Our 2026 marathon: Progress, challenges and what comes next

In his latest blog, COO Darryl Elmouchi, M.D., shares how we’re pacing ourselves: celebrating progress, improving length of stay and adjusting course as needed.

Last month, I reflected on my first year as a Providence caregiver and shared some insights on the road ahead as we continue acting boldly and advancing our journey as one system. At the heart of this journey is our commitment to be the best place to give and receive care — where patients feel safe and supported, and caregivers feel they belong and can do their best work. 

I want to build on that conversation and offer more thoughts on where we are now and where we’re headed next. Many people have asked if we are “over the hump” of our financial challenges. As much as I’d love to say, “YES,” the reality is more nuanced. 

A marathon, not a sprint

For years, I was an avid distance runner, and running a marathon was always on my bucket list. I completed my first — and only — marathon about a decade ago. Two things got me through those 26 miles: remembering the full distance so I could pace myself and keeping my eyes on the next step. 

I share this because our situation today feels a lot like running a marathon. The difference is that external factors keep extending the course as we run. HR1 — The One Big Beautiful Bill Act — is an example. 

Celebrating our progress

Now, in the early part of 2026, we can be proud of the tremendous progress we’ve made across so many fronts: quality and safety, clinical care, advocacy, research, and financial improvement. We should celebrate how far we’ve come. But we must also acknowledge that we’re still mid-race.

Managing LOS to better serve our communities

One of the biggest levers we’re pulling to strengthen our family of organizations is improving length of stay. As demand for our services continues to grow, caring for patients more efficiently in our hospitals creates capacity to serve more people. This means re-examining nearly every process and removing barriers that slow us down. 

Efficiency is more than moving faster. It’s also about safe, high-quality care. Patients recover better and face fewer risks when they’re not in the hospital longer than needed.

Anyone who has been hospitalized, or supported a loved one in the hospital, knows how frustrating it can be to wait for tests, procedures or a clear discharge plan. Improving LOS across our ministries will enhance quality, safety and the patient experience, while continuing to improve financial sustainability. 

Your stewardship made a difference

Last year, your efforts around discretionary spending made a significant impact. Limiting nonessential spend was one of the toughest decisions we made, and I know it wasn’t easy. I sometimes felt like the Grinch helping to implement it, but the tens of millions of dollars saved allowed us to direct more resources to the front lines of care. 

Adjusting our course

Now that 2026 is underway, we’ll be making a few adjustments to the discretionary spend management program. We’ll share more information soon, but the overall approach will remain largely the same. While I know this isn’t what everyone wants to hear, I hope we all take heart knowing these savings meaningfully support our Mission and those we serve. 

Moving forward, mile by mile

We are on a collective journey of continuous improvement. I can’t say how many miles we have left in our marathon, but I do know we’ve made remarkable progress together. 

I remain deeply grateful for each of you and the work you do every day.

Darryl's Rounds is for caregivers and core leaders, where he shares candid insights and real stories to encourage teams across the family of organizations to connect, learn and apply best practices. For more insights and updates, follow Darryl on LinkedIn and join the conversation.