Theory #5: Time to line the CEOs up against the wall!

In my experience, hospitals virtually never force their execs to take public responsibility for major problems. It’s always somebody else’s fault, and would you believe, miracle of miracles, the problem is usually due to a contractor that “did work for us temporarily.”

Seems to me that nobody thinks about impact this must have on patients. It’s bad enough when you learn that your mom is more likely to get sepsis at her neighborhood hospital than one down the road; it’s quite another to find out that the man who’s ultimately responsible for the infection rates is still drawing running the institution and drawing a big salary.

If you need proof that hospital leaders are in a protected glass bubble, you don’t need to look hard. Think back on some of the worst hospital screw-ups of last year (such as massive data losses, repeated serious HIPAA violations, massive drug overdoses, even hospitals letting patients die on the floor of their ED), then ask  yourself who faced serious consequences or a least a public reprimand afterwards. Was it the hospital CEO?  Sure, that’s likely (not)!

Hey, after all, when Esmin Green died on the floor of the Kings County Hospital Center while waiting for psychiatric treatment–after being ignored by a psychiatrist, nurses and two security guards–some of those rank and file folks took some heat, sure. But as far as I know, Health and Hospitals Corp. head  Alan Aviles still runs the show.  Aviles did offer some mea culpas for the death of  Green, but his head is definitely still upon his shoulders, figuratively speaking.  By my lights, he should be forced to be a security guard or a nurse for a week or two to really find out what’s going on over there. But no, you can be pretty sure he’s back to business as usual, two years after poor Esmin died of neglect on his emergency department floor.  (Here’s Aviles’ response to Green’s death.)

What’s worse, this isn’t unusual. I don’t have stats, but I’d bet that north of 95 percent of such cases, nothing happens to the CEO  whose job it is, ultimately, to prevent such from happening. Rather than holding CEOs and other execs accountable, to their community as well as their colleagues, a hospital’s instinct seem to be to actually shelter the exec during times of crisis and keep him/her far from the public eye.

Well, you know? I say the heck with that. It’s about time that hospital leaders took a public, firm, principled stance on how major problems might have taken place — and did so, in public, within 24 hours of a major mistake taking place. And let’s see a few folks fall on their sword if they’ve actually been in charge where someone died so needlessly as Esmin Green did.  Hiding behind PR reps is absolutely represensible. And CEOs who don’t talk to their staff in a humble and humane manner about what happened are no better.

Can’t take the head when you make a mistake, Mr. CEO?  I say you’re in the wrong business.  If they can’t get it right,  I say, make sure everyone knows what they did — say, by following them around and  posting “Megan’s Law” style posters describing how people got hurt.

Yeah, that scenario may be harsh, but you get my drift here. The bottom line is that the model of the untouchable, inaccessible hospital leader has no place in today’s marketplace.