Editorial: Johns Hopkins All Children's resignations first step toward restoring trust

The resignations of the CEO of Johns Hopkins All Children's Hospital and two other hospital administrators Tuesday is the first meaningful step toward restoring the community's trust in the venerable institution. The next step should be a thorough public accounting of the factors that contributed to a surge in the death rate of patients in the St. Petersburg hospital's pediatric heart surgery unit -- and of why the safety concerns were not addressed in a more aggressive, transparent manner. The Baltimore-based Johns Hopkins Medicine promises to follow through, and it owes that to its patients and the entire Tampa Bay region.

The resignations of Dr. Jonathan Ellen as All Children's CEO; Dr. Jeffrey Jacobs, the chief of the division of cardiovascular surgery; and Jackie Crain, vice president and chief of staff, amount to a house cleaning in the top leadership ranks. Responsibility for systemic failures of any large institution ultimately rests with its leaders, and there is ample evidence a change in direction is necessary to restore All Children's reputation and preserve its future.

A Tampa Bay Times investigation by staff writers Kathleen McGrory and Neil Bedi revealed serious problems with the pediatric heart program that were hidden from the public. The mortality rate tripled between 2015 and 2017 to become the highest of any pediatric heart program in Florida, with nearly one in 10 patients dying last year. The investigation found surgeons repeatedly made serious mistakes. Needles were lost in at least two infants' chests. Sutures burst. Infections mounted.

Read: Johns Hopkins promised to elevate All Children's Heart Institute.Then patients started to die at an alarming rate.

Yet All Children's administrators were slow to address the issues even as the program's staff raised safety concerns as early as 2015. There also was a lack of candor about the issues as the hospital continued to promote the program externally and internally. Ellen told the Times this spring the Heart Institute had its "challenges'' under control and had slowed surgeries to the lowest level possible without shutting down. But records and interviews show the hospital couldn't handle the less complicated cases, either. The hospital said it halted all pediatric heart surgeries in October and was conducting a review of the program, but no public statements by All Children's or Johns Hopkins were released following the publication of the Times investigation until the resignations were announced.

Related: Top All Children's executives resign following Times report on heart surgeries

Johns Hopkins said the right things Tuesday in a public statement. Kevin Sowers, the president of the Johns Hopkins Health System, will temporarily lead All Children's. The board of Johns Hopkins Medicine has commissioned an external review of the program and "we will share the lessons learned from that review to ensure that Johns Hopkins, Johns Hopkins All Children's and other hospitals around the country can learn from and avoid the mistakes that were made.'' That review should be made available to the general public, and so should an earlier review by the top-ranked Texas Children's Hospital that All Children's has refused to release. State and federal regulators also should investigate.

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Since arriving in St. Petersburg about six years ago, Ellen's contributions to the community have extended beyond All Children's. He chairs the task force working on the consolidation of the University of South Florida in Tampa and its campuses in St. Petersburg and Sarasota. He has been president of the St. Pete Innovation District, a key development area for the city, which includes All Children's and USFSP. And he chairs the board of trustees for the Foundation for a Healthy St. Petersburg, a nonprofit which seeks to address health disparities in Pinellas County. Presumably, new leaders will have to step up to fill those civic roles.

Johns Hopkins All Children's Hospital is a remarkable community asset that should be preserved and protected. Generations have entrusted it with the care of our sickest, most at-risk children. That trust has been tested by the revelations of the serious issues within the pediatric heart surgery unit, and the change in leadership is a necessary move to start rebuilding that trust. It cannot be the last one.