Leadership transitions and the impact on patient care.

Leadership transitions are increasing dramatically in hospitals, both at the very top and in top roles such as nursing, operations, finance, medical staff, and so on. Increasingly, new leaders will articulate the importance of "customer orientations" as one of their strategic themes because of the importance of being more market-driven in today's environment. This article explores the strengths and potential pitfalls in both articulating a theme about becoming more patient-centered and implementing that theme in a complex organization so that it actually shapes transactions between front-line staff and patients. The article closes with a discussion of the dilemmas of sustaining a complex initiative across time when many of the key leaders in an organization will inevitably be changing during that time.