Summa Health doesn’t know the precise reasons for its failed application to restart its emergency medicine program. That will come in the next two months, the national accrediting agency for physician training programs amplifying on its decision announced last week. What is known is that Summa carried much baggage into the process. It has been less than two years since the debacle that saw Summa Emergency Associates, the physicians staffing the emergency room, exit after more than 40 years at the health system.

That departure triggered a broader physician revolt and eventually the resignation of Thomas Malone, the Summa chief executive. The fallout included the highly regarded residency program in emergency medicine losing its accreditation.

Summa has been on the comeback. Yet it hardly is a stretch to think the accrediting agency would want to see more progress for a sustained time.

Recall why the agency acted in the first place, citing delays in emergency patients receiving specialized care, residents seeing patients without supervision, and patients sent home without an examination by an attending physician. The new physician team from U.S. Acute Care Solutions lacked adequate teaching staff. Add the baggage from the legal scrap with Cleveland Clinic Akron General over the hiring of a new program director for the emergency medicine program. The settlement prohibits the director from clinical work for a year.

The encouraging thing is Summa intends to apply again, and that determination reflects advances elsewhere under the leadership of Dr. Cliff Deveny, the interim chief executive since March 2017. Upon his return to Summa, where he earlier practiced and worked in leadership positions for two decades, Deveny faced a projected $60 million operating loss. By year’s end, the loss had been reduced by half.

That feat required the difficult task of eliminating positions, plus steps to reorganize and consolidate, Summa now on a path to recovery, or returning to its income position before the emergency medicine mess. Among the improvements, the health system has expanded access and hours. Which points to what is most important under Deveny. He has worked to repair relationships — with physicians, nurses, staff members and the community.

At its core, the challenge facing Summa goes to rebuilding trust and its reputation for quality. Both suffered during the troubles of last year. It isn’t enough to construct a gleaming tower at City Hospital, or make other physical improvements, as necessary as they are. Summa has the job of regaining confidence in the health care it provides, returning to the reputation it long earned and enjoyed in Akron and surroundings.

Part of that involves the greater transparency Deveny has advanced as a tool for improving communication, morale and performance. As Summa knows well, an emergency medicine residency program is about the medical training — and the larger education for young physicians, drawn from the institution as a whole. That is where Summa appears headed to its benefit and that of the community. The expectation is the next time it applies, it will have more progress to show.

Beacon Journal/Ohio.com editorial board