Christy Smith, Chair, Hospital Authority of Metropolitan Nashville and Davidson County at Nashville General Hospital (NGH)

In an interview with Invest:, Christy Smith, chair of the Hospital Authority of Metropolitan Nashville and Davidson County at Nashville General Hospital (NGH), shared her focus on revitalizing the hospital’s community ties and “rekindling the deep, multi-generational connections NGH has with families.” Smith, Managing Director – Investments at Wells Fargo Advisors, emphasized collaboration, fiscal responsibility, and addressing perceptions to strengthen NGH’s mission.

What are your top priorities for the hospital and hospital authority?

While positive stories from our history endure, newer, flashier developments like the East Bank have drawn attention. NGH still plays a vital role in Nashville, but recent negative headlines risk overshadowing our mission. Without community engagement and understanding of our focus, these perceptions can linger. I’m optimistic about our path forward, with strong leadership guiding us to rebuild bridges with the mayor’s office, council, and other healthcare entities, strengthening our role in the community.

As a safety-net provider, what strategies are in place to ensure high-quality, affordable care remains accessible?

One of the most important things you can do with any entity is make sure you’re a fiscally responsible steward — both of the money you generate and the funds you receive from federal, state, or local sources to support your charter and your community. Having that mindset of fiscal responsibility is very important. I think that’s been a key milestone that has changed, and as we go forward, I’m excited about how a real plan can guide those dollars to strengthen our institution and continue serving Nashville.

In addition to that, we’re focused on increasing access through initiatives like the Nashville Healthcare Center in Bordeaux, which offers comprehensive primary and specialty care, and diagnostic imaging in a community that is considered a healthcare desert. And programs such as the NGH Food Pharmacy and Hope Meds directly address social and financial barriers that impact health by providing reduced-cost or free access to prescriptions and foods needed to manage a chronic diseases.

How is the hospital addressing health equity and working to improve outcomes for Nashville’s diverse and underserved populations?

Getting the word out and educating the population about their health so they can stay out of the hospital is important. We can’t be all things to all people. Building strong relationships, whether through government affiliates or private entities, and partnering across Nashville’s healthcare community allows for continuums of care and specialty engagement for patients who may need services beyond what Nashville General provides. Ultimately, it lets us double down on what we do best. We’re also tackling health equity through outreach programs like community screenings and our Food Pharmacy initiative, which addresses diet-impacted chronic disease by prescribing — and then providing — healthy foods and nutrition education.

How does the hospital collaborate with local healthcare providers, educational institutions, and other community groups?

We have long-standing clinical partnerships with the city’s public health department as well as academic partnerships with local universities for workforce development and medical training. Of course, this summer, we reaffirmed our vital partnership with Meharry Medical College. These collaborations not only expand access to care but also strengthen the pipeline of future healthcare professionals who understand the needs of Nashville’s diverse population.

Nashville General Hospital also partners with several faith-based groups through its Congregational Health and Education Network. They take knowledge, for example, how food can directly influence health outcomes both in treatment and prevention, and bring those messages into congregations. The goal is to spread awareness about how to stay out of the hospital and, if you are admitted, how changes in diet and lifestyle can help you recover and avoid readmission. These are simple but powerful lessons, and that’s what CHEN is all about.

How are challenges like workforce shortages, rising health costs, and inflation affecting service delivery and operational stability for your organization?

Healthcare is a tough industry day to day, week to week, year to year. From the physical demands of standing on your feet and moving patients to being fully present with every person you meet, it requires constant energy and focus. Each time you walk into a room, you have to be on point, with the same energy and bedside manner you had 15 or 20 minutes earlier. That can wear people down.

COVID made things even harder. It created an environment where many decided it wasn’t worth it — financially, emotionally, or physically. On top of that, people don’t tend to stay in one job as long as they used to. Think back to our grandparents’ generation; they were proud to say they worked at a place like Ford for 40 years.

Our approach is to remain proactive and people-focused. We are committed to supporting our dedicated care teams through competitive pay, workforce development, and ongoing training. The Board and hospital leadership are reviewing compensation structures and implementing retention strategies that acknowledge the demands placed on healthcare professionals while promoting a culture of excellence and respect.

What planned facility improvements or technology upgrades will enhance patient care and operational efficiency?

We’ve just gone through a major technology change with the implementation of an Oracle-based electronic medical record system. That’s been underway for the past two years, though it was planned even before my time here. We’ve seen it implemented and our physicians and clinical staff trained on it.

We’ve also made updates to our patient portal, HealtheLife™, and are continuing to look at how to improve it. Looking ahead, the Board has asked our CEO, both Dr. Elders, in the interim, and our permanent leadership going forward, to focus on workforce development and review the employee pay structure to ensure retention. We’ve also asked for a clear technology plan, making sure our investments in equipment and robotics are being used effectively.

Additionally, there are plans to modernize critical areas such as the Emergency Department, patient rooms, and public spaces to improve the care experience. These upgrades will help enhance both patient comfort and staff workflow efficiency, aligning with our broader vision of revitalizing NGH’s role in Nashville’s healthcare ecosystem.

What are your key goals and priorities for the hospital and hospital authority over the next two to three years?

At some point, we’ll need to consider either revamping our current facility or evolving into a new one. Those conversations have already begun. The goal is to be thoughtful about where we’re going and to make sure that whatever we build or renovate is aligned with our mission.

I’d also like us to keep investing in our employees to ensure we retain the wonderful people who work here every day, and to remind them that not all change is bad. This is an exciting time. If we can hold on through the transition, we’ll be in an incredible place, and everyone will be proud to work at Nashville General Hospital.

A vital part of our progress is our partnership with the Nashville General Hospital Foundation (NGHF). Through its Greatest Needs Fund, the Foundation helps turn compassion into action — supporting patient care, upgrading equipment, strengthening our workforce, and improving the spaces where healing happens. Every contribution, no matter the size, fuels our shared mission to provide exceptional care for every Nashvillian. To be part of this meaningful work, visit NashGenFoundation.org and make a gift today.

Over the next few years, we’ll continue focusing on three priorities: fiscal health, workforce stability, and community trust. Together, these form the foundation for sustainable growth and for continuing our legacy of caring for every Nashvillian, regardless of circumstance.