CEO Dr. Toby Cosgrove on 4 Cleveland Clinic philosophies

Toby Cosgrove, MD, calls caring for patients a "sacred privilege." As president and CEO of Cleveland Clinic, he and his team are constantly working to improve and live up to that special right.

Dr. Cosgrove — a retired cardiothoracic surgeon and former Air Force surgeon during the Vietnam War — and his team are working in unique ways to transform four main things. During the Becker's Hospital Review 4th Annual CEO + CFO/CIO Roundtable keynote address, he detailed some of the beliefs and improvements at the Cleveland Clinic.

1. Access. When people in Washington, D.C., talk about patient access to care, they talk about insurance. But Dr. Cosgrove noted, "When you're sick, [access] means being seen by a caregiver." Cleveland Clinic is working on giving patients more of that type of "access."

For instance, when a patient calls Cleveland Clinic for an appointment, the person who answers asks the caller if they would like to be seen that day. In 2014, Cleveland Clinic coordinated 1 million same-day appointments, he said. Additionally, the Clinic launched shared medical appointments, which Dr. Cosgrove called "good for the patient and the physician," since physicians can see about a dozen people with the same medical problem at once, and patients get a built-in "group therapy" session with others who share a similar diagnosis.

With healthcare becoming more futuristic day by day, seeing a physician no longer requires patients to travel. Telemedicine is becoming more prevalent, and Cleveland Clinic has invested in Healthspot technology — pods that can be deployed in places like college campuses, pharmacies and other remote locations. Inside the pods, patients are equipped with blood pressure cuffs and the like. They connect via video with Cleveland Clinic clinicians. Dr. Cosgrove said options like this have "substantial potential" to improve patient access to care.

2. Affordability. According to Dr. Cosgrove, one way to improve the affordability of healthcare is to look at what causes premature death and strain on the system — things like obesity, a sedentary lifestyle and smoking. Cleveland Clinic started combating these issues with its own employees.

For instance, there is a blanket smoking ban on Cleveland Clinic's campus, and the system also stopped hiring smokers by testing for nicotine during the interview process. According to Dr. Cosgrove, there is now just a 5 percent incidence of smoking among employees.

To combat obesity, Cleveland Clinic removed trans fats from foods served on campus and started offering employees free memberships to Weight Watchers, Curves, yoga classes and fitness centers. As a result, Cleveland Clinic workers have lost a combined 500,000 pounds, and the cost of health insurance per member per month also dropped.

3. Efficiency. Making healthcare more efficient can also make it less expensive to provide. While remaining mindful of patient safety, Cleveland Clinic has standardized its joint implant offerings with the input of physicians, resulting in $5 million in savings on implant costs in two years, said Dr. Cosgrove.

Additionally, Cleveland Clinic turned to its employees to help find efficiency opportunities through the My Two Cents program. The program allows front-line employees to share their ideas on how to make the Clinic more efficient. According to Dr. Cosgrove, the ideas garnered through the program — such as stopping some escalators at night — have saved "lots and lots of money" for the Cleveland Clinic.

4. Patient experience. "The only reason we have a hospital or clinic or any of us have a profession, that's because of patients," Dr. Cosgrove said. Cleveland Clinic is constantly looking at improvements to put the patient first.

For instance, the system worked with fashion designer Diane Von Furstenberg to design a new patient gown. Dr. Cosgrove jokingly called the gown his "greatest crowning achievement." The wrapped frock allows patients to remain fully covered and comfortable during their hospital stay or appointment.

Another aspect of providing patients with a first-rate experience is employee engagement, which Cleveland Clinic has also focused on. Dr. Cosgrove said the Clinic had all employees meet to talk about the "Cleveland Clinic experience" and emphasized that all workers — even nonclinicians — are caregivers. Now, everyone's badge says "caregiver," which has driven employee engagement and helped drive patient experience improvement.

Dr. Cosgrove closed with a paraphrased quote from former President Theodore Roosevelt that applies to Cleveland Clinic's philosophy on healthcare: "Nobody cares how much you know unless they know how much you care."

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