© Karen Gausman and Nancy Molter
Patricia Dallas Horoho was born on March 21,1960, at Fort Bragg in Fayetteville, North Carolina to retired Army officer Frank Dallas and Josephine Dallas. She is the wife of retired Army Colonel Ray Horoho and the mother of John and Maggie Horoho.Her father fought in World War II, Korea and Vietnam, and served in the 82nd Airborne and Special Forces.2 She earned her Bachelor of Science in Nursing from the University of North Carolina at Chapel Hill in 1982. After joining the Army, she received a Master of Science as a Clinical Trauma Nurse Specialist from the University of Pittsburgh. As a resident graduate of the Army’s Command and General Staff College and the Industrial College of the Armed Forces, Horoho earned a second Master of Science in National Resource Strategy.3
Commissioned as a second lieutenant in 1983, Horoho initially worked at Evans Army Community Hospital, Fort Carson, Colorado, as a staff nurse and eventually head nurse in its Level III emergency department. She was then appointed as a nurse recruiter in Pennsylvania where she was recognized as the Pittsburgh Battalion Staff Officer of the Year.4
While serving as the head nurse of the emergency room at Womack Army Medical Center, Horoho was on the front line treating the wounded in the aftermath of the 1994 Green Ramp Disaster (Pope Air Force Base crash).5 She also deployed to Haiti in support of Operation Uphold Democracy (1994 -1995) with the Army’s first Health Facility Assessment Team.6 She went on to assignments as chief nurse and Commander, 249th General Hospital (Fort Gordon, Georgia) and then Assistant Chief of the Army Nurse Corps Branch at the U.S. Army Personnel Command.
While assigned to the Pentagon as Assistant Deputy for Healthcare Management Policy, LTC Horoho was one of the first responders after the terrorist attack on Sept. 11, 2001, setting up triage at the attack site. In 2002, she was honored as one of 15 nurses selected by the American Red Cross and Nursing Spectrum to receive national recognition as a “nurse hero.”7
In 2007, COL Horoho became the first woman and nurse to command Walter Reed Health Care System. Under her leadership, the Triad of Care was established and implemented across the Army, and in less than 12 months the hospital went from the worst customer service standing in the Department of Defense (DoD) to winning the DoD’s Best Customer Service award.8
Horoho became the 23rd Chief of the U.S. Army Nurse Corps in 2008, receiving a two-grade promotion from Colonel to Major General. As Chief of the Army Nurse Corps, she served concomitantly as Commander of Madigan Army Medical Center and Western Regional Medical Command. As the Western Regional Medical Commander, she led the transition of the command from a six-state to a 22-state regional command.
MG Horoho’s tenure as Chief was defined by standardizing processes across the Corps, ensuring a standard patient care experience, resulting in increased provider job satisfaction and a significant and sustained decrease in adverse events. Furthermore, several of her visionary accomplishments led to major transformations within the Army Nurse Corps.9 These include:
Patient Caring Touch System (PCTS): The PCTS emerged from a comprehensive assessment and gap analysis of clinical nursing capabilities in the U.S. Army Medical Department (AMEDD) directed by MG Horoho. The PCTS provided a framework for standardized, patient- and family-focused care delivery across the AMEDD. The standardized system transformed Army nursing care delivery from an expert-based practice model to a systems-based care model, allowing measurement of select patient outcomes across the AMEDD.
Centers for Nursing Science and Clinical Inquiry: At Horoho’s request, the Centers concept was developed by the Nursing Research Consultant to consolidate various types of nursing experts across the Army working on a prioritized Army nursing research agenda. The concept served to better meet the needs of frontline nurses and nursing executives for real-time evidence to guide nursing care decisions. The Centers, for the first time ever, enabled Clinical Nurse Specialists, Nurse Methods Analysts and nurse scientists to move evidence rapidly from question to answer to translation to evaluation. In addition to its agenda of research priorities, the Centers also had Nursing Practice Councils that fostered autonomy, best practices and educational programs for RN and LPN combat nursing skills.
Army Nursing Leader Academy: Originally designated as the Department of Nursing Science at the AMEDD Center and School, under Horoho’s direction, the department was transformed by its leaders into the Army Nursing Leader Academy to re-cue nurse training platforms into flexible, adaptable modules able to produce any required nursing capability needed for AMEDD and U.S. Army missions. The Leader Academy was the first of its kind in that it addressed career-long learning of all Army nurses by focusing on building skills, knowledge and behaviors to produce sustainable, full-spectrum leaders.
Force Structure: Force structure was addressed to include development of talent management and retention and recruiting strategies with the goal to realign resources to meet the Readiness and Resiliency campaign initiated by the Surgeon General. The plan included bartering with the line to get authorizations moved and accepted for senior nurses to serve in Central Command, Africa Command and Pacific Command. Ultimately, a nursing voice was provided at the strategic table, uniting Medical Command and Forces Command.10
In July 2011, MG Horoho was assigned as the Special Assistant for Medical Affairs to the Commander, International Security Assistance Force Joint Command in Kabul, Afghanistan, where she led a 14-member multi-disciplinary team conducting a health service support assessment (HSSA) of the deployed force. The NATO Medical Center of Excellence would eventually adopt this team’s 2011 HSSA as best practice at the 2014 NATO Summit.11
In December 2011, following her promotion to Lieutenant General, Horoho became the first woman and first nurse to become Commander of the U.S. Army Medical Command and Surgeon General of the U.S. Army. She served as Commander of a worldwide staff of 156,000, operating in 29 executive agencies and 480 facilities, and serving 3.9 million active and retired personnel and their families.12 As the 43rd Army Surgeon General, LTG Horoho masterminded the vision and architecture for a reorganization of the Army’s $14 billion health care delivery system. As Commander of the U.S. Army Medical Command, she developed and led key leader engagements and leadership development to promote the ongoing cultural transformation of Army Medicine from a disease-focused health care delivery system to a proactive system for health.
Among LTG Horoho’s many military awards and citations are the Distinguished Service Medal with Oak Leaf Cluster, Chevalier of the Legion of Honor of France, Japan's Defense Cooperation Award Second Class and the President’s Lifetime Achievement award. She is a Fellow of the American Academy of Nursing and has received numerous other civilian awards and honors.
Following her retirement from the Army in February 2016, Horoho joined Accenture to lead its military health business as the client account lead and managing director for military health. She joined UnitedHealth Group in 2017 as CEO of OptumServe – the end-to-end federal business of Optum and UnitedHealth Group. In the midst of the COVID-19 pandemic, her agility and ability to effectively leverage resources resulted in OptumServe rapidly standing up both the Priority Identification Vaccine Operating Tool (PIVOT), which informs and monitors equitable COVID-19 vaccine administration, and Vaccine Outreach – Implementing Community Engagement (VOICE), which provides customized community engagement and collaboration to address vaccine hesitancy and difficult-to-reach consumers.13
1 At the time of her selection to Chief of the Army Nurse Corps, she was promoted to Major General. Upon subsequent selection as U.S. Army Surgeon General, she was promoted to Lieutenant General.
2 “Surgeon General Horoho,” DVIDS, 11 December 2011, accessed on 23 April 2021, https://www.dvidshub.net/video/132168/surgeon-gene...
3 Henry Cunningham, “Obama Nominates E.E. Smith Grad for Army Surgeon General,” Fayetteville Observer, 5 May 2011; Patricia D. Horoho, US Army Medical Department Office of Medical History, n.d., accessed on 24 April 2021, https://history.amedd.army.mil/surgeongenerals/P_H... “Lt. Gen. (Ret.) Patricia D. Horoho to Speak at SON Commencement, Receive UNC Doctor of Laws,” Carolina Nursing, 28 April 2017, accessed on 23 April 2021, https://nursing.unc.edu/lt-gen-ret-patricia-d-horo... John Harvith and Patricia Lomando White, “Alumnus and U.S. Lt. Gen. Patricia D. Horoho, 43rd Army Surgeon General, To Be Speaker at Pitt Commencement April 29,” PittChronicle, 2 April 2012, accessed 23 April 2021, https://www.chronicle.pitt.edu/story/alumnus-and-u... “Patricia D. Horoho,” University Awards and Honors, 16 May 2014, accessed 23 April 2021, http://uawards.umn.edu/honorary-degree-recipients/...
4 Personal Correspondence with LTG (Ret) Horoho, 28 September 2021.
5 Mary Ellen Condon-Rall, Disaster on Green Ramp (Washington DC: Center of Military History, 1996): 27.
6 W.E. Kretchik, et. al., Intervention, Intervasion: A Concise History of the U.S. Army in Operation Uphold Democracy. (Fort Leavenworth, Kansas: 1998, U.S. Army Command and General Staff College Press), 131-132.
7“Medical Response to 9/11 - Patricia Horoho and Malcolm Nance,” health.mil, 12 September 2016, accessed on 23 April 2021, https://www.health.mil/News/Articles/2016/09/12/Me...
8 Customer Service Award, Walter Reed Army Medical Center. Accessed 28 September 2021, https://www.airforcemedicine.af.mil/News/Display/A...
9 Lewis L Barger, III, 2008-2011: The Transformation of Army Nursing (JBSA Fort Sam Houston, TX: AMEDD Office of Medical History, 2016): 5, 6, 20, 35; Patricia Horoho, “Army Nursing: Transforming for a New Century of Caring,” The US Army Medical Department Journal, (October-December 2011), accessed 21 April 2021, https://www.appropriations.senate.gov/imo/media/doc/hearings/032515%20Lt.%20General%20Horoho%20Statement%20-%20US%20Army-%20SAC-D.pdf; ANC Group Interview, interviewed by Robert S. Rush, 19 September 2015, in San Antonio TX, transcription, AMEDD Oral History Program, Army Medical Department Center of History and Heritage, Fort Sam Houston, TX.; Her Deputy Corp Chief was COL Suzanne Clark.
11 Statement by Lieutenant General Patricia D. Horoho, The Surgeon General United States Army Before the Senate Committee on Appropriations Subcommittee on Defense, First Session, 114TH Congress on Defense Health Program, March 25, 2015, p. 11; accessed 28 September 2021, https://www.appropriations.senate.gov/imo/media/doc/hearings/032515%20Lt.%20General%20Horoho%20Statement%20-%20US%20Army-%20SAC-D.pdf.
12 Rob McIlvaine, "Horoho Takes Oath as First Nurse, Female Surgeon General," U.S. Army, 9 January 2012, accessed on 21 April 2021, https://www.army.mil/article/70556/horoho_takes_oath_as_first_nurse_female_surgeon_general...; Patricia Horoho, interviewed by Robert S. Rush, 13, September 2013- 27 August 2013, in San Antonio TX, eight-part transcriptions, AMEDD Oral History Program, Army Medical Department Center of History and Heritage, Fort Sam Houston, TX.
13 Retired Army Lt. Gen. Patricia Horoho joins Accenture US. Marcy 25, 2016. Accessed 29 September 2021, https://www.consultancy.uk/news/3435/retired-army-...; Heather Seltel-Kirk, Covid Lessons Learned and Future Opportunities for Federal Health, Interview with Patricia Horoho, CEO OptumServe, March 19, 2021, accessed 29 September 2021, https://www.fedhealthit.com/2021/03/covid-lessons-...