1) The Cleveland Clinic's overall strategy was to redefine how they treated patients in their care. With the message of "The patients are why we are here", the Cleveland Clinic did just that. Headed by Dr. Cosgrove, the clinic "tore down the hospital's organization and started over". The multidisciplinary teams were organized them to be more around the patient perspective and defined around disease systems or organ systems. Even offices were moved around and new institutes were set up to be led by a respected physician who was committed to a team culture with excellent managerial and interpersonal skills. "Support Institutes" were made and included patient care experience, legal, finance, marketing and human resources. By 2014, the Cleveland Clinic's patient satisfaction had improved and patients complaints dropped measurably. The Cleveland Clinic measured their success by focusing on the ability to learn and quality improvement by the teams. Transparency allowed the clinic to learn form their mistakes and grow from them.
2) One example of the Cleveland Clinic doing something well, was their cost reduction. The Cleveland Clinic focused more on having their physicians knowledge about the process of care and not just an analysis of charges. With transparency, the clinic was able to compare different cost approaches. With this new strategy, cost reductions resulted to $481 million, with $152 million indirect costs and $329 million in clinical costs. Another example of the Cleveland Clinic doing something well was their use of MyChart. MyChart included digital data and images, test values, doctors' reports, and extracted values from non-digital data. MyChart allowed both physicians and patients to view the same information. Patients were enabled to have control over all of their data, created and cancle appointments, request prescription renewals and contact their doctors.
3) In my experience, there has been a mix of both patient first care and just another sick person that a doctor had to deal with. The Children Hospital in Orange County, CHOC, was a place where I felt that their only interest was to treat the children with the best care possible. Although I was a young during my time there, and not looking at things like patient records, or costs, I felt that they truly looked after my wellbeing both physically and mentally. I would be regular checked on by my physicians and nurses periodically talked and did activities with me. On the other had, I have been in doctor care where it felt very impersonal, where money was the second most talked about topic and then followed up with where will the next time I see you. Which translated to me as when will you pay me next. So in my opinion, once patients experience a patients first type care, they will started demand or go to places where this is the number one strategy.
Hey Nathan, good outline of all the points. I wanted to talk a little bit about how I think Cleveland Clinic's patient first mentality is very similar to trends in IT and software development.
ReplyDeleteOne key takeaway I had from their overall goal of patient first was that they broke down such a large goal into manageable pieces. This draws a striking similarity to me that the agile development methodologies have had on software. Rather than now trying to wrangle this massive issue into completion through very high level analysis and sweeping changes at once, Cleveland Clinic took a very systematic approach to chipping away at the large issue of patient care. They used creativity and bucked the status quo in multiple cases, ran tests and surveys, and looked for validation that what they desired was actually happening in a valuable way.
While there was a lot of brainstorming and idea generation involved, the path they took was supported by results and iterated accordingly if things did not go as planned. One thing they specifically did well in my eyes in addition to the MyChart portal and cost reduction was driving caregiver unity through half day small group meetings and re-alignment of patient care teams. I think it was critical that they began to break down the hierarchical view of hospital care in order to develop a better patient experience.
I agree with you that the "Patient first" mentality is very similar to IT and software development. I feel like services in society are slowly moving towards providing better customer service. This is quite good, even though we can never satisfy everybody. I like how you also brought up how they broke down such a large goal into manageable pieces. It shows that they are figuring out better ways to achieve that goal.
DeleteYou brought up a good point that transparency allows clinics to learn from their mistakes and grow from them. In my own opinion, I think that it also helps improve patient care as they are minimizing medical errors and providing better healthcare for patients.
ReplyDeleteYou also brought up a really good example of the different types of ways doctors treats their patients. There's ones that showed that they really care about your wellbeings by listening and asking follow-up questions, there are others that would just rush the meeting time with them and immediately prescribe drugs or medicine for you. I do agree that patients usually go to the ones where their opinions are respected more, and if they did not get unnecessary prescriptions.