See the complete system
Identify how people, information, culture, process, technology and execution interact.
LEADERSHIP & OPERATING PARTNERSHIPS
Align leadership, culture and systems for reliable execution.
Practical operating support—including Fractional COO role coverage—for established, multi-site, regulated and operationally complex organizations across industries. Healthcare is a core area of experience, not the boundary of the work.
USE THIS PATH WHEN
The visible symptom is not the complete problem.
- Goals stall between decision and execution
- Team trust or accountability is inconsistent
- Workflows vary across functions or locations
- Measures do not drive timely decisions
- Growth or regulation has outpaced the operating model
PRINCIPAL-LED OPERATING SUPPORT
Experienced judgment stays close to the work.
Every executive engagement is led by Melissa Thornton, MSN, MBA, RN—not handed to a junior consulting team after the agreement is signed.
Experience includes full-risk healthcare, multi-state operations, quality, workforce performance, financial accountability, technology and enterprise execution.
Meet Melissa →Stay close to implementation
Connect decisions to owners, measures and operating realities.
Build internal capability
Strengthen the organization’s ability to learn, improve and carry the work forward.
SELECTED PRIOR OPERATING IMPACT
Experience built in complex operations.
Selected results reflect Melissa’s prior operating leadership experience—not 5T client engagements. Organizations are not identified to respect confidentiality.
REQUIRED ENTRY PATHWAY FOR LARGER CLIENTS
5T Executive Operating Diagnostic
Starting at $7,500A focused current-state assessment that identifies constraints, clarifies priorities and recommends the right partnership structure before a larger engagement begins.
Start the Diagnostic →Diagnostic includes
01High-level operating context and objective review
02Leadership and operating-system interviews as scoped
03Constraint and priority assessment
04Recommended operating response
05Executive readout and next-step scope
Final timing, responsibilities and deliverables are confirmed in the applicable proposal or statement of work.
TEAM & CULTURAL TRANSFORMATION
Build a culture that supports the work.
Culture changes when leaders consistently shape expectations, communication, decisions, accountability and the systems people use every day.
Request a Team Transformation Scope →Leadership alignment
Create shared priorities, decision rules and consistent expectations.
Trust & psychological safety
Strengthen honest communication, respectful challenge and early problem identification.
Roles & accountability
Clarify ownership, handoffs, decision rights and follow-through.
Team operating rhythms
Establish dependable huddles, reviews, escalation and learning cycles.
Cross-functional collaboration
Improve how information and work move across teams.
Manager capability
Equip leaders to coach, communicate, remove barriers and sustain expected behaviors.
ONGOING OPERATING PARTNERSHIPS
Executive operating support—
without adding another full-time executive.
Each partnership is principal-led and designed around the organization’s size, complexity, priorities and required level of execution.
Final scope, responsibilities, payment terms, confidentiality, timing and deliverables are governed by an approved proposal or statement of work.
01
Founder Advisory Partner
Starting at $2,500 / monthFounders who need structure, accountability and experienced guidance but are not ready for fractional executive leadership.
PARTNERSHIP INCLUDES
- Two advisory sessions per month
- Monthly priority and KPI review
- 30- or 90-day action plan
- Review of one focused business challenge
- Limited email support
- Access to applicable 5T templates
- Quarterly operating-health summary
NOT INCLUDED / PARTICIPATION
Work outside the approved scope, licensed professional advice and client-owned implementation responsibilities are not included. An engaged executive sponsor and timely access to agreed participants are required.
02
Growth Operating Partner
Starting at $7,500 / monthGrowing organizations that need better workflows, stronger accountability and more consistent execution.
PARTNERSHIP INCLUDES
- Biweekly executive operating sessions
- One active improvement workstream
- KPI scorecard development and review
- Workflow and SOP improvement
- Team-role and accountability clarification
- Monthly operating review
- Leadership decision support
- Prioritized implementation roadmap
- Reasonable between-session access
NOT INCLUDED / PARTICIPATION
Work outside the approved scope, licensed professional advice and client-owned implementation responsibilities are not included. An engaged executive sponsor and timely access to agreed participants are required.
03FRACTIONAL COO ROLE COVERAGE · PRINCIPAL-LED
5T Operating Partner
Starting at $15,000 / monthOrganizations that need Fractional COO role coverage, ongoing executive operating leadership and hands-on execution support without adding a full-time COO.
PARTNERSHIP INCLUDES
- Fractional COO role coverage aligned to the agreed scope
- Weekly executive operating session
- Up to two active transformation workstreams
- Monthly executive operating review
- Leadership alignment and accountability
- KPI and performance-management structure
- Workflow and process redesign
- Quality and operational improvement
- Team operating rhythms
- Technology and tool recommendations
- Special-project oversight
- 30-, 60- and 90-day execution priorities
- Executive decision support between scheduled meetings
- Quarterly strategic progress review
- One quarterly virtual leadership workshop
NOT INCLUDED / PARTICIPATION
Work outside the approved scope, licensed professional advice and client-owned implementation responsibilities are not included. An engaged executive sponsor and timely access to agreed participants are required.
04
Enterprise Transformation Partner
Starting at $30,000–$50,000+ / monthComplex organizations requiring a team-based transformation, operating office or executive special-project structure.
PARTNERSHIP INCLUDES
- Executive sponsor and steering-committee support
- Multi-workstream transformation leadership
- Transformation or program-management office structure
- Enterprise KPI and governance design
- Market, department and cross-functional alignment
- Quality, productivity and financial-performance initiatives
- Change-management structure
- Leadership and workforce alignment
- Technology-enabled workflow transformation
- Executive reporting
- Risk, dependency and barrier management
- On-site support as separately scoped
- Access to additional 5T advisors as required
NOT INCLUDED / PARTICIPATION
Work outside the approved scope, licensed professional advice and client-owned implementation responsibilities are not included. An engaged executive sponsor and timely access to agreed participants are required.
EXECUTIVE FAQ
Clarify the engagement before work begins.
Who leads the engagement?
Every executive engagement is led by Melissa Thornton, MSN, MBA, RN. Additional support, if needed, is identified in the approved scope.
Is 5T limited to healthcare?
No. Healthcare is a significant operating foundation, while the 5T framework applies to established, multi-site, regulated and operationally complex organizations across sectors.
What is Fractional COO role coverage?
Within an approved scope, it is principal-led operating support that translates decisions into plans, ownership, measures, operating rhythm and barrier removal without adding a full-time COO.
How does the diagnostic work?
The diagnostic uses a focused current-state review to identify constraints, clarify priorities and recommend the appropriate operating response before a larger engagement.
How are scope and pricing determined?
Final scope considers complexity, risk, locations, urgency, active workstreams, client participation and delivery requirements. Pricing and terms are confirmed in a proposal or statement of work.
What information should we avoid sharing initially?
Do not submit PHI, patient or member information, employee records, credentials, financial-account details, confidential contracts or proprietary data through the public website.
Does 5T replace legal, clinical, financial or HR counsel?
No. 5T provides operating support and does not replace licensed legal, clinical, tax, financial, actuarial, compliance or human-resources counsel.
What happens after an inquiry?
5T reviews the high-level information, confirms fit and proposes the most appropriate next step. Detailed or sensitive information is exchanged only after a suitable process is established.
WHERE IS THE SYSTEM BREAKING DOWN?