 A recent study has proposed that the declining performance of hospitals in the U.S. could be related to the leadership traits of hospital CEOs. Studies show that the quality of care provided by U.S. hospitals is substandard. Every year, hundreds of thousands of Americans die from preventable medical errors, making such errors the third leading cause of death in the United States. Despite an initiative launched in 2010 to revamp healthcare by holding hospitals accountable and disclosing measures of quality of care, research suggests that the U.S. healthcare system remains largely in the same shape. Among the various factors that affect hospital performance, leadership style has been suggested as an important driver of quality of care. To examine this relationship between leadership and hospital performance, the authors of the current study surveyed CEOs and other employees of hospitals from three different performance tiers and compared their perceptions of CEO behavior. The three levels of hospitals the researchers looked at were low-performing hospitals, high-performing hospitals, and hospitals that implemented a management style described as lean. Lean management, which originated in the manufacturing industry, refers to practices that aim to maximize value for customers while minimizing waste, and has become a growing trend among healthcare facilities worldwide. The survey asked employees, both CEOs and followers, to indicate what traits among a list of 44 are demonstrated by CEOs at their respective hospitals. This list included qualities such as setting clear directions, giving personal attention, and showing professional will and personal humility. While the survey responses of the CEOs showed no significant differences among the three tiers of hospitals, the responses of the followers varied significantly between low and high-performing hospitals, and much more between low-performing hospitals and lean management hospitals. Between low and high-performing hospitals, responses varied for six traits, whereas between low-performing and lean management hospitals, responses varied for 33 traits. No significant differences were observed between high-performing hospitals and lean management hospitals. According to the authors, the variations in responses support the growing body of evidence suggesting that the leadership traits of CEOs have some influence on the performance of hospitals in the U.S. They admit, however, that any definitive statement on the relationship between leadership, particularly lean leadership, and hospital performance would require more quantitative research.