Let’s set the stage for a discussion of leadership…

As reported by The New York Times on June 5th…

In one of the largest murder cases in Ohio’s history, a doctor was charged on Wednesday with killing 25 people over four years by prescribing fatal doses of fentanyl, a powerful opioid, to critical-care patients at hospitals in and around Columbus.

Note: Obviously, this is a case that will journey through the court system for quite some time. Regardless of guilt or innocence, poor care was delivered and people died…

As reported by ABC News on July 11th…

The CEO of an embattled Ohio hospital resigned on Thursday and nearly two dozen workers were fired amid allegations that the hospital prescribed excessive painkiller doses that led to 25 patient deaths.

Mount Carmel Health System CEO and President Ed Lamb said he planned to resign by July 25…

“These last months have been difficult for our health care system, and, in times such as these, new leadership has the ability to facilitate healing and help restore the trust of the community,” Lamb said in a video statement Thursday.

Note: It is unclear whether Ed Lamb resigned voluntarily, was asked to resign, or was forced to resign. For THIS discussion, let’s assume that Ed Lamb had the support of the Trinity Health System and chose voluntarily to step down…

The CEO’s Resignation is an example of both great leadership FORTITUDE and classic leadership FAILURE…

First, the FORTITUDE. Too many leaders try to hold onto power when their organizations fail. They blame their circumstances, their staff, the government, or any other scape goat that they can find in the wake of a failure or catastrophe. Too many leaders view organizational failure through a self-centered lens – “It was not my fault, but just the actions of rogue employees and partners!”, or “I didn’t know this was happening!” Too many leaders protect their own jobs and their own futures at the expense of subordinates whom they can fire, layoff, or penalize.

At Mt. Carmel, Ed Lamb did the right thing by resigning…

• First of all, we need more leaders who take responsibility for the cultures that they either create or allow to fester under their leadership. Full stop! Culture matters and the leader is instrumental in defining and creating culture. If the culture is rotten, leaders are at fault.

• Second, we need more leaders who are unwilling to punish their subordinates in order protect their own careers. Many leaders pretend to be heroic saviors in the face of failure – firing staff, reassigning leaders, implementing broad changes, and so on. All of those actions may be necessary. But, if they are efforts to deflect the spotlight from the leader at the top, then they are acts of corruption, not correction. When failure happens, leaders need to look first at THEMSELVES and answer what they should have done differently to avoid the failure. In most cases, that list will be long, and the leader should be willing to fire themselves first.

• And finally, we need more leaders who recognize that different skill sets are needed at different times in the life of an organization. Maintaining excellence is a far different challenge than turning an organization from failure to success. Innovating is different than problem solving. Creating culture is different than designing processes. And, the list goes on. Too many leaders assume that they are the answer to any situation and that their skill sets are appropriate for every challenge. This is just not true and leaders need to understand what they are good at doing and when they need to defer (i.e., resign and step aside) to someone else as a better leader for the times.

For all these reasons, Ed Lamb at Mt. Carmel did the right thing to announce his departure from leadership. With more than 20 people fired in the aftermath of this disaster in Ohio, it is clear that Mt. Carmel suffered a cultural problem of tolerance for mediocrity. With a failure this big, it is clear that the CEO could and should have done something different. And, with Mt. Carmel’s reputation in tatters, it is clear that new leadership is required.

So, let’s give Ed Lamb the credit for demonstrating enough FORTITUDE to step aside and recognize his own contributions – either through action or inaction – to the tragedy that has rocked the Mt. Carmel Health System. Society would be better off if we had more leaders, managers, politicians, and professionals who could demonstrate the same level of FORTITUDE of leadership.

All that said, this is also a study of significant, and predictable, leadership FAILURE. In other words, this type of extreme failure – whether it was highly visible such as murder charges against a doctor, or more hidden such as poor quality outcomes on a daily basis – could and should have been predicted.

As reported on www.columbusceo.com, posted by author Bob Vitale on April 10, 2017 and updated the next day…
As the current chairman of the 40,000-member American College of Healthcare Executives, Lamb also has encouraged his fellow professionals to get more engaged in the national healthcare debate, particularly to push back against what he sees as a negative undercurrent. He worries that constant focus on problems of the US system will become a self-fulfilling prophecy, that practitioners will get discouraged and create a downward spiral in quality of care…

“I really get annoyed when I hear dialogue that goes on and says healthcare in the United States is a disaster,” he says. “I beg to differ. … We need to focus on the great things that we’re doing. We need to tell that story. And we also need to focus on the things that we have challenges with and do a better job.”

As the leader of the ACHE, and as the CEO of Mt. Carmel, Ed Lamb had a responsibility to speak truth…to the powerful, to his constituents, to the public, and to himself. And the TRUTH is that healthcare – both in the USA and around the world IS A DISASTER. Although health care SCIENCE is advancing rapidly, health care DELIVERY continues to fail…

• Standardized processes are absent or inadequate.
• Thousands of patients die needlessly due to mistake or poor coordination.
• Costs have spiraled massively out-of-control and are robbing society of other opportunities (education, environmental protection, infrastructure development, etc.).
• Access to quality care is insufficient, leading to healthcare bankruptcies in some countries and ridiculous care delays in other countries.

What healthcare needs – and what every organization or every industry that is falling short needs – is leaders who are impatient with mediocrity, intolerant of excuses, and visionary of what must and can be done. We need leaders who boldly set direction and strategy, who both empower and expect perfection, and who are humble enough to admit failings, shortcomings, and problems.

Ed Lamb…and probably both the board of directors who hired him and the ACHE members who elected him…are guilty of accepting a health care system that falls desperately short. Whether in an effort to make themselves feel better about the poor state of healthcare, or whether they are blinded to the truth, or whether they truly believe that today is the best we can be (which a few great healthcare providers prove is wrong), this type of rose-colored view of the world leads to ultimate failure. If not spectacular failure like at Mt. Carmel, then hidden cancers of failure that surface in daily performance – long delays, poor processes, inconvenience for customers, high costs, and more.

In short, a great leader is never satisfied and rarely defensive. A great leader always wants more, and when they achieve greatness they embrace the spirit of “great is not really good enough”.

So, in this one example – the tragedy of Mt. Carmel Health that will undoubtedly be studied for years – we have an example of both Leadership Fortitude with a leader who accepts responsibility and recognizes the need for leadership change when necessary. We also have an example of arrogance and overconfidence that went before the fall. Examples of both Leadership Fortitude and Leadership Failure.