The Cleveland Clinic patient experience program has been mentioned several times in this blog and the CC CEO, Delos Cosgrove commended for his progressivism and values. Now the Clinic has achieved one of the highest distinctions possible: a feature piece in the May 2013 Harvard Business Review.
Entitled “Health Care’s Service Fanatics,” the article extols Cleveland Clinic as a model not just for health care but for all service organizations. The authors note “it has long had a reputation for holding down costs” while still improving service delivery. The Clinic was indeed cited by a Forbes columnist as exemplifying “Doing Both” and has partnered with five other leading health care organizations to form a new group to research that dual objective.
And the accomplishments cited certainly are impressive. The Clinic’s patient satisfaction rating as measured by the Center for Medicare and Medicaid Services rose from 55 percent in 2008 to 95 percent in 2012.
The authors report that the Clinic’s efforts began in 2009 when CEO Toby Cosgrove began a still ongoing organizational transformation campaign. This became led by James Merlino, a Cleveland Clinic surgeon and now Chief Patient Experience Officer.
There were three stages in this endeavor: (1) publicly acknowledging that patient experience was a problem; (2) developing an understanding of patient needs; and (3) making all employees supporters of the program. All very good organizational development practice!
The first step illustrates the importance of good organizational communication, without which change is impossible. The second utilized surveys and studies so that patient needs and feelings were discovered, leading to understanding of what changes were indicated, also best practice. And the involvement of all employees is indeed a key to successful change.
In the process, all staff went through a half-day session in small groups of eight to ten, in which, for example, a doctor might sit next to a janitor, for facilitated discussion on patient service. Mixed groups like this are indeed an excellent way not just to get new insights but also to break out of our usual restrictive outlooks. Healthcare workers are particularly prone to having fixed mindsets, often reinforced by professional organizations and unions. (Beth’s improv work is another way to promote new ways of thinking.) In addition, all managers went through half day training sessions each quarter on how to keep their employees actively involved.
Celebrating short-term wins is one of the principles of John Kotter’s “definitive” Leading Change, and this too was part of the Cleveland Clinic endeavor. A “caregiver celebration” (which utilized financial rewards) recognized employees who had made particularly notable contributions.
Maintaining momentum in change efforts is a huge problem. One answer to this at the Clinic was to have managers submit annual plans for specific ways in which their team would improve patient satisfaction.
All very laudable! Of course even the best stories may leave some doubts. Who wrote the HBR article? James Merlino – but with Harvard Business School professor Ananth Raman . Raman is identified as having an “outside perspective” and presumably has no stake in the program. Still you might want to find out more about what those doctors and janitors think about it all!
The article notes that to get the all-staff half day meetings required overcoming a good deal of resistance regarding staff time and costs. Such is customary and it is good that the opposition was overcome, but a half day of training time is not really a very large amount. And the fact that only managers got additional training and mandates for submitting plans is inconsistent with the “everyone must be involved” principle. Yet, overall, this article lives up to its premise and what Cleveland Clinic is obviously worth of study and emulation.
–Jim Murphy has a solo consulting practice called Management 3000, focusing on organizational development and change management. Formerly he led the Massachusetts Bay Organizational Development Learning Group, was Human Resources Director for the City of Boston Assessing Department, and served as a consultant with the Boston Management Consortium. His consulting practice includes management coaching as well as research and writing on employee relationships, leadership, healthcare and collaborative practices. Having produced newsletters for several organizations and being a frequent content writer for the”Confident Voices in Healthcare” blog, he is interested in writing and research opportunities, as we all consulting and coaching.