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Since the introduction of the Patients First motto, there had been discussions about how to instill that purpose more strongly into the culture of the organization. Creating the motto, making patient experience a strategic priority, revamping the mission, vision, and values, and appointing a chief experience officer proved not to be enough. And while we could point to a number of success stories in improving the patient experience in the units and in addressing physician communication, caregivers were not aligned and did not live the patient experience. It became increasing clear that we needed to do something so that everyone would comprehend the importance of the patient experience. We needed to shock the system. We needed an all-hands-on-deck training program.

Although we had little granular patient experience research at the time, we all knew anecdotally that patients paid attention to virtually everything. It didn’t matter how good the medical care was or whether every safety contingency was covered. If a phlebotomist was rude when awakening the patient, a nurse seemed preoccupied, or a doctor didn’t explain things completely, the patient left with a negative perception. We needed to evoke something dramatic to get everyone wrapped around the patient.

The why was pretty clear. Despite our early efforts, we still had terrible patient experience scores. Patients were continually complaining, often about simple things like rude behavior, not knowing what was going on with their care, and poor coordination between caregivers. The pressure on the culture was mounting for all of us to change.

We were relatively new at patient-centered thinking, and no one in our organization had experience with culture-change initiatives on the scale of the entire Cleveland Clinic. At our strategy session in late 2009, we had committed to develop a culture of “engaged and satisfied” caregivers for the purpose of achieving enterprise goals. This obviously meant alignment around the patient. Cosgrove had talked about it for years, but we hadn’t done anything yet to achieve that change. We were behind, and he was frustrated.

We Learned from Others

To get started on building our cultural alignment training program, several members of the patient experience team and others from HR benchmarked organizations known for great service delivery. We looked at healthcare organizations but also wanted to learn from outside industries. Natural targets were hospitality companies and other service leaders.

The InterContinental Hotels Group manages Cleveland Clinic’s hotel properties, and Campbell Black, regional director and general manager, graciously allowed us to spend a day with his senior leadership. They gave us a behind-the-scenes look at how they developed employees and sustained their excellent service culture. Black made several very important points, highlighting the need for ongoing training and constant individual recognition of great work. He also underscored how InterContinental aligns everything around the customer and holds employees accountable to the organization’s values.


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