In this month's mailbag, H&HN Daily readers respond to recent pieces on what Joe Paterno's legacy means for health care leadership, how health care executives can successfully make decisions in a rapidly changing environment and whether hospital CEOs are experiencing more burnout and turnover.

First off, several readers responded to "Flaws and All," H&HN managing editor Bill Santamour's piece on what Joe Paterno's legacy means for health care leadership, including Robert R. Bash, an administrator at Doctors Hospital at Deer Creek in Leesville, La.

"I completely agree with your conclusions. Life in general is such that we can and do make mistakes; however, there are certain mistakes that are fatal. That is also true in my hobby of flying. It takes the team looking out for each other so that we do not make one of those fatal errors. Thank you for your thoughts on this subject."

Reader Dennis J. Hertz, an administrator of OBGYN in Lancaster, Pa. also weighed in:

"Thanks for the article. I have been trying to find a learning moment in this as well. When is adhering to the organization's compliance plan just not enough? Paterno said he didn't know what to do and regrets he did not do more. Perhaps there is one more lesson left in the Great Experiment. It's up to us each to learn, and Joe said learning comes first."

Reader Jane Sherwin responded to Joe Flower's recent article on how health care executives can prepare for an era of rapid-fire decision-making, "Better Ways of Thinking About the Future."

"What a great perspective on what hospital CEOs are up against and how they might cope. I've been writing about health care for many years and I still am puzzled by the fact that hospitals can actually be 'run' and 'reformed' while all the clinicians are trying to care for patients. The kind of thinking you propose seems perfectly suited to hospital operations."

Reader Dike Drummond, M.D., commented on my recent blog, "What's the Cure for Hospital CEO Burnout?"

"Interesting spin here Haydn. Here's what I am reading in your report on the state of the hospital CEO profession. Burnout is high. There are lots of reasons why. Get better at succession planning. Really, that's all the industry has to say about 'the cure for hospital CEO burnout?' Feels like throwing in the towel to me. As in, there's nothing we can do about this issue or for these hard-working overstressed people, so let's fire up the CEO turnover treadmill and get better at onboarding the next one, because that's what's coming. There are literally hundreds of ways to support a CEO physically, emotionally, intellectually and spiritually that would lower their burnout rate, and it all starts with seeing them as human and not a commodity position on the org chart."

And finally, reader Martin Kleinbart, senior vice president, strategic planning and business development for Citrus Valley Health Partners, responded to my recent blog, "Will HIEs Live Up to Their Promise?"

"I read your article with great interest. We are a three-hospital system in Southern California that is taking the leap on our own into implementing an HIE. We have taken a different approach on our implementation. Instead of it residing in IT, we view this as a major strategic/business development activity that is vital to achieving our vision of being an integral partner to elevate our communities' health. As such, as the SVP of Planning and Business Development, I have the great honor of leading this project. I have tremendous support from the CEO, the Board and the medical staff to ensure that it happens. We are trying to bring together community physicians, large medical groups and community laboratories to build a community-based record. A lofty goal, but one that we view as vital for an accountable care world."

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