The two top executives of Shady Grove Adventist Hospital in Rockville have been removed by its board following a month of criticism from patients, doctors, employees and government regulators.

The board Wednesday night accepted the resignation of chief executive Cory S. Chambers and removed chief operating officer Kiltie Leach. Leach will continue to oversee Washington Adventist Hospital in Takoma Park.

The Shady Grove board also issued a statement promising to improve patient care. The actions come in the wake of allegations that staff cuts at the 263-bed hospital threaten the safety of patients.

Some doctors at the hospital said the 600 staff nurses are too busy to learn patient histories or help any but the sickest patients. Layoffs of staff members who transported patients or equipment have forced nurses to do more of those tasks themselves, they said.

As a result, nurses gave patients the wrong drugs, violated doctors' orders and missed symptoms that should have been reported to physicians, doctors said. The staff's concerns boiled over last month when a patient from the intensive care unit died after being left unattended elsewhere in the hospital.

Maryland health officials launched an inspection that lasted 10 days and generated an outpouring of complaints. Since Oct. 18, nearly 100 patients or families reported incidents to the state's office of health care quality. State and national hospital regulators have visited the hospital, studied medical records and interviewed nurses, administrators and doctors.

Maryland's findings could subject the Rockville facility to stricter scrutiny from regulators and threaten the hospital's eligibility to collect Medicare payments.

Initially, the hospital disputed some of the criticisms as alarmist. But Maryland officials said they have confirmed that the doctors' complaints reflect serious problems.

Doctors said a growing number of patients were reluctant to be hospitalized there. Shady Grove officials acknowledged yesterday that hospital admissions dropped below expected levels in recent weeks.

"We needed to take ownership of the issues that have occurred at Shady Grove," said Ron M. Wisbey, the longtime chairman of the hospital's parent firm, Adventist HealthCare Inc. "We want to bring a level of communication, efficiency and absolute care for our patients, our employees and our organization."

Wisbey, 63, will become interim chief executive of Adventist HealthCare. He is a Seventh-day Adventist minister who once was the church's top official in an eight-state region with 590 congregations.

Harold Lee, who currently presides over the church's region, will be interim chairman of the Adventist HealthCare board, and Terry White will be interim president and chief operating officer of Shady Grove. White is a veteran administrator at Adventist hospitals in the Southwest.

Maryland health officials said they will cooperate with the new management team and expressed hope that things can improve soon.

"I am very concerned about this--I can't emphasize that enough," said Maryland health secretary Georges C. Benjamin. "But it's very clear to me that management is taking these concerns seriously. They're taking their medical and nursing staffs seriously."

Ruth M. Jacobs, a Shady Grove infectious disease specialist who complained that the quality of care at the hospital has deteriorated sharply in recent years, said she wasn't sure what to make of the announcement yesterday.

"I'm happy that there is some change," she said. "However, I do not have faith that they are solving their problems by laterally transferring Kiltie Leach."

Jacobs said doctors should carefully observe how the new leaders are chosen.

"I believe we deserve more than an old-boy-network selection process," she said. "Physicians, including myself, will be watching this process very closely. We need competent and qualified administrators."

Barry Aron, a urologist who joined other staff doctors in complaining about the care last month, said he hopes the situation has bottomed out.

"I think that the problems have been identified, and it's time we all work together to put them behind us," he said. "It's not about individuals. It's about restoring the institution to the wonderful status that it had in the not-too-recent past."

Cheryl Winchell, a Gaithersburg family practitioner and a member of the Adventist HealthCare board, predicted the hospital will rebound.

"Every organization has times where they get into trouble," she said. "The nice thing about this group of people is they take the high road. We won't be punitive against physicians who are upset. We will make this place run right."