Are you as relieved as I am that the national elections are finally over? Whether you backed the winners or the losers, the endless barrage of nasty commercials from every side kept a lot of fed-up Americans from clicking on the TV for the last few months. Some of us even resorted to reading books, for gosh sake.

The question is: Will the results resolve much when it comes to health care? Will the bitter partisanship that paralyzed the federal government suddenly cease? I tend to be an optimist, but I'm not betting money on that possibility.

The battle over corralling the national debt will no doubt get ugly, and could smother any attempt at truly wise compromise on critical issues like Medicare and Medicaid. At the same time, the major engines of reform, like care coordination, quality reporting and pay for performance, are steaming down the track and are unlikely to get derailed, though a multitude of critical details remain to be hammered out.

How do you lead a hospital in uncertain times? It's a question we here at Hospitals & Health Networks ask a lot. The consensus is that leadership is changing in subtle ways. CEOs are spending less time on tasks that should be delegated and more time empowering their executive teams, educating their boards and reassuring and inspiring their staffs.

In last month's issue of H&HN, six hospital CEOs discussed "The Evolution of Leadership." They had plenty of interesting things to say on the topic.

"It's pretty dark and murky out there right now," said Britt Berrett, CEO of Texas Presbyterian Hospital in Dallas. "As a result, I've spent a lot more time describing the future as I see it than anything else and during any other occasion in my career."

J. Thomas Jones, CEO of West Virginia United Health System, said, "We have to recognize that some of the things we've done for years, such as analyzing financial statements, can be done by somebody else. We need to be more visionary and strategic and, quite frankly, spend our time more appropriately."

Everyone agreed that top executives must be more visible to staff listening to their concerns and openly discussing the challenges facing the organization.

"Communication is crucial. It has always been important, but it's even more important today," said Mary Starmann-Harrison, CEO of Hospital Sisters Health System in Springfield, Ill. "Everyone wants to know the 'why,' not just the 'what' We need to provide more information, so people understand why we're taking the steps we're taking."

Said Carol Dozier, R.N., CEO of Ivinson Memorial Hospital in Laramie, Wyo., "We need to be educators Board members, physicians and members of the community keep asking, 'What's going on?'"

The most important task of today's leader may be the most challenging, given all the uncertainties: instilling hope. "We have a responsibility to set the tone and to be inspirational and to see a positive future," said Kathryn Raethel, R.N., CEO of Castle Medical Center in Kailua, Hawaii.

What a leader does day to day changes according to the times, but the essence of leadership is timeless: Educate, communicate and inspire. It's something hospital executives understand and embrace. If only our leaders in Washington would, too.

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