Quick Fix Leads to Permanent Cure

he hospital director's medical emergency could result in a crisis of confidence for the hospital staff, its patients and the public at large. The director's collapse and medical outlook have grabbed the attention of the public and policy elites, with possible long-term consequences for the hospital.

Ackerbein's decision to delay selection of a deputy director for more than a year has exacerbated the crisis and left the organization without permanent leadership. Thus, an immediate short-term crisis must be addressed and a mid-term direction must be established to stop an unfolding disaster with long-term consequences.

Madsen and Ross both have strengths they bring to the crisis. In addition, both have areas in which they are not comfortable. Madsen is comfortable with ceremonial roles and routine director duties, and he brings the ability to provide confidence and continuity to the hospital staff.

As a chief of staff, Ross is familiar with many of the day-to-day responsibilities of the director's role in hospital administration. In addition, she has become interested in management and planning. On the other hand, she does not appear ready to assume fully the representational role of a permanent director, even though she had been selected as understudy.

Thus, these individuals collectively are key to mitigating the short-term crisis of confidence, but only if they can mobilize their talents. There is a need to avoid interpersonal conflict and the appearance of jockeying for power in this leadership vacuum.

Since Madsen has been acting for the past month, he should approach the returning Ross to discuss strategy and the draft press release. A joint recommendation on short-term leadership and direction is critical. Both leaders must put aside their personal ambitions and look to the greater good of the institution.

Thus, Madsen and Ross should discuss their recommendations for acting director and deputy director. Which individual assumes which role is less important than the need to support each other. They could effectively complement each other's strengths while mitigating their weaknesses.

The press release has the power to alleviate external concerns while building short-term confidence with the Health Agency administrator and the hospital's employees. It is the first opportunity for these two leaders to maintain control of the hospital's policy-making agenda in the short run. The press release must provide a status report on Dr. Ackerbein's medical condition and expected length of absence, a formal designation of an acting director and deputy director, and a statement of continuity of service to the community.

Madsen and Ross should be prepared to brief the Health Agency administrator and staff in an all-hands meeting on plans to develop a strong internal management team, rather than copying the "one man band" leadership style of Ackerbein. They should focus on a high-involvement strategy enabling employees to pull together during Ackerbein's absence and create a collective vision for the hospital. This can be done by capitalizing on Ross' interest in executive development seminars and creating a climate for individual and organizational growth.

Ross and Madsen, as interim director and deputy director, should map the political terrain and build a base of support. They must present their goals, plans and activities as a strategic short-term direction for the hospital in order to inspire confidence in their effectiveness as interim leaders. They have the opportunity to develop a cadre of future hospital leaders by exposing existing staff to new responsibilities in a formal and structured manner. This crisis could lead to effective team building by creating a "pitch in" atmosphere where all can weather the storm together.

Thomas C. Accardi joined the faculty of the Federal Executive Institute in Charlottesville, Va., in 1997. He previously served at the Federal Aviation Administration as director of the Flights Standards Service, which is responsible for regulating the aviation industry.