Wednesday, September 08, 2010

Attorney General's report found disciplinary action against Paul Levy to be adequate

---but expressed additional concerns. Here are some excerpts from the report:

The outstanding reputation of an organization and its CEO are valuable assets of any charitable organization. The personal relationship between the CEO and the Employee, which continued throughout her tenure despite repeated expressions of concern by senior staff and certain Board members, clearly damaged his reputation and, of greater concern, endangered the reputation of the institution and its management. As such his continued, repeated and acknowledged failure to appreciate and address the situation merited, if not compelled, disciplinary action by the Board.

...had the entire Board been informed and taken definitive action when concerns regarding the relationship were first expressed to Levy, much, if not all, of the damage would have been averted. The Board members who communicated their concerns to the CEO or management, but then failed to convey them to the full Board, may well have felt such direct communications were sufficient. Others may have heard rumors, but failed to follow-up. With the acknowledged aid of hindsight, it is now clear the entire Board should have been informed and taken action years before the lodging of the Complaint. Accordingly, the Division cannot conclude that neither the Board nor senior management of the Medical Center is without some level of responsibility for these events.

...Respect for Mr. Levy and his accomplishments may have created among some Board members a level of deference to management that was, and is, inconsistent with the level of vigorous and fully independent Board oversight that would have compelled definitive action far earlier.

...As early as 2003/2004, the existence of a personal relationship between the Employee and Levy became known within the Medical Center. During that time, the Board chair and BIDMC senior staff raised concerns with Levy, particularly in the context of her direct reporting relationship to him. At this point, at least one other Board member was aware of the relationship...

During this period, the Board, through the ad-hoc committee, interviewed Paul Levy
and former Board chair Lois Silverman. Levy outlined his reasons for hiring the Employee as well as the general nature of his personal relationship, including travel and other outside of work activities. Levy declined to answer certain questions about the nature of the relationship and acknowledged that this left others, including Board members, to draw their own conclusions...

He further confirmed that members of his management team and two former
Board chairs had, over time, questioned him about his relationship with the Employee and that he had done nothing in response to these inquiries...

Two aspects of her compensation and employment history do merit discussion.
First,while her overall salary was within the range of her job grade, she was the only non-physician director who received a bonus in all four of the years reviewed. Second, both positions that the Employee held at BIDMC and BI-Needham were newly created and not maintained after she left. In the context of the widely known personal relationship between the CEO and the Employee, each is inevitably subject to the perception that it was influenced by the personal relationship...

Neither the record nor Mr. Levy dispute that he (i) failed to separate a professional and personal relationship with an employee ofthe Medical Center and BINeedham
that spanned many years and was known throughout these institutions; (ii) was
alerted on numerous occasions by staff and Board chairs that he needed to take action to end either the personal relationship or the employment relationship; and (iii) failed to heed those warnings.

While the Division cannot measure the impact of these failures, the public attention, exposure and criticism which inevitably took place most certainly had a
negative impact on the institution...

OK. Levy's been punished enough and the final chapter in this controversy has played out. But there are lessons here on several levels that should not be lost. First, Levy has long been an advocate for patient safety. A significant element of patient safety is the culture of the hospital. His behavior was a distraction and created a toxic atmosphere. His personal life is his business until it creates a ripple effect across the organization. To the extent that it does, patient safety may be threatened. Second, Levy's credibility as a leader in transparency has been damaged. It would appear that in this particular matter Levy was anything but transparent over a period of several years. Finally, there may be a more general lesson here regarding hospital leadership. With rumors spreading throughout the organization (as cited in the Attorney General's report) where was the hospital board? What about the medical staff? Why their silence over a period of years? CEOs are powerful and there may have been perceived intimidation. This, according to the Attorney General's report, was no excuse for the board's failure to act sooner. This should be considered a never event.

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