Minnesota Security Hospital needs change

I came to Minnesota to serve.

Although I was appalled during my recruitment as CEO at the Minnesota Security Hospital, I was reassured that the state was determined to transform the facility into a person-centered, recovery-supportive organization.

What did I see? Persons in restraints calmly watching "Battle for Los Angeles." A young autistic man in a barred cell on an abandoned unit. Staff carrying metal handcuffs. A leadership team vilifying staff.

I met with union stewards and found employees who were ready, able and motivated. Trust was hesitant, but I was impressed with their willingness to partner.

Soon, I received an anonymous letter alleging some alarming behaviors by some of the leadership. The most concerning was a habit of absence among some critical, extremely well-paid leadership staff. A medical leader who was working from home. Physicians who were present less than 40 hours a week. Doctors who failed to make rounds.

A time study determined that perhaps $100,000 a year in time pilfering was occurring.

Although I was given encouragement to address these issues, the unspoken communication was "we support you — unless someone complains."

The most difficult task in changing a culture is addressing the poor performance of the specially skilled and highly educated. Although their contribution is paramount, allowing their wrongful behavior to go unchallenged undermines the moral authority to address the performance of less-compensated staff. Failing to address behavior inconsistent with the vision of the organization among the ­highest-paid earns resentment from those who are working harder but compensated less.

My dealing with these behaviors — including one particular unacceptable event involving a physician — resulted in several people alleging that I had created a "hostile working environment." Their allegations were investigated and found to be without merit.

One allegation was that I had been perceived as "threatening" the medical director. I had suggested, when he was proposing what I considered a potentially unlawful course, that the attorney general be consulted. That consultation never occurred.

I was told by officials at the Department of Human Services that I did not have the authority as CEO to request a legal opinion from the attorney general's office.

No one ever asked why I thought the behavior in question was illegal. Instead, I was told that suggesting the request of a legal opinion was considered "threatening." I was asked to resign.

What is the culture that promotes these types of actions?

During my tenure, I met dozens of staff whose caring amazed me. I truly believe they are the majority.

But the noise of those who complain about change, accountability or loss of personal power is greeted by bureaucrats who assume that complainers must be capitulated to. The "agitator" must be removed. Resignations or reassignments of those urging change are frequent.

Redirecting a corrupt culture is difficult. Sometimes agitation is needed.

When attention is focused on lowering the volume of those who are loathe to self-­examination, the status quo wins.

The questions of importance are: What has been accomplished over the last year since I left? Are persons served safer? Is staff safer? Is the public safer? Is staff more inspired to excellence? Are families more optimistic? Are communities enriched by the facility?

Transformation is hard. It involves stress. It is not sought out or endured by all.

If top leaders cannot tolerate the stress, why would others in the organization embrace it?

My hope for Minnesota is that the Department of Human Services will block out the noise and stay focused on its goals long enough to achieve something of which those served and those serving can both be proud.

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