5 Ways Cleveland Clinic Leads the Way in Transparency

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Transparency is a huge buzzword in healthcare, but one health system is making the term its own by progressively demonstrating transparency through a variety of reporting techniques.

Cleveland Clinic CEO Delos "Toby" Cosgrove, MD, is credited with developing the system's "outcomes books" when he served as chief of cardiac surgery. The physician leader brought outcomes reporting to the forefront of the system's culture, as many of the system's institutes now publish their outcomes in the books, which are mailed to physicians across the country.

In a recent Forbes article, Dr. Cosgrove spoke on five keys to a culture of transparency within a hospital or health system.

1. Take outcomes reporting into your own hands. As chair of cardiac surgery, Dr. Cosgrove would hold an annual presentation in which he would report on his physicians' complication and mortality rates. This internal reporting had a "sobering effect" on surgeons, according to the report, and many left the presentation with unwavering initiative to improve their outcomes before the next reporting period.

2. Assess clinical care with metrics besides mortality. Cleveland Clinic aims to assess its heart procedures with a range of metrics, including complication rates and, for some procedures, whether a patient needed a ventilator or dialysis afterward, according to the report.

3. Let data inform best practices. Cleveland Clinic has maintained a patient registry since 1972 to track long-term outcomes. The registry is not always convenient to maintain, as the system sometimes had to use private detectives to track down patients who either moved or didn't respond to calls. But "every time we looked at the outcomes, we found things to do better," Dr. Cosgrove said in the report. For instance, the registry helped Cleveland Clinic cardiologists learn of the difference in outcomes for vein grafts versus arterial grafts, which are now the standard of care.

4. Find new ways to build credibility with patients. Cleveland Clinic uses an array of reporting tools to increase patient trust. After facing criticism that physicians prescribed products for which they served as consultants for, and not providing full disclosure, the system now requires physicians to list any corporate consulting work on his/her website. The system has also offered patients online access to their electronic medical records and provides outcomes books for many of its institutes.  

5. Leverage data for business strategy. Dr. Cosgrove took his reporting practice for his surgeons (mentioned in the first point) and also shared that information with cardiologists at Cleveland Clinic, who are the physicians responsible for surgical referrals. This way, the physicians knew which surgeons had the best performance, according to the report, and Dr. Cosgrove effectively "tied the outcomes to referrals and thus to his business." He also began mailing copies of the reports to referring physicians nationwide, who he said are "appreciative of [Cleveland Clinic's] candor," according to the report.

More Articles on Transparency in Hospitals:

4 Sources of CMS Reporting Variability
6-Step Roadmap for Communicating Accountable Care to Stakeholders
Population Health Management is a Two-Way Street: Encouraging Patient Engagement


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