Abstract
As healthcare systems transition toward Learning Health Systems (LHS), the need for executive-level leadership in systems thinking becomes urgent. This commentary advocates for the institutionalization of a Chief Systems Engineer (CSE) role in hospitals to embed systems engineering (SE) principles within leadership structures, navigate complexity, integrate technology with clinical workflows, and drive continuous organizational learning. Drawing on lessons from high-reliability industries and existing healthcare initiatives, this commentary argues that establishing dedicated SE leadership is essential for achieving both horizontal and vertical integration across clinical, operational, and strategic domains. It outlines the responsibilities of the CSE, aligns them with LHS goals, and offers recommendations for sustained and scalable implementation across healthcare organizations.