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Introduction

Our greatest patient experience achievement has been our ability to execute the work, an achievement I owe to my mentor and friend from Harvard Business School, Ananth Raman. He helped me understand the importance of how to operationalize the change.

Execution has taken our patient experience improvement from aspirational goal to operational reality, gained the respect of leaders across Cleveland Clinic, and drawn the attention of healthcare institutions around the world. The success of our execution is palpable. Our organizational metrics are improved, our caregivers live the patient experience, our leaders drive it, and most important, our patients feel it. The challenge going forward is to sustain and improve upon what we’ve done. It’s easy to fix something broken; it’s much harder to take something successful and make it better. While our strategy will evolve and tactics will come and go, the navigational focus of patients as our true north and our fundamental alignment around the patient must never waver.

In January 2014, I spoke to a group of physicians from Hillcrest Medical Center in Tulsa, Oklahoma. The Medical Group’s CMO, Jeffrey Galles,1 e-mailed me after the meeting and observed that his senior hospital leadership often says, “We can’t all be Cleveland Clinic.” My response was, “Yes, you can!” It’s about leadership mindset and how the organization aligns around a Patients First philosophy and sets the patient experience as a strategic priority. And while it’s true that initially we invested materially in our patient experience initiative, today we know better how to achieve success without spending a lot. Setting a patient experience strategy and developing and executing tactics need not be expensive. Implementing nurse hourly rounding does not require infrastructure or special technology; it requires leadership, training, and accountability. Distributing physician-specific scores to doctors and teaching them communications skills require are efforts that the courage to start, leadership, and accountability. You see the common threads here. Leadership rounding is another great example: it could be started tomorrow by every hospital CEO throughout the world, for low cost and high payoff.

Personal Learnings

I’ve read many books and articles on organizational transformation and leadership, and they’re all very good at describing what and how things were done. Few have addressed the leadership missteps or learning opportunities in the struggle to be successful. I didn’t enter medicine to be a healthcare organization leader but fell into the role. The information in this book represents the work of numerous people, many much smarter and more capable than I. The results are neatly organized and presented here, which does not do justice to our trial-and-error process. When I talk about what we’ve accomplished, I often tease audiences that they’re seeing the “sausage,” which tastes great, but is the end product of a very bloody factory that we have long since closed down. Even with the many people dedicated to Cleveland Clinic’s initiative, ...

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