertiary and quaternary care health systems in the state, our mission to improve the health of the community resonates with our staff and is impactful to them in ways that make them feel like they're making a difference every day in the work they do.
Parrinello: We keep the patient and family at the center. Healthcare is a people business, and most enter it because they care — that’s our cultural foundation. We have a Professional Nursing Council that gives front-line nurses a voice in helping leadership adjust work schedules, unit staffing ratios and other operational functions as needed to provide care efficiently and effectively. We also emphasize interdisciplinary teamwork. Everyone, from physicians and nurses to environmental service personnel and others, contribute to the patient experience and workplace wellness.
As an academic medical center, we also inspire and prepare the next generation of healthcare professionals. That, combined with research innovations, improves health and wellness beyond our hospital walls.
Why is it important to include nurse leaders in the C-suite? How do their perspectives add value to strategy and transformation?
Spisso: Nurses understand patient care in its totality. They coordinate across disciplines and are present 24/7. That gives them unique insight into system improvements and effective investment in quality and safety. My background in critical care and trauma gave me visibility into where we need to invest in resources to make care safer, more efficient and value-added.
Parrinello: Like in engineering or the auto industry, people who know the product often make the best leaders. In healthcare, the product is patient care — and nurses understand it deeply across the continuum. Nurses understand all of the roles that are required to provide patient care — from nurses and physicians to social workers, physical and occupational therapists, and beyond. That makes us especially effective in strategy and operations, especially when pertaining to workforce development and finding ways to recruit and retain high-quality care givers.
How do you prioritize wellness, engagement and belonging for your employees?
Parrinello: We’ve invested in what we call interdisciplinary teaming, or team-based training and peer support with people who have different skill sets around patient care. We also hired a chief wellbeing officer — a psychologist focused on systemwide support for emotional wellness at work. Additionally, we have behavioral teams who train staff in behavior modification and de-escalation techniques to help provide a safe work environment. We’re very focused on work-life balance, so we prioritize scheduling to encourage time off for staff, and leaders organize many activities for younger staff who may not have family in town to create a social environment.
Spisso: Since COVID-19, we’ve expanded wellness resources. We began with small group feedback and launched the Nursing Professional Practice Committee to enhance collaboration and support. We have wellness officers across departments, mindfulness sessions, counseling and department-specific programs — especially in high-stress areas like pediatrics and oncology. We also regularly recognize and reward staff to improve their engagement and motivation and help them feel valued.
How are you using technology to aid in workforce demands and burnout?
Parrinello: Our chief wellbeing officer leads a team focused on addressing those issues for faculty and staff across our missions — education, research and patient care. In the clinical space, we’ve implemented voice-to-text tools like DAX in Epic to reduce the documentation burden, and our health technology innovation lab is working to develop AI tools that help extract clinical population data from records for reporting measures. That allows our clinical teams to spend more time with patients and less time in front of a computer.
Spisso: We’ve used AI in business functions like compliance for years, automatically flagging unauthorized chart access. Clinically, we now use ambient listening to eliminate the need for scribes, improving privacy and efficiency. We're hiring AI leaders in both our health system and school of medicine to guide the ethical rollout of new tools.
What recommendations would you give to other CEOs looking to improve their culture?
Spisso: As a leader, you have to walk the talk and lead by example. You can't just say words that people can't connect to a larger purpose. I aim to be a visible leader and make rounds at least once a week, and I have an open-door policy for all staff.
We also have a very collaborative process every year where we set our clinical and transformational goals. Every department and leader have input, and we monitor those quarterly and share publicly throughout the institution. Everyone has a vested interest because they are called to the table to participate and really help us craft that path forward for the organization. I think that's very important in teaching institutions because you have all levels of hierarchy, but you want to make sure everyone on the team is treated with respect and their input counts.
Parrinello: One of the best pieces of advice I would share is the importance of bringing interdisciplinary groups together and listening to all voices about what is needed to improve the organization. It’s important not to lose touch with the people who are at the bedside and directly involved in the work of the organization. Encouraging them to share their ideas about the programs they think we should grow and develop, or what’s working in the care environment and what isn’t, is invaluable.
Also, remember that healthcare is a team sport, and each member of the team is critical to the patient experience. For instance, if a patient's food isn't delivered warm and on time, if their room isn't clean, if they aren’t transported from point A to B by someone who is friendly and capable, their experience is not good. Working as a team creates optimal patient experiences and creates desirable work environments that foster employee retention and recruitment.
What are you most proud of professionally?
Spisso: At UCLA, we invest in mental health when many others are stepping away. We’re building a dedicated mental health campus set to open in 2026. We’ve also launched a mobile healthcare program for Los Angeles’ homeless population, about 60,000 a night, offering primary care at encampments. And while cancer was once a poor prognosis for patients, through our cancer program and the discovery research conducted at UCLA on life saving cancer drugs, so many people are surviving cancer to live full lives. These accomplishments truly reflect our mission, and I'm proud of the work our team is doing to serve the community. With 10 million people in Los Angeles County, we have a lot of work to do.
Parrinello: Being part of growing our health system from one hospital to eight integrated facilities, including long-term care and home care, is one thing that makes me proud. We also built clinical service lines in distinct physical spaces for our children’s hospital and our cancer center, which recently earned National Cancer Institute designation. Co-location on one medical center campus allows us to provide interdisciplinary patient care, involving specialists from multiple practice areas, quickly and conveniently. We are also part of a top-flight university where more than 3,000 biomedical researchers are working to bring scientific discoveries from lab bench to patient bedside. It takes strategic collaboration and breaking down silos, but we are improving quality by bringing professionals from different academic departments together to collaborate with a focus on optimizing patient care.
What advice would you give to nurses aspiring to executive roles?
Parrinello: Don’t rush to become an executive. Your bedside and clinical experience will serve you well — use it to understand and care deeply about how to best provide patient centered care. Then, when opportunities arise to work on interdisciplinary teams or lead a project involving other parts of the organization, take them. That’s where leadership grows and you never know what opportunities will come from that work.
Nursing gave me the best foundation for leadership. Whether you stay in clinical care or aim for the C-suite, know that nursing prepares you to lead, to collaborate and to care at the highest level.
Spisso: I never actively pursued a role but was always approached to apply for the position. My advice is: If you focus on doing your best in the job you are in, people notice. Be excellent where you are. Your path won’t always be linear but there are learnings along the way. Don’t focus on the title — focus on gaining meaningful experience and building a team that believes in you. The skills you develop along the way are what prepare you for leadership. Nurses already have leadership foundations — build upon them and stay open to opportunity.
I’m so grateful I became a nurse, it gave me a foundation built around patients and the team — and nurses bring that every day.
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Explore results from a recent Vizient and Laudio Insights survey about the importance of the nurse manager role in driving workforce stability and patient outcomes. The full article outlining the survey results was recently published in Nurse Leader.