MedOn operating idol: Cleveland Clinic

What I gleaned from Cleveland Clinic's CEO about performance standards: either you're doing top-level work and giving 100% -- or you're preparing to leave.

And he points that goal at himself:

Tensions are so high that when Clinic leader Delos "Toby" Cosgrove was asked recently about possible layoffs, he responded passionately, banging his fist on the table.

"We have agonizingly thought this through," said Cosgrove, whose hospital system is one of the largest employers in Ohio with about 39,000 workers. "Our posture is we're going to do everything we possibly can to avoid layoffs here."