How to Build Superior Patient Experience the Cleveland Clinic Way

SHIFTING FOCUS TO THE NEEDS OF THE PATIENT

In December of 2004, the 77-year-old father of James Merlino, a colorectal surgeon in training at the Cleveland Clinic, came to the hospital for a biopsy, expecting to be discharged later in the day. Merlino’s father never left the hospital, unexpectedly dying seven days later.

As he describes in his book, Service Fanatics: How to Build Superior Patient Experience the Cleveland Clinic Way, Merlino was devastated by his father’s death, not only because it was so unexpected but also because of the way his father had spent those final days — days of frustration at unresponsive nurses, insensitive doctors and inefficient service, combined with the growing fear that he was going to die.

His father’s death was a turning point for Merlino, who recognized that, contrary to what was taught to rising young doctors, medicine should not be simply the emotionless treatment of disease. Hospitals needed to focus on the entire experience of the patient.

Merlino left the Cleveland Clinic but returned a few years later under a new CEO who had launched a revolutionary Patients First mission for the hospital. Merlino would eventually become the Chief Experience Officer of the Cleveland Clinic. Service Fanatics is the story of how he and the new CEO, Toby Cosgrove, turned the mission of Patients First into reality. Today, the Patients First mindset drives every decision and process of the Cleveland Clinic.

The Cleveland Clinic story is one of overcoming resistance and derision and battling the egos of doctors who treated patients as numbers or diseases, not as people. While doctors attempted to resolve the disease as best they could, they had no awareness of the fears and needs of the person behind the disease. The patient was almost irrelevant; it was the ailment that was the focus.

It is the story of transforming a hospital into a place in which every person on staff is considered and expected to be a “caregiver.” In his quest to transform the hospital’s approach to patients, Merlino conducted extensive research with other hospitals and explored other organizations and industries beyond the medical profession.

One of the first steps in creating a new Patients First environment, Merlino writes, was to precisely define the goal. The challenge in medicine is that the customer is not always right. In Merlino’s specialty, for example, patients must rise from bed the day after their surgery since getting up and walking around is essential to ensuring a good recovery. Patients, however, consider this obligatory exercise the sign of an insensitive doctor. Thus, unlike a restaurant, customer satisfaction can be a treacherous measure for whether a hospital is doing the best job it can.

Eventually, Merlino and his team at the Cleveland Clinic defined Patients First as 1) Safe Care, 2) Quality Care, 3) Customer Satisfaction and 4) High Value Care — in that specific order.

Service Fanatics is the careful narration of an organization meeting a customer-service challenge, and it is at once unique but filled with lessons for all types of organizations. Building the involvement of staff; adding to rather than changing your culture; executing by fixing processes first, then identifying best practices; and myriad other insights into transforming an organization, captured in valuable bullet points at the end of each chapter, will help leaders from all industries focus and align their businesses to the needs of the customer.

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