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"You really have to look for diversity--not just from the standpoint of cultural background but diversity of experience to bring about the most robust and healthy management team. I think it is a requirement that you seek out the talent in your organization from many different walks of life and look to support that and mentor that," says Continuum COO Gail Donovan.

People should be promoted when they are ready--not as a test to see if they are ready, Donovan maintains. She warns of the dangers of over-promotion: the "Peter Principle," where someone gets promoted too far, too quickly. Although Cracolici was named "interim CEO" before officially moving into the role eight months later, Continuum was confident in the direction of his growth.

"Our interest in appointing him interim CEO was truly to see him evolve into the role. It was never considered to be just an experiment. If you accept an interim position, you have to be careful that someone has the skills and capacity and matches what it is you're looking for in the role," says Donovan. The system structure gives Continuum greater ability to put people in promotional roles, Donovan says, by providing support that a CEO of a standalone hospital might not receive. For example, Cracolici has extensive legal, staffing, and facilities management resources at his fingertips.

"What was great exposure for me was the opportunity to not have to leave an institution, but have mobility in lateral and promotion opportunities within the same system. If you're a freestanding hospital, you're either limited to stay in your position for the balance of your career or leave. Here, I had the best of both worlds," Cracolici says.

CEO²

When you're a faith-based system, your CEO is more than just your strategic leader. He's the moral compass of your organization, ensuring that the values and beliefs of the ministry carry through in business. The process of replacing him can be filled with stress and uncertainty, unless you have an internal candidate ready to step in.

"If you have nobody qualified, of course, you have no other option. But when the qualified person is in your presence and you can talk that person into broadening the scope of their role for the duration of their career, it permits that assurance, in our Catholic ministry world, that this leader is not going to be doing things that will be out of our comfort zone ethically and morally," says Jim Coller, president and CEO of St. Mary's and St. Vincent's Hospitals in Green Bay, WI. "It gives us a person who has already built up a long, positive history with the doctor community, the business community, the employees, and the like."

St. Mary's and St. Vincent's are part of Hospital Sisters Health System, a Roman Catholic system headquartered in Springfield, IL, with 13 hospitals scattered throughout Illinois and Wisconsin. Coller had been CEO of St. Mary's Hospital Medical Center for more than 20 years when the CEO of St. Vincent's, St. Mary's neighbor and biggest competitor, retired. Rather than hire a new CEO, Hospital Sisters expanded Coller's management duties to include both St. Mary's and St. Vincent's.

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