Wednesday, January 16, 2013

In appreciation: Ehud Kokia

Ehud Kokia resigned as CEO of Hadassah Medical Organization (HMO) this week.  I want to share some thoughts about him before time passes.  Why?  By presenting his example, I hope to give confidence to my skeptical or cynical readers that there are leaders in the health care system who are exemplary human beings.  During my time as a hospital CEO and in the two years since, I have had the privilege to meet a number of such men and women.

Ehud is emblematic of those people who take on the job for the best of reasons. They sign up not for ego boosting or self-gratification, but because they are kind and caring individuals who want to provide a service to their communities in the most humane and professional manner possible.  They want to advance knowledge among health care professionals in a way that supports patient-centered care.  They respect and admire all of the people in their organizations, from the custodians to the neurosurgeons, understanding that the best ideas can emerge from any place and any person.  Over the years, I have mentioned a few of the American CEOs who embody these values, but they also exist in other countries.  Ehud is one such person in Israel.

Ehud and I first met two years ago, when he was running Maccabi Healthcare Services, one of the four health maintenance organizations in Israel.  (You can think of each organization as a combination of a major primary care and multi-specialty practice and an insurance administrator, funded by the national health care fund.)  He was highly successful in enhancing the business and operational aspects of the firm, but also was a leader in improving the quality of care delivered to that system’s patients. Ehud later joined HMO, seeking the challenge of running the country’s preeminent academic medical center at Ein Kerem and an associated community hospital at Mt. Scopus.

Now, just fourteen months later, he has chosen to leave.  In that short time, he has secured the respect and affection of administrative and clinical leaders, but also many other folks throughout HMO.  He could have stayed for many years, but he selflessly decided that another type of person would be better suited to the job, as the circumstances facing HMO had changed dramatically in the period following his recruitment and arrival.

For someone who believes so strongly in the clinical, research, and training mission of an academic medical center--and in the people who carry out that mission--a decision to resign is painful and wrenching.  Ironically, it was the intensity of that belief that led Ehud to his decision.  I’d like you to hear that in his own words, so I conclude with excerpts of his email to the staff this week (with help from Google to translate from Hebrew to English).  This is a man who still has much to contribute the community, and I am sure he will serve elsewhere with distinction during his next chapters.

Last night, Monday, I announced my resignation to the Board as CEO of Hadassah. During the brief period in which I served in that role, I found a wonderful bunch of people who have seen our hospital as their home for years, who do everything possible to empower and enhance the institution.

I found a center here with enormous capabilities in medicine, research and teaching. I found many areas where the hospital leads not only Israel, but also in the world. We must all be aware of this fact and be proud of it.

Along the path of both my personal and professional life, transparency is a cornerstone in matters practical and administrative: I tried to share as much as possible with the various functional areas of the hospital and connect them as one leadership team. Accordingly, any information obtained at the level of senior management was brought to the attention of the wider management circles. Instead of "we" and "them", we tried to create a system view of "all together."

I place great importance on quality. I began a campaign to introduce processes of quality to every corner of our hospitals. Improving service delivery and ambulatory medicine outpatient clinics also received special attention. We refreshed Hadassah management ranks, both at the clinical department directors and senior management level in the organization. A new manager came to Mount Scopus, a new CFO, deputy director Ein Kerem hospital and quality management and strategic planning.  In recent months, I examined programs to promote the status of the Mount Scopus campus in order to exploit its capabilities.  In parallel, I took part in populating the new hospital tower [at Ein Kerem], and we watched the building come alive.

Against all this was a background of growing financial distress. After several months it became clear to me and my management team that the cash flow deficit was larger than had been reported and had continued for several years. We prepared a program to intervene in this area, but we all have in the near future a very significant overhaul of Hadassah.

Against this background and in view of the fact that the economic situation was not clear enough for both sides when I started in this job, I announced to the Board that I had decided to leave. I will do what is required to allow a proper and orderly transfer of the position to the next person.

Dear colleagues, what I take with me and strains my heart is the "Hadassah spirit"--friendships and human connections we created, the names and faces of wonderful people, and especially the knowledge that these relations will continue to exist despite the geographic distance. I wish with all my heart success at Hadassah in the future.

Photo credit:  Ofer Vaknin, Haaretz

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