CEOs of any organization know that the key to keeping their job is reliant on two things: performance (i.e., the ability to continually meet organizational benchmarks) and perceived performance (i.e., ensuring "politics" don't drive a wedge between the leader and the board — or other key stakeholders that influence the board).
Yesterday, Becker's covered the story of James Thaw, president of CEO of Athens (Ga.) Regional Health System, who resigned following a flop of an electronic health record rollout.
On May 15, medical staff leaders sent a formal letter to administration highlighting patient safety and other concerns resulting from the implementation, according to a Athens Banner-Herald report. (I'm awaiting a response from the system on when exactly the implementation went live).
In the letter, the physicians claimed the "aggressive" rollout had resulted in: "medication errors ... orders being lost or overlooked ... (emergency department) patients leaving after long waits; and of an inpatient who wasn’t seen by a physician for (five) days."
Several medical staff stopped exercising privileges at the hospital following the implementation, choosing to practice instead at competing facilities — a potential death knell for any executive charged with leading an organization in the current fee-for-service world.
While neither Mr. Thaw nor Athens Regional has publicly tied the resignation to the EHR fail, the timing suggests the two were closely linked. And I have little doubt they were.
The story as I surmise it is this: A seasoned executive (Mr. Thaw previously served as president at Broward General Medical Center and Chris Evert Children's Hospital in Fort Lauderdale, Fla.) loses support from critical stakeholders over the botched rollout — support that he needs to continue to carry out his job responsibilities effectively.
What's always challenging about covering executive resignations (from a journalistic perspective) is that you never quite know the back story. Did he resign after realizing he'd lost the support he needed to be successful on the job? Did he realize his taking the fall for the failed rollout was the only way to get the lost critical physicians back? Or, did the board threaten to force him out if he didn't take the fall? We'll likely never know. (James, if you're reading this, please contact me as I'd love to share your perspective.)
While certainly the CEO is similar to a ship's captain (he or she is ultimately responsible for it and may "go down with it" if it comes to that), it's hard to blame the entire mess on just one person.
I assume if Athens Regional is like any other health system undergoing a major EHR roll out, there were numerous consultants on hand, not to mention an internal committee, tasked with setting the implementation timeline, ensuring adequate training and performing risk management. (I put in a request to the hospital for more detail on the structure here and am awaiting a response.)
Did these groups have (and share) concerns before the rollout? Were they dismissed? Or, did they deem the timeline and training adequate? We don't know and likely won't.
The story is interesting because it adds yet another concern for executives as they consider their roles, their tenure and their job security. (On the flip side, perhaps those systems that have already successfully rolled out EHRs are looking a little more attractive for the best candidates).
As I read about Athens Regional and Mr. Thaw I can't help but think what is being labeled an EHR fail is really a change management fail. And, at the heart of any leadership role is change management. This is especially true for any industry in the midst of change, which is certainly the case for healthcare.
The story of Athens Regional is the story of an organization not adequately prepared for change, and leaders should take note that one of the most important things they do — and one of the most fundamental today if they want to stay in their roles — is to manage change.
Want to brush up on your change management skills? Read my article on "3 Ways Leaders Can Ace Change Management."