When Virginia Beach, Va.-based Sentara Health shifted to a four-market operating model in May 2025, each of its 12 hospitals was placed under one of four regional markets, each led by its own president. The goal was to enable local decision-making while preserving systemwide coordination.
More than a year and a half later, two of those market presidents connected with Becker’s to share what the model has actually delivered.
Dana Weston Graves and Joanne Inman lead the system’s two southeast market regions: Ms. Graves oversees the southeast market anchored in Norfolk, and Ms. Inman leads the southeast market based in Virginia Beach. Both hold the title of senior vice president and acute care market president.
The clearest early signal came in length of stay. When Sentara created market-level chief medical officer and chief nursing officer roles as part of the reorganization, clinical leadership gained accountability across multiple hospitals rather than within a single facility. The southeast market hospitals ran a length of stay ratio of 1.05 from January to August 2024. The market is now at a 0.91 ratio during the same time frame in 2026.
“It’s really a testament to our clinical leaders and specifically our chief medical leaders,” Ms. Inman said, “who are establishing a common framework, who are on the ground and applying best practices, and leaning in, doing the hard work on the ground in order to drive those kinds of results.”
Ms. Inman said the improvement reflects how the market model changed the conditions for clinical progress.
“It’s really making it easier for us to adopt and apply best practices, to understand where something maybe is not going as well as it is in another place, and then applying new tests of change to help elevate and rise the tide for all of our facilities,” she said.
Surgical volume has also grown. Through August, the southeast markets’ hospital operating rooms were up approximately 600 operating room cases year to date. That gain came despite the broader industry shift of surgical cases from hospital settings to ASCs.
For Ms. Graves, the volume figure matters less than what it represents: a new way of making decisions about where care is delivered.
“It’s not that measurable number alone that really stands out as a testament to the market model,” Ms. Graves said. “It is how we are deciding what surgeries are done where and the fact that today in our market model, the aim is not for every hospital to be up in the exact same types of cases, but we’re stepping back to ask ourselves, what should we do where, what is going to provide the greatest access to our community, the greatest levels of expertise in our staff and allow us to utilize limited capital in the best way.”
The centers-of-excellence thinking behind those decisions comes from market leaders working together. Rather than Sentara hospitals competing against one another for procedures or new surgeons, Ms. Graves and the system’s other market presidents decide together where investment and expertise should go. The result, she said, is that operating room volumes keep growing and every hospital thrives by focusing on what it does best, without any one facility losing out.
Speed of decision-making has also improved, though Ms. Graves noted the shift is felt rather than measured.
“We are able to make decisions that reach the community faster,” she said. “Just the ability of us as leaders to think about a broader population and not get hung up on what’s best for one place has been really rewarding to see.”
The ambulatory setting has emerged as a particularly important integration point. Ms. Inman cited conversations with the executive vice president for ambulatory services as an illustration of how the structure now connects different lines of business.
“Having all of us at the table together and understanding how access in the ambulatory environment can enable us to achieve things within acute care, whether that’s a reduction in unnecessary emergency room visits or keeping patients out of the hospital or from readmitting, has allowed us to quickly align around the workforce that we need to achieve those goals,” Ms. Inman said.
Neither leader came into the transition without hesitation. Ms. Graves said her concern was not for herself but for the teams managing change alongside everything else pressing on healthcare organizations.
“I was worried that we could lose some of what made us special on the ground, some of that local identity, and so much of the local leadership that having a hospital president there in the hospital every day brought us,” Ms. Graves said. “Looking back on it now, I think our team showed us what they show us every single day, which is that they are incredibly resilient and that they will adapt to whatever change is in front of them.”
Working across two southeast markets, Ms. Graves and Ms. Inman have developed a collaboration model built on shared stakes and clear lane assignment. It helps that the two leaders are aligned on their true north: the patients and community, Ms. Inman said.
“We succeed together, we fail together,” she said. “Whether it is something that is more centered in Dana’s market, I want her and her team and the community and our patients to feel the success of whatever it is that we’re working on.”
When decisions require a clear point person, they align on it deliberately up front.
“We have an intentional conversation to create clarity on the front end,” Ms. Inman said. “’Dana is going to take the lead and run with this conversation around the GI service line,’ and then she pulls me in when needed. She brings me to the table to be part of the conversation, and I’m completely comfortable with her taking that lead.”
Ms. Graves described the partnership through a navigation analogy.
“Strategy is about getting the right address in the GPS, and that is what Sentara has entrusted to Joanne and me for the southeast market,” Ms. Graves said. “We are responsible for putting the address into the GPS, identifying where we are going as a market. Now, whether we take route one, route two, no tolls, who cares? As long as we get to the address.”
An example for the next generation
The collaboration has taken on meaning beyond the office for both women, who are mothers. Their children have grown up hearing the two of them work through difficult decisions in real time, often during evenings and car rides between commitments.
For Ms. Graves, the realization came during one of many evenings she and Ms. Inman spent working through a major market initiative. One of her young sons walked up and asked, unprompted, whether she was talking to “Miss Joanne.”
“There was a split second where I had a moment of guilt, like: I’m on the phone and my small child assumes that I am talking about work,” Ms. Graves said. “That quickly turned into a moment of immense gratitude and pride because my 4-year-old and my 6-year-old little boys will one day be adult men, and they may choose to have families themselves, and it will be completely normal for them to have strong, empowered, really smart women in their lives that they hear making decisions.”
Ms. Inman has had similar moments with her two daughters, ages 15 and 11.
“I believe that the most important lessons are learned by what you experience, not what you’re taught,” Ms. Inman said. “What I started to realize in those moments was that my daughter was experiencing two female leaders talking through a challenging situation and giving each other the space to provide their perspective, to offer a different opinion or path forward, maybe just express frustration with the situation in a really healthy way, and then to move past that and focus on, ‘Now what are we going to do about it?’”
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