Pros
Change in top leadership toward progressive transformation. Resources to do PR and public health positioning. Good intentions of the very top leadership. Motivated team of care providers (Drs, Nurses, Pt Contact teams). Well-intentioned and eager employees with positive attitudes capped by organizational management issues.
Cons
Lack of vision, leadership, courage and willingness to take action by key leadership besides 1-2 key leaders. Many in positions of potential change prioritize personal job security over organizational leadership, because that is how they got to where they are. Opportunities are avoided because dodging risk results in making non-decisions, avoiding potential risk, not making waves and managing symptoms of the organization instead of having the vision to see the big picture, solve for the long-term and have the courage to take action to fix the problem versus the symptoms. The result is poor recruitment, retention, job satisfaction, lack of confidence in leadership and the "sinking ship" scenario. Confirming symptoms include continuing loss of physician network, reduction in utilization of facilities, inconsistent procedure flow, divergence among admin and staff, management teams pressured to prioritize the corporate line over honest communication, sense of staff not feeling involved until disinterested, staffing instabilities and a general sense that all is not well and being covered by the fluffy PR campaigns.