CEO Cosgrove Shares Insights with Health Care Council Members

The Nashville Health Care Council recently hosted a briefing with Delos M. (Toby) Cosgrove, MD, president and CEO of Cleveland Clinic. A sought-after speaker and noted expert on the efficient, effective delivery of care, Cosgrove shared his insights with 250 executives in attendance.

William H. Frist, MD, former majority leader of the U.S. Senate and noted transplant surgeon, facilitated the program. “Much like Cleveland Clinic, Nashville is a center of experimentation and innovation,” Frist said in his introduction. “We welcome the opportunity to host Dr. Cosgrove and hear first-hand about the groundbreaking work at the Clinic.”

Cosgrove, who like Frist is a cardiac surgeon, joined Cleveland Clinic in 1975 and was named chairman of the Department of Thoracic and Cardiovascular surgery in 1989. Under his leadership, Cleveland Clinic has consistently been identified as one of America’s top four hospitals by U. S. News & World Report and is one of only six healthcare services organizations to be named to the “World’s Most Ethical Companies” ranking by the Ethisphere Institute.

A graduate of Williams College, Cosgrove received his medical degree from the University of Virginia School of Medicine and completed his training at Massachusetts General Hospital, Boston Children’s Hospital and Brook General Hospital in London.

A decorated veteran, he served as a surgeon in the U.S. Air Force.

At Cleveland Clinic, Cosgrove presides over a $6 billion healthcare system that also includes eight community hospitals, 18 family health and ambulatory surgery centers, Cleveland Clinic Florida, the Lou Ruvo Center for Brain Health in Las Vegas, Cleveland Clinic Toronto, and the new Cleveland Clinic Abu Dhabi. Cosgrove said the Abu Dhabi facility was built “from the fiber optics up” to the most forward-thinking standards.

Cosgrove has made the importance of patient-centered care and the overall patient experience a point of emphasis and has launched major wellness initiatives for patients, employees and the larger community. He was instrumental in Cleveland Clinic’s reorganization of clinical services into organ and disease-based institutes.

In his remarks to the Nashville healthcare community, Cosgrove described his system’s highly regarded model of care and discussed how the organization plans to evolve during this transformative time for the business, as well as the practice, of healthcare. He also spoke about the constant need for innovative technologies in healthcare, along with the importance of using metrics to illustrate and measure the value of services.

Cosgrove pointed out, “At Cleveland Clinic we subscribe to the belief that quality care, proven by measured outcomes, leads to reduced costs and healthier patients in the long run. Encouraging our patients to become active in their own care through dialogue and transparency has allowed us to maintain a high quality standard of care while reining in expenses, ultimately allowing us to improve our delivery system.”

Cosgrove’s new book, “The Cleveland Clinic Way: Lessons in Excellence from One of the World’s Leading Health Care Organizations,” explores these themes and takes an in-depth look at today’s healthcare system and processes. In the book, Cosgrove focuses on eight trends that he says are shaping medicine including the effectiveness of collaboration, the benefit of big data, the need to focus on healthcare instead of ‘sickcare,’ and the impact of empathy on patient outcomes.

Senator Frist asked Cosgrove how thinking about patient care had changed in the last 10 years, observing that the change in approach to treatment had been transformed from what was almost a guild system organized around doctors’ specialties to medical disciplines organized by disease.

Cosgrove said taking a multidisciplinary approach with a focus on wellness of the mind and body allows providers to share thoughts on the best way to care for the whole patient. Innovation happens, Cosgrove said, “when people bump up against each other at the borders” where several disciplines are interacting. “This is how we bring innovations into practice by bringing together ideas,” he continued.

Cosgrove added Cleveland Clinic has produced more than 600 innovative products, “with 1,500 more in the queue,” and formed more than 60 companies that are producing solutions to medical care and added capabilities.

Wellness and behavioral choices impacting health are a major part of Cleveland Clinic’s focus for staff, as well as for patients and the larger community. Frist asked what steps had been taken to achieve a totally smoke-free workforce of more than 40,000 employees.

Cosgrove answered that before the Clinic implemented the decision, they designed a progressive program that started with not allowing smoking in public spaces at the Clinic … then moved to free smoking cessation programs … then began testing for nicotine … and then, finally, moved to not hiring anyone who smoked. Cosgrove noted, "We may have saved more lives doing that than I saved in a career as a cardiac surgeon.”

Cleveland Clinic has taken a similar approach to the problem of obesity in the workforce and community. “We started with requesting that onsite McDonald’s outlets make changes in the food they served,” he said, noting that local newspapers ran headlines describing this as a “Big Mac Attack.”

As part of this program, Clinic vending machines no longer include candy bars; and the system offers onsite exercise programs, free access to Weight Watchers meetings, and a partnership with the YMCA to improve the health of the community. “As a group, we have lost 43,000 pounds as a result,” Cosgrove said enthusiastically.Cleveland Clinic has made a commitment to utilizing its intellectual capital to grow its brand, successfully using technology, training, innovation and motivation to achieve its goals as a leader in providing healthcare in a changing environment and in sharing those best practices with others. Cosgrove said he believes eventually there will be standards of care across the country, and the evolution of “cookbook” medicine will be important in an economically restrained environment.