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In the four years she's held the position of executive vice president/chief operating officer at St. Francis Hospital and Medical Center, Kate Roche has cemented her legacy at New England's largest Catholic hospital. Roche, a nurse before she became a businesswoman, has led the hospital through a large-scale expansion project, while improving the continuum of care for patients.

Roche wanted to position the organization to continue to grow, and to help prepare it for the dramatic new reforms that are already beginning to reshape the health care industry today.

One of Roche's proudest accomplishments was the opening of the John T. O'Connell Tower in February 2011, a state-of-the-art building that includes a new emergency department with 72 private treatment areas, hybrid operating rooms and six dedicated orthopedic operating rooms for the Connecticut Joint Replacement Institute.

"The new Tower positions St. Francis as a pioneer in instituting the latest technologies, processes and amenities the healthcare industry has to offer," Roche said.

Roche has also worked to create a new service line strategy focusing on managing patients across the continuum of care. The strategy will allow the many facets of the hospital's specialists to work in tandem in providing comprehensive care with a continuum of multi-disciplinary services for patients.

"As healthcare reform evolves, we believe the creation of service lines, the new Tower, our affiliation with aligned providers and a commitment to patient-centered care will position St. Francis as a true healthcare leader in the community," Roche said.

Catherine Limansky, director of communications and health promotion at St. Francis, said Roche's strengths lie in her background in nursing and patient care.

"Since Kate has been here, she's come in and she's brought the balance of knowing about patient care and having the business sense to bring the two things together," Limansky said. "The way that she's realigned different clinical areas within the hospital to really look at the whole continuum of care from birth to death, rather than just looking at the day someone's in the hospital has brought a better system of care to our patients."

Part of that realignment means the hospital is not just looking at the five or ten days someone's in the hospital. They are bringing physicians in and making them more like partners in the patient's care, rather than simply a doctor in the community who refers patients in to the hospital.

"I think she emphasizes education and wellness," Limansky said. "We've tried to get the system to look at all parts of care. (For example) with cancer care, when someone finishes with chemo or radiation, they're still your patient and your responsibility. We make sure the follow-up happens and that we keep them well."

Roche said the focus on patient care and delivering superior quality to the patients the hospital serves every day is her priority and her passion.

"Achieving that goal requires the building of an operations team that has the skills, vision, mindset and leadership to move the organization forward with success," she said. "I understand the importance of putting the right people and systems in place to achieve the goal of quality patient care."

Roche is known for her strong relationships with staff and being very approachable.

"Having started as a nurse, she really understands what that piece of things is all about, and what it means for every individual patient," Limansky said. "As tough as her job is, balancing the finances and everything from materials management to facilities management, she balances all of that with the patient in mind."

With that patient focus, Roche has also helped institute a value-centered management of fiscal resources. This has included major changes in vendor operations and relationships, in food service, medical supplies and others, resulting in substantial savings.

"We have worked with the clinical leadership team to evaluate time, cost and process to maximize efficiency and effectiveness," Roche said.

Roche advises other women seeking leadership positions to embrace climbing the ladder, be patient and accept new challenges.

"Every new position allows you to experience new opportunities, and these opportunities can sometimes seem overwhelming and intimidating," she said. "It is vital to use each step as a foundation, a building block, so that when you get to each new level, you have the ability and the experience to handle any challenge that comes your way."

Roche said she looks forward to an exciting and changing future at St. Francis.

"My future goals at the hospital are to continue to develop and mod a solid infrastructure to handle whatever healthcare reform brings our way," she said. "It is certainly an exciting time to be in healthcare and to be a part of this transition that will shape the delivery of healthcare in the U.S. and right here in our community."

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