Unfortunately, most of the executive leadership in this organization do not practice what they are holding others accountable for and it is beginning to show as others are outshining them. At times, the senior leadership appear to be in a state of desperation as they make quick decisions without thinking them through all the way nor taking the time to fully prepare staff for the changes. There is an expectation for the staff / physicians to just get it, accept it, and do it. There are a few key players that will need to leave the organization before it can become completely successful; the current COO is the main one. Most of the staff and physicians are making what was initially thought to be impossible, completely possible and a reality.