As hospitals and health systems navigate anesthesia workforce shortages, rising labor costs, and increasing surgical demand, many are rethinking what they need from an anesthesia partner. The traditional tradeoff between local alignment and national scale is no longer acceptable, and so a growing number of organizations are looking for models that deliver the benefits of both.
NorthStar Anesthesia’s expansion across the Chicago metropolitan area offers a case study in this approach. Through partnerships with UChicago Medicine AdventHealth Bolingbrook, Hinsdale and La Grange, and Rush Copley Medical Center, the organization is combining the benefits of national infrastructure with locally embedded clinical leadership.
Several forces are reshaping the anesthesia landscape:
At the same time, operating room efficiency remains the primary driver of hospital financial performance.
In this environment, scale provides advantages in recruiting and infrastructure, but without local alignment, those advantages often fall short.
“Every market is different,” said Romeo Kaddoum, MD, Chief Medical Officer of NorthStar Anesthesia. “What drives success is the ability to apply scale in a way that reflects the needs of each facility, each care team, and each community.”
In Chicagoland, NorthStar’s focus has been stabilizing anesthesia teams and improving operational performance through strong, accountable local leadership.
At UChicago Medine AdventHealth Hinsdale and La Grange, early priorities centered on recruiting and building a sustainable staffing model.
“Having a consistent, engaged leadership presence on-site has made a meaningful difference,” said Christine Orlando, COO at UChicago Medicine AdventHealth Hinsdale. “There is a clear sense of accountability and partnership, which translates into better coordination and a more reliable surgical environment.”
At UChicago Medicine AdventHealth Bolingbrook, the emphasis has been on aligning staffing strategy with financial performance.
“What stands out is the ability to connect staffing strategy with financial outcomes,” said Tristan Shaw, CFO. “Reducing variability in coverage and building a more stable model has a direct impact on both cost management and surgical throughput.”
At Rush Copley Medical Center, the focus has been on retention and care team continuity, while consistently delivering marked improvements in quality outcomes year over year.
“Consistency in the care team has been critical,” said Abby Hornbogen, Chief Nursing Officer. “When clinicians know each other and work well together, it improves communication, efficiency, and ultimately the patient experience.”
Across these partnerships, improvements have centered on recruiting, retention, and reduced reliance on locum tenens coverage, all of which directly impact cost and OR performance.
A defining feature of this model is the investment in local leadership. Regional clinical leaders are embedded on-site from the outset, practicing clinically while building culture, strengthening relationships with surgeons, and ensuring accountability for performance.
NorthStar also invests in these leaders through structured training and mentorship, strengthening both clinical and operational capabilities.
“We are intentional about developing leaders who are not only strong clinicians, but also effective partners to the hospitals we serve,” said Randy Moore, CRNA, Chief Anesthetist Officer and Executive Vice President of Clinical Strategy. “That combination is what enables teams to perform consistently at a high level.”
A strong local presence enables more consistent, dedicated teams. By aligning teams within a region, organizations can improve scheduling flexibility, reduce coverage gaps, and strengthen collaboration across care teams.
| Traditional Model | Regional Leadership Model |
| Staffing variability | Consistent teams |
| Coverage gaps | Scheduling flexibility |
| Heavy locums reliance | Strong retention |
| Independent facilities | Regional collaboration |
| Reactive staffing | Strategic workforce planning |
“The consistency of care delivery improves when teams are aligned and supported locally,” said Dave Tkachuck, President and CEO of UChicago Medicine AdventHealth La Grange. “We have seen how a strong team model and consistent leadership presence contribute to both clinician satisfaction and patient outcomes.”
In a competitive market like Illinois, creating a stable and supportive environment is critical to retaining strong teams.
For hospital executives, anesthesia is no longer simply a coverage function. It is a strategic lever that directly impacts operating room utilization, case volume growth, physician alignment, and financial performance.
“We are seeing more organizations evaluate anesthesia through an operational lens, not just a clinical one,” said Stephen Kelanic, Chief Medical Officer at Rush Copley Medical Center. “The ability to recruit, retain, and deploy teams effectively has become a differentiator.”
As a result, evaluation criteria are evolving. Leaders are increasingly focused on recruiting capability, operational discipline, financial transparency, and long-term stability driven by strong local leadership, ongoing mentorship, and the ability to build and sustain high-performing teams. Organizations that combine national resources with strong local alignment are emerging as preferred partners.
As demand for surgical services continues to grow, the need for sustainable anesthesia workforce solutions will only increase.
Models that integrate scale with local execution are likely to play a central role.
NorthStar’s expansion in Chicagoland reflects a broader shift: success will depend not on size, but on how effectively scale is deployed through strong local leadership and consistent execution at the site level.
