State of the Clinic Address 2019

Ladies and gentlemen, welcome to the State of the Clinic. Please welcome CEO and president, Dr. Tom Mihaljevic. Good morning. Welcome to the State of the Clinic. Thank you very much for joining me. Special thanks to our elected officials and community leaders in the room and all of you watching from around the world. Today’s program is framed by history. We’re one year away from celebrating the centennial of Cleveland Clinic. For 99 years, we have fulfilled a single mission: to provide better care of the sick; investigate their problems; and further educate those who serve. Throughout generations, we always stay true to who we are: patient centered, organized as a team, led by clinicians. We have accomplished so much together. The patients we care for are what matter most. They inspire us with their bravery. In 2019, Cleveland Clinic cared for more patients and families than ever before. Your dedication made it a year to remember. Let’s reflect on all that we achieved. ♪ “Newsweek Magazine naming the Cleveland Clinic as the second best hospital in the world. Just the name Cleveland Clinic, it just makes you feel confident. 2019 was a record year for organ transplants at the Cleveland Clinic. The Cleveland Clinic once again celebrating a quarter of a century as the nation’s top ranked hospital for heart care. I’m very thankful that I had the opportunity to come to Cleveland Clinic and have this amazing care. ♪ With this new initiative of plan a care visits, we’re all very much involved. It’s really a team approach. Only on that one and that one. This one and this one? Yeah. I know. To be the best place for care everywhere, we need to be on their phones or on the desktop computers. ♪ The best thing about the Cleveland Clinic is the people. That’s our greatest resource. I’m so impressed by them. The entire team is the best I’ve ever seen. Cleveland Clinic Indian River Medical Center and Martin Health Systems are celebrating a hospital integration. It’s all about ensuring that our patients across the nation, across the globe, have access to the best care possible. ♪ This is indeed a celebration, as we look at this step in the process of bringing this 185 bed hospital to life. Hundreds of people turned out today at the Lou Ruvo Center for Brain Health to celebrate it’s first 10 years in it’s fight against neurodegenerative disease. ♪ We are a research institute in a health care organization. We know exactly how our research is going to advance patient care. ♪ Without team science, we’re really not going to get anywhere in this coming century. It’s where the fire is, it’s where the new breakthroughs come. ♪ Cleveland Clinic is the largest employer in northeast Ohio and touches more lives than any other provider in the area. ♪ You’re one community, it’s not Cleveland Clinic and surrounding communities, Cleveland Clinic is the community. They’re willing to pay their employees to give their time and their energy. The Cleveland Clinic has received the largest gift in it’s 100 year history. What philanthropy does is it allows us to be great and to keep pushing the envelope, to be better and better at what we do. Today, we get a first look at Case, in Cleveland Clinics health education campus and it’s huge facility houses state of the future technology. We’re gonna be able to be the best we can be because we have the best resources. ♪ This is the best place in the world. So much is just focused on patient care and putting patients first. I’m thankful that they’re able to share their knowledge, their compassion, and their care with everyone that comes here to Cleveland Clinic. I’m grateful for that. ♪ (Applause) Together we strive for a vision of the future. Cleveland Clinic will become the best place to receive care and the best place to work in healthcare. To achieve our vision, we created a strategy which has five goals: we will transform care as a lifelong partner to our patients; we will engage our caregivers as members of the team; we will embrace digital tools to enhance the patient and caregiver experience; we will optimize our resources as stewards of our organization; and we will expand our reach to double the number of patients served. Now let me be clear you will not be asked to see twice as many patients because our caregiver team will grow in parallel. We must also do the right thing, for the right reason, in every decision we make by following simple principles: treat patients and each other like family; treat Cleveland Clinic as our home. This is a framework. This speaks to what we value. To guide us, we have four care priorities: we care for patients, caregivers, organization, and the community. They are linked together. Every action we take supports them. We care for patients in the most vulnerable moments of their lives. We do everything to keep them safe and healthy. Becoming the safest place for health care is a journey that never ends, and we know that it is not easy. Due to your hard work, I can stand before you and proudly say Cleveland Clinic is a safer place today than a year ago. A safer place for our patients and their families, and a safer place to be a caregiver. Despite our best efforts, serious safety events happen. These are events that can result in harm to the patient, yet they can be prevented. We are one of the few health systems to publicly report serious safety events. I call on every health care organization to do the same and for every rating organization to make it a requirement because we owe this to the patients and to the families who trust us with their care. At Cleveland Clinic we’ve learned that the best way to prevent safety events is to work as a team. We expect everyone to use the safety checklist for every procedure. And also we require each other to speak up for safety. Speaking up takes courage and should be celebrated. To celebrate our culture, we created the Speak Up award. Our first award went to Hey-yoon Kim, a resident at Fairview Hospital who voiced a concern and saved a life. This January, we launched a new series, good catch. Now we practiced for this one, okay? My basketball skills are still there, but I’ll keep my day job. (Audience Laughter) I’m visiting caregivers throughout our health system who report near misses. I was delighted to meet Kaitlyn, a pharmacist at South Pointe hospital. She noticed the mistake, spoke up, and through that, prevented a medical error. Kaitlyn showed us that nothing stands in the way of doing the right thing. There you go. Safety is and will always be our top priority. Quality is the outcome. We measure outcomes to hold ourselves accountable. The most important outcome is our patient’s survival rate which is among the best in the country. This directly reflects the number of lives we save. Our journey to be the safest place for health care takes teamwork and continuous improvement. We have formed the largest team in healthcare focused on patient safety. Every day, twenty five thousand caregivers participate in the tiered daily huddles. In two short years, huddles have become a core part of who we are and bring us together as one Cleveland Clinic. You shined a light on every corner of our organization through these huddles. You know about every elevator not working, every patient who needs help, and every example of our caregivers working as a team. Exceptional patient care is one way we touch lives. We touch even more lives by sharing our expertise with the greater medical community. We do so through innovation, research, and education. Clinical Innovation is at the heart of our culture. Cleveland Clinic has been creating the future of healthcare since 1921. Let’s take a look at our 2019 clinical firsts. ♪ In a landmark approach for kidney transplantation, a team of surgeons from the Glickman Urological and Kidney Institute performed the world’s first robotic single-port kidney transplant. This minimally-invasive procedure enables the donor kidney and all surgical instruments to be placed through one small incision, allowing the patient a faster, less painful recovery. Women suffering from uterine factor infertility are without a uterus and unable to carry a pregnancy. Now, there’s hope. In a first for North America, a Cleveland Clinic patient has given birth after receiving a transplanted uterus from a deceased donor. The transplant and birth are part of an on-going clinical trial led by a Cleveland Clinic multi-specialty team. In the US, approximately six patients a day have become too ill for a liver transplant and are removed from the waiting list. Living liver donation has improved the chances of finding a donor, but has traditionally required an open surgery. A team from the Digestive Disease and Surgery Institute is one of only a few in the world now able to remove laparoscopically a section of the liver from a living donor, becoming the first in the Midwest to do so. This minimally-invasive approach improves outcomes and physicians hope it may inspire more people to donate. Each year, more than 1,600 babies in the US are born with spina bifida, resulting in physical and developmental disabilities. A surgical team from Cleveland Clinic’s Fetal Care Center successfully performed Northern Ohio’s first in-utero surgery to repair the birth defect. Although never cured, the in-utero corrective surgery for spina bifida decreases further nerve damage and improves the child’s quality of life. ♪ (Applause) We touch countless lives by researching the treatments of tomorrow. External research funding is a benchmark of success. We continue to exceed our goals and our success is attracting scientists of the highest caliber to join our team of teams. The new Center for Immunotherapy and Precision Immuno-oncology will develop personalized treatment options for patients with cancer. Philanthropy fuels discovery. We received the largest gift in Cleveland Clinic’s history from the Lord Foundation. It will support research and education for future generations. We educate caregivers to continue our mission around the world. Opening the Health Education Campus is one of our proudest moments. This is more than a building. It’s a platform for future caregivers to shape medicine as members of teams. There’s been a wonderful experience to collaborate with our colleagues from Case Western Reserve University on this project. We’re also grateful for the generosity of the Mandel Foundation. Their gift created the Mandel Global Leadership and Learning Institute. This institute expands on our rich development options for caregivers. Our caregivers are truly exceptional. You have always been Cleveland Clinic’s greatest treasure. People often ask me, “What does it mean to become the best place to work in health care?” The reality is my opinion is only one of many. This is something that we have to define together. You’re very passionate about providing the best patient care. To do this, you need to feel included, safe, healthy, listened to, and appreciated. The best place to work is diverse and inclusive. This results in better outcomes for patients and teams. We have more than 67,000 caregivers, of which three quarters are female and one third are minorities. Our guiding principle is that leaders should reflect the diversity of our workforce. We’re being intentional about this and have identified diverse caregivers with leadership potential. They are a key part of our future. The best place to work has to be safe. Last year we pledged to speak out on workplace violence and your safety. It is an epidemic within health care. We discuss all reports of violence in tiered daily huddles and address them immediately. We have 24/7 police coverage in our emergency departments. Cleveland Clinic aspires to be the safest place to work because violence is never part of your job. The best place to work supports your health and well-being. Our employee health plan offers the most affordable access to our clinical services and wellness programs. As a runner, I am delighted to see that you enjoy these programs. Because this is a demanding profession, we must take good care of ourselves so that we can take good care of others – both physically and emotionally. The compassionate care we provide creates a wonderful benefit for patients and for their families. While this enriches our own lives, it also takes an emotional toll. Because we develope meaningful relationships with our patients, their loss becomes ours. And I know this from personal experience. There is nothing more difficult than facing a family who has just lost a loved one. Code Lavender is a support network that we designed to help our caregivers recover from their losses. The best place to work also listens and responds. Cleveland Clinic listens to your input through the Office of Caregiver Experience. We measure engagement and take action. Overall, our engagement is improving, yet it is a quest that never ends. We recognized that our physicians have unique challenges. Burnout is at an all time high across healthcare. We see the complexities for different genders and generations of physicians. We hear your concerns. At the enterprise level, we hired more pharmacists to assist with refills and scribes to help with the documentation. Locally, we’ve charged leaders to address the work environment and create flexibility for their teams. And these efforts are just the beginning. We’re hearing all caregivers and creating the changes you ask for: we’re making improvements to the electronic medical record; we increased the minimum wage to 15 dollars an hour; we awarded extra time off to help you decompress; and we announced fully paid maternity and parental leave for eligible caregivers. Because we care for the whole extended family, especially for your youngest ones. You told me… Yeah applause is fine. (Applause) You told me how important it is to be with your family during this special part of your life. I remember when my twin daughters were born, I desperately wanted to spend more time with them. This policy change is among the most progressive in healthcare. It gives me tremendous pride that our organization can take a leadership role in supporting young families. While we care for the young ones, we also care for our most senior members. Dr. William Proudfit, former Chair of Clinical Cardiology, recently passed at the age of one hundred and five. I met Dr. Proudfit last summer with Dr. Cosgrove. We were absolutely amazed by his deep clinical knowledge, his true passion for Cleveland Clinic’s history, and his impeccable memory. Finally, the best place to work makes you feel appreciated as a part of a family. For the first time ever, we hosted holiday meals at every hospital to express our thanks. And I must admit, I really enjoyed filling up your plates with mashed potatoes. (Audience Laughter) My special skill. It reminded me of working through holidays in the cardiac operating rooms. My daughters back then were still in diapers and they would come to visit me on Thanksgiving and Christmas Day. Serving this meal highlighted how many of you spend time away from your families to care for our patients and their families. Thank you very much for your service. (Applause) Cleveland Clinic, like every health care organization, faces two major challenges: the first challenge is creating access to the highest quality care; the second challenge is making that very care more affordable. It is remarkable to consider how many patients do not have access to the best of health care. Only 1 in 200 Americans has the opportunity to experience care at Cleveland Clinic. Yet, we know every person would benefit from the quality of care we provide. Therefore, it is our ethical obligation to serve as many patients as possible. Care should also be affordable and our goal is to create a sustainable model for the highest quality, most compassionate care. Because of the phenomenal care you provide, Cleveland Clinic is healthy and thriving. We are attracting more patients which translates into good operational results. Last year was unique. In addition to caring for more patients, we benefited from a strong economy. The generosity of our donors was historic and we grew – especially through our expansion in Florida. These gains allow us to reinvest in what matters – our caregivers, our mission, and growth. We reinvest in caregivers with one of the most supportive benefits packages in healthcare. It covers our finances, health, well-being, and career. We continuously reinvest in our mission by expanding clinical programs, supporting education, and funding research. We also reinvest in growth to expand and offer our services to more patients in need. Growth comes in many forms, one of which includes our locations around the globe. Here now is Bill Peacock, Chief of Operations, to provide an update on where Cleveland Clinic is growing. ♪ Greetings from the roof of 33 Grosvenor Place, future site of Cleveland Clinic, London. The hospital is on track for completion in 2021, and the new medical office building will open later this year. The London construction is one of many projects under way to position Cleveland Clinic as a global healthcare system. 3400 miles southeast, a new cancer building is under construction, alongside Cleveland Clinic Abu Dhabi. It will provide world-class cancer care to the region, beginning in 2022. Continuing east to China, our Cleveland Clinic Connected team is advising on the activation of the Shanghai Luye Lilan Hospital. This facility will provide a wide range of high quality patient-centered services. ♪ In Canada, we expanded sports health and services to Midtown, Toronto, and are offering virtual visits directly to employers in the Canadian market. We recently celebrated the 10 year anniversary of the Lou Ruvo Center for Brain Health. The center continues its focus on patient care and advancing research in neurodegenerative disorders. Across south Florida, we’re expanding facilities to serve more patients, and are working to renovate and backfill the Weston bed tower. We continue to invest in Ohio as well. Two projects are in the design stage. First, a neurological building on Main Campus will consolidate services from our oldest buildings, and incorporate new technology to treat patients. Second, we will double the size of the Cole Eye Institute, growing our footprint for patient care and research, while also renovating the existing space. Also in northeast Ohio, to support the Fairview Hospital community, we will build a new Moll Cancer Center, medical office building, and a parking garage. To the east in Mentor, we will create a new hospital with a flexible and modular design. We’ll break ground this spring, and open in 2021. We’re proud to share these projects with you. They represent Cleveland Clinic’s commitment to grow and invest across our enterprise and allow care for more patients across their lifetime. ♪ (Applause) I am most excited about how Cleveland Clinic is leading the adoption of digital technologies. We have only begun tapping into their potential. Caregivers will spend less time on computers and more time with patients. Just imagine a day when you never touch a keyboard in an exam room. That will be revolutionary. (Applause) New voice technologies and machine learning will assist you. In the future, patients will also access care wherever they are, whenever they need it. We already lead the way on virtual visits which save patients time and travel. We have performed nearly a hundred and fifty thousand virtual visits to date. Through our partnership with American Well, we will expand the use of telemedicine to offer Cleveland Clinic’s second opinion. We can reach millions of patients around the world. In the intensive care unit, we use remote monitoring for alarms and vital signs enhancing the care for our sickest patients. These are amazing tools that allow us to reach new geographies and transform care. Cleveland Clinic is an important part of every community we serve. When the communities around us thrive, so can we. While health care has rapidly advanced, we are facing new challenges in public health. Vaping, a device that never existed before, now endangers our our teens and as a parent I am deeply concerned about this. Opiate addiction takes one hundred and thirty American lives every day, and has ravaged our communities – especially here in our home state of Ohio. Babies in the United States die at a higher rate than any other developed country. These are public health issues we are addressing at Cleveland Clinic. We have openly supported efforts to curb vaping and ask adults to be role models. Our clinicians are reducing opioid prescriptions and managing pain with alternative therapies. Our investment in neurological care will address the underlying issue of addiction, which, oftentimes is mental health. And we go into the community teaching new parents to care for themselves and their babies. Cleveland Clinic advocates for a healthy environment. I’ve learned from your many, many emails that you are very passionate about the topic. So by popular demand, we removed plastic straws and foam products from our cafeterias. (Applause) We also create healthier communities through employment. We are firmly committed to hiring job seekers from our neighborhoods. We have hundreds of interns and reach over 15,000 students through school-based programs. We host job workshops in the community. To help those in need, you embraced our Community Service Time Off program. It gives you paid time for your services at our partners such as the Food Bank. This is just one way we invest in a healthier community. We care for patients regardless of their ability to pay. We give financial assistance and we educate our neighbors on healthy lifestyles. Our combined efforts created more than 1 billion dollars in community benefit for 2018. (Applause) This is a record for us. We are intent on giving back. Always. The legacy we’ll leave is the number of lives we touch. As we expand into new communities we will never forget why we are here – to care for patients. Here is a story about our caregivers’ teamwork in Florida to put patients first. ♪ We had lost my brother to a massive heart attack. And it was almost five years to the day. Mom had started to have issues with breathing. She called me and says, Mother, I just am worse I can’t breathe. So I said, I’m coming to get you and we’re going to the emergency room. ♪ She was very severe, so we had to move very fast to make the diagnosis. And I saw some arrhythmia as that I was very concerned about so that’s when I told them that we should get in touch with Dr. Faulkner. She presented with a very bizarre form of ventricular tachycardia that was very difficult to control. They worked on her all Friday, Saturday, then they told us that nothing was working. We were at that point, new to the Cleveland Clinic and integration was on the forefront of our thoughts. I said I think we need to really push for her to go on to Cleveland Clinic, Weston and go to the next steps of this advanced heart failure diagnostic workup. And the fact that they’re Cleveland Clinic now just makes it so easy. She was here in two, three hours and we started working on her immediately. ♪ It is very stressful but yet, on the other hand, I felt good to be there and have her in very good hands. ♪ It’s high mortality. And it’s something that if you don’t diagnose it quickly, the patient can just crash and there’s basically no way back from it. The doctors were predicting she only had three or four days left to live. Her heart disfunction was deteriorating rapidly. It’s very likely she would have died without being able to do heart transplant. The illness was so acute that she goes immediately to the top of the list. And the next day at three, my phone rang and they said, we have a heart. ♪ It just felt like there was a ton of weight that had been building and it just all came off. ♪ I think about getting my heart, putting my heart in. Like that’s just a big part of me. Cleveland Weston just celebrated the hundredth heart and so I’m number 89. After I was transplanted, Dr. Faulkner actually came here from Indian River to Weston to see me. That was a really special moment. There is not any story that better signifies what the power of integration of a system across the region could do. At the end of the day, it’s just the best possible care for the patients. The ER at Indian River, saved my life. When I went to Cleveland Weston, they absolutely saved my life. To have a patient come to you at this time of their direst need and have our team offer a solution, that’s an inspiration. Every single person there, they believe in you – no matter how bad you are – and that makes all the difference. ♪ (Applause) I recently visited our newest caregivers in Florida, and I’m so impressed by your dedication to our mission. Thank you for treating Paige like a family member. Your teamwork reminds me why I have never been more excited to be a caregiver. This is a magical, complex, noble profession. We change the lives of the people we touch. We have never had better access to tools and knowledge with an ability to impact care. Now it is up to us to seize these opportunities. This is our responsibility. Cleveland Clinic is here to lead the way. I want to thank you for your trust and the opportunity to serve you. You have made a difference for our patients, each other, our home and the communities we serve, for which I am very grateful. Thank you again for joining me. Have a wonderful day. Thank you. (Applause)

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