In the book Accountability and Effectiveness Evaluation in Non-Profit Organizations (2000, Routledge), authors James Cutt and Vic Murray state, "Evaluators draw their conclusions about performance from inadequate data, informally gleaned impressions and pre-existing beliefs. Evaluatees often try to avoid blame rather than accept responsibility for those matters for which they are accountable. Many games are played with evaluation systems to ensure positive conclusions." The scenario in this quote, not uncommon in healthcare, keeps the healthcare industry from reaching its fullest potential. Triumphing over the dynamic forces that dictate healthcare's role in communities requires a leader who is dynamic as well as one who can redefine an organization's goals, redevelop its strategies, and respond to the outside threats and opportunities that come along.

The American College of Healthcare Executives (ACHE)'s valuable monograph, Evaluating the Performance of the Hospital CEO, presents the results of a 2001 survey involving chief executives affiliated with ACHE. The findings and recommendations in this monograph can help trustees and corporate officers complete the indispensable task of performing an unbiased evaluation of their hospital CEO. Case studies feature interviews with CEOs of both rural and urban, government and private (including, not-for-profit and investor-owned) hospitals and healthcare systems.