I noted your comments about the “right people” and the “wrong people” being on the proverbial bus within an organization [“Practice Improvement Is People,” From the Editor, March/April 2009]. You've hit on one of my disagreements with Jim Collins in his book Good to Great. I think he intentionally overemphasized the “wrong/right” dichotomy because he was writing an exhortational leadership book.
There is an obvious and much more pragmatic approach, and that is to work directly with the people you have and train them in the skills and abilities needed (e.g., communication, negotiation and teamwork) to improve the organization. The level of function of struggling organizations can be substantially improved by investing in developing these skills, and the results will leave you with an organization that can benefit from continuity and senior skill sets … and relatively few invited to leave the bus.