Analysis of Cleveland Clinic

Cleveland Clinic was considered a multi-specialty healthcare system situated in Cleveland. The facility was treating patients from 147 countries and 50 states in total. It handled a large number of patients has the most significant population (72%) came from North East of Ohio State. The clinic system 43,000 employees in total including physicians, nurses and affiliated physicians. Additionally, the system had community hospitals in the North East part of the state with ambulatory centers, and primary care offices. The paper aims to do environmental and analysis: both internal and external to Cleveland clinic. These are factors that present future opportunities and threats to the organization. The essay will identify the major problem in the case and provide evidence for the case. The paper will then proceed to a detailed analysis of the problem and later suggest alternatives for the existing problem. Recommendations and anticipated consequences form the last part of the paper which come from the recommended alternatives and consequences that respond to contingency actions.

Environmental analysis

Information technology

Cleveland clinic ad an integrated medical electronic record called MyPractice that served all the physicians working in the hospital. Through utilizing common data warehouse organized longitudinally by the patient. All the applications to the facility were subject to debate within the organization. The system used accepted standards of information available for each record. The patient records were characterized by digital images and data, reports, testing values and values originating from non-digital data. Medical computers were used in transmitting data from one point to another within the Cleveland system
In 2005, the Clinic introduced a secure portal, Dr. Connect through which the physicians reviewed the care delivery to patients. The platform allowed connection of the referred patientsa timely access to their real-time information. The hospital also introduced electronic prescribing, and as a result, an add-on software was purchase which patients paid a monthly fee.

Health utilization models

The hospital appointed its Chief Experience Officer in 2007 for the record. While the outcomes measured success rate, perceptions of patients and the care experience. The model ensured efforts that were to be done while the patients were at the point of care and majorly focused on encouraging the doctors, nurses, and patients. With increased focus on the special needs, the hospital management was alerted to on issues about food in the hospital. The leaders within the clinic promoted the culture of service where all were made to be responsible for the patient experiences. All the employees were encouraged to work in commitment to align with the clinic's purpose.

Payment

The charges within the clinic were in 2015 were based on Medicare reimbursement and the private rates of negotiated care. 43 percent of the hospital received insurance from the Medicare thus contributing to 29% of the revenues. Medicaid only contributed to a small percentage of patient volume and the revenues. The out of state health insurance plan included that of the clinic and other leading healthcare providers. The patients residing in other regions simply made contracts either the clinic for paid posted charges or negotiated charges. The billing process was simplified by the hospital through sending of the consolidate bills regarding physician bills ad the services delivered to the patient. Bills from separate departments of the hospitals were harmonized and paid at one point.
Strengths and weaknesses have been adequately presented in the case analysis. The hospital provided for avenues for growth. For example, in the last ten years, the clinic had pursued some avenues for regional growth. The clinic ventured into providing 45% of care in the whole county and further 25% in broader northeastern Ohio. The main competitor of Cleveland known to be an affiliate of Case Western Reverse University, which served patients from an average of 90 locations (Michael & Elizabeth, 12)
With the introduction of online platforms such as MyConsult, life-threatening conditions were solved. The product conduct reviews of information sent via electronic means thus leading to the technological transfer of information. Through the aid of such devices, it was possible to diagnose and review a few health conditions (Michael & Elizabeth, 13).

Internal expansion

The clinic had attracted patients from all parts of the world leading to numerous debates about the process of establishing facilities and partnerships. Citizens traveled from Canada to the United States to get themselves sophisticated services. For example, John Hopkins and The Mayo clinic received the most considerable number of patients simply through brand recognition.
The clinic was marked with robust development in 2006 when it began to design and plan the construction of a new facility, Abu Dhabi whose finance as provided by the local government. The goal of the government was transplanting to be a patient's clinical care through employment, processing, and technology (Patrick, 2016). The leaders of the hospital consisted of six members who could recommend doctors for training and were paid by the local government. With the completion of the hospital in 2011, the facility boasts of culture operationalized strategy and recruitment of medical staff (Michael & Elizabeth, 14).

Statement of the problem

Before Cleveland hospital came to be known, the main problem was lack of measurable quality through improving structure, processes and healthcare outcomes. It also covered the respect for the patients’ dignity, housekeeping services, and facilities. Dr. Cosgrove worked towards the ultimate, measure of quality soon after becoming the CEO of Cleveland clinic. While in the leadership position, he asked all the departments to do measurements for all the health outcomes and deliver the report. Every clinical team was, therefore, to consider improving the quality of health provided to the patients. The health professionals were accustomed to begin making health reports. The clinic published outcome books for every department.
The clinic saw the major reason for measuring outcomes as it contributes to quality improvement and learning purposes. In seeking to improve health care delivery, the primary audience was external physicians. The second purpose of driving improvement was transparency. The Clinic recognized that each institute was tasked with defining good care for the patients and the conditions in which they are rather than the patient procedures. Back in 2015, the clinic books were based on the volume of the process, and the outcome was uncertain on how to be measured.

Analysis of the problem

The problem is traced to a period when the widely expected Clinton Administration proposals on healthcare increased pressure for the hospitals during the 1990s to form networks that offer a full range of services to compete for the government contracts. The private insurance companies were only contracting the service providers thus providing limits for the choices made by the patients. The clinic, therefore, ventured into forming a regional health organization through the acquisition of eight hospitals within Ohio state thus forming a family of health clinics.
During the time, a group of employers emerged from comparing, collectin and publishing comparative data on the quality of healthcare. The leaders within the clinic were concerned that some of the available information was not risk-adjusted thus inability to reflect patient care quality. By 1998, the clinic had strategized on coming up with a quality institute where it enhanced the quality of care. The institute also made information available to both doctors and the patients. In 2000. The clinic was the first health facility in publishing its outcome measures starting with surgical procedures.
Between the 1990s and 2000, the process of improving quality in healthcare gave a wider focus on evidence-based and compliance practices. Accreditation of institutions was based on these measures. The hospital tracked the performance of the employees through the use of compliance measures. During the beginning of the 1990s, the clinic put its investments in Information Technology thus adopting several online platforms with one common database that is organized around the patients. After the technological invention, series of applications followed beginning with MyPractice in 2000 that integrated administrative applications for the clinic staff, MyChart to provide the patient records (Michael & Elizabeth, 3).

Alternatives

While improving the quality of healthcare, Cleveland clinic significantly increased its attention to wellness beginning with the staffs who were covered by self-insured health plans in annual subscriptions. The clinic promoted the initiative of smoking cessation. The clinic was involved in several attempts to ban smoking as a way of promoting the well being of the citizens. The money that was not spent in the initiatives were used to organize cessation classes on smoking.
The employees in the clinic participated in health risk appraisals and programs that was m majorly aiming at behavior change towards achieving better health. The clinic organized a way in which the employees could see the patients and who would assess their risks and guide on appropriate measures of management. The employees with chronic manageable health conditions are free to enroll in with high participation rates. Additionally, the clinic had achieved reduced admission of patients with known diseases (Michael & Elizabeth, 8).

Rationalization of the health system

The Clinic was comprised of three large hospitals and small community hospitals. The admission rate of the physicians at the community hospital was estimated to be at 45%. Some of the hospitals were profitable while some recorded modest losses. The community hospitals had higher admission rates compared to the others and contributed to one-third of the revenue. The aim of moving forward was defined by Cleveland clinic where some departments were moved to the community hospitals. Cases of inpatient psychiatry were concentrated at the community hospital thus reducing the number of trauma case in Cleveland hospital. Often, efforts were made for effective coordination that was tighter across locations. The goal came up with a multi-special team that utilized system-wide resources in delivering the right care at the right place.

Recommendations

There was a need to establish more community hospitals in improving the quality of care since the community hospitals served some functions such as referral centers for stroke rehabilitation, complicated acute care and observing at-risk populations.

References

Michael E. Porte and Elizabeth O Teisberg. (2016). Cleveland Clinic: Transformation and Growth 2015. 9-709-473.
Patrick Moore. (2016). Going Nuclear. The Washington Post