Humberto Vitorino Dantas was the man who couldn't retire. After a distinguished career directing the finances of the state of Ceará's health secretariat and unified health system, Dantas was tapped to resuscitate a troubled, almost-abandoned hospital some 30 minutes from Fortaleza, Brazil.

Messejana Hospital was a decrepit 70-year old facility, with some 1,600 employees, a large (but unknown) number of patients, and many, many visitors. It was like a small city and it had all the problems and unexpected emergencies of a small city, including muggings, bank robberies, and power outages. "To keep the power substation from bursting into flames, we had to cool it by positioning a row of fans to blow on it," recalled Dantas.

As Messejana's financial administrative director between 1998-2002, Dantas took charge of all resources. "Of course the managers always think that the solution to any problem lies in the managerial level just above them," he said. Dantas once telephoned a unit head to discuss the spider web that had been growing in a corner. "She had to understand that she was responsible for everything that happened on that unit." Dantas said his most important contribution at Messejana was making managers realize that the buck stops with them.

In four years Dantas engineered a remarkable turnaround. He said he was able to face his challenges with greater courage because of his participation in the secretary of health leadership development program (known a the PDL in Portuguese). "The leadership program helped me with what I consider the greatest challenge of administering a hospital—the interpersonal relations," said Dantas. "My main job is to motivate my staff. The PDL gave me the motivation to motivate others."

Now a well-regarded cardiac hospital where complicated procedures are routine, Messejana attracted many new patients and received a lot of media attention because of its dramatically improved quality. But as the management team looked deeper they saw that some improvements were not consistent. "I'm never satisfied," admitted Dantas, "We were determined to make our image reflect true quality. Because if you come into the hospital and you see a little trash on the floor, you immediately make a negative decision about this whole hospital. That little piece of trash reflects badly on the surgeon's abilities."

He focused on management. "People don't get it. I'm always trying to convince people that hospital administration should be the highest priority. Because you can't have good services without good management."

Although he is clearly a gifted leader, Dantas was eager to enroll in Ceará's follow-on leadership development program, LiderNet in 2002. "If you don't grow, you die," he said simply. Like all Lidernet participants (who call themselves "Lidernautas") Dantas completed a real-world, specific action plan as part of the course curriculum. His most urgent challenge? Turning around yet another hospital in trouble, Hospital Geral Cesar Cals in downtown Fortaleza, a project Dantas compares to doing a complete overhaul of an airplane while it is in flight. "They give me the hospitals that are the lemons!" he said cheerfully. Several construction projects need to be started immediately. "What alarmed me the most when I first saw Hospital Geral Cesar Cals was all the patients with rain falling on their heads." In the ambulatory care unit people would sit and wait to be seen holding their legs balanced above the water. The water on the floor could be 20 centimeters deep—more than ankle high. "This is what my retirement is all about!" he joked. Chronic flooding caused bio-safety issues. The deteriorated physical plant has become the top priority.

Dantas said that LiderNet's curriculum, forums, and resources enhanced his management repertoire. "The leadership development programs help me find the paths to take. It is wonderful to exchange ideas about how things could be solved. The course and the reading for the course strengthened and supported me." He is applying the M&L Leading & Managing Framework to design and implement his new action plan. "I have to do an internal and external scan to know exactly what kinds of people I have. Are they the kind to sit and do nothing? Do I have the right people in the right jobs?" Dantas is not yet certain how many employees he is responsible for—about 1,500, he thinks—and he believes some seven departments report to him.

Dantas will lead his team in focusing. "You have to teach managers to focus or they will be called away for everything," he said, "Managers often get lost in trying to control things that don't produce results." He took out a pencil and drew a straight line. "Norms and standards are straight lines," he said, "but real situations are not. I accept some variance from that straight line—it can appear somewhat wavy—but I don't want people toiling over there way outside the objectives."

He will also hold meetings to align and mobilize people. "Managers must feel themselves to be part of the change. What motivates people is when they see that they can really do something about their challenges. I have to work hard to give people enthusiasm for the work they do and to help them see that even if they hit an obstacle—if there is a little stone in their path—they shouldn't just give up! They don't need to come to a stop. I'm always trying to get people to go beyond that little stone."

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