Let's rewind to March 2020. Schools, restaurants, places of worship, and businesses are all closing their doors. The number of confirmed cases of Covid-19 is beginning to resemble a crisis, and hospitals are facing an uncertain and frenzied landscape. Two competing health systems that care for most of northern Ohio, take an unorthodox step to tackle the immense challenges of the incipient pandemic: their leaders pick up the phone and hatch a plan for their rival organizations to collaborate.
Recognizing the Covid-19 crisis represented a problem much bigger than their institutions could face alone, Cleveland Clinic and University Hospitals, whose flagship facilities are only separated by 1,500 feet, agreed to partner and share resources in order to ensure the best possible care for their community.
Advisory Board's Rae Woods recently spoke with Dr. Robert Wyllie, Chief of Medical Operations at Cleveland Clinic, and Dr. Eric Beck, Chief Operating Officer at University Hospitals, about bringing their two competing systems together. Here's what struck us about their unique experience and the lessons they've learned along the way.
"That's the power of relationships and the power of cultivating those relationships, particularly when you're fighting a common cause." – Dr. Beck
One of the most striking features of the partnership between Cleveland Clinic and University Hospitals is the strength of its relationships at the individual human level. These relationships, they say, are rooted in mutual respect both for each other's organizations and for each other as individuals. The "power of relationships," as Dr. Beck refers to it, starts at the top-most levels of their organizations: for example, Dr. Wyllie and Dr. Beck cite daily phone calls throughout the pandemic, especially whenever a question or potential disagreement arose, as one of the reasons for the success of the partnership between their two organizations.
The duo role modeled this spirit of collaboration daily and set the tone for their teams, who likewise reflected the value of cultivating strong relationships to work together effectively.
"There's a fondness for the teams that have come together – those relationships really flourished during the pandemic," says Dr. Wyllie.
"We think about a system of care not being just within a single health system, but within a region or geography. The ability to leverage data and to pool the talent around that data are enduring examples of how collaboration is […] synergistic." – Dr. Beck
"Systemness" is the ability of a health system to overcome challenges and make progress because of its scale, not in spite of it. Getting different facilities within a system to begin pulling in the same direction with a common goal in mind requires adjusting entrenched habits, realigning communication routes, and building decision-making consensus. While simple in principle, the competencies required to build "systemness" can be challenging to achieve. And, as Cleveland Clinic and University Hospitals discovered, they are the same competencies that are required to effectively bring two competing systems together toward a common goal.
But like any journey toward "systemness," there were bound to be points of misalignment along the way. Dr. Wyllie and Dr. Beck occasionally found that there were some subjects on which they had to agree to disagree. In those moments they would bring their internal experts together and create an open, respectful dialogue between the teams, which they credit with enriching their decision-making.
It was also important for the two systems to recognize that they did not need every site, every physician, every team to operate in the exact same way. They allowed room for some variation and set guidelines to decide where it was and was not warranted, always maintaining focus on their common goal – improving the health of the people of northern Ohio.
"We want to maintain the structure and the communication that we have, not only with each other, but with [other organizations as well], so that we can continue to leverage those relationships and improve the health of Northern Ohio."– Dr. Wyllie
Cleveland Clinic and University Hospitals aren't letting their partnership fade in the post-pandemic landscape. They recognize that the advantages of sharing resources—and combining their data and analytic power—can be parlayed into addressing problems outside of Covid-19 as well.
"The ability to carry that same approach into long-standing, enduring public health issues in our region is really what we're committed to," noted Dr. Beck. Already, their organizations have discussed tackling the challenges of infant mortality and the burden of addiction in their community.
These are public health problems that exist outside the scale that can usually be addressed by a single system, or even by a single sector. In fact, both systems point to opportunities to extend their collaborative endeavors to organizations across the health care ecosystem, from start-up companies to health plans to public health agencies.
The unique partnership between Cleveland Clinic and University Hospitals provides an example of the value created when competition can be set aside in favor of collaboration—and the untapped potential benefit it can yield for society.
The lessons from their partnership can help other rival organizations team up to tackle the complex, structural challenges facing the U.S. health care system, such as infant mortality, racial disparities in care, opiate addiction, and the mounting behavioral health shortage. Finding common ground among competitors remains uncharted territory for most health care leaders. But it's a model worth emulating.
Interested in learning more about the experience of Cleveland Clinic and University Hospitals? Check out the full podcast episode here.
Cleveland Clinic – now in its centennial year – is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S. News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. Among Cleveland Clinic’s 70,800 employees worldwide are more than 4,660 salaried physicians and researchers, and 18,500 registered nurses and advanced practice providers, representing 140 medical specialties and subspecialties. Cleveland Clinic is a 6,500-bed health system that includes a 173-acre main campus near downtown Cleveland, 19 hospitals, more than 220 outpatient facilities, and locations in southeast Florida; Las Vegas, Nevada; Toronto, Canada; Abu Dhabi, UAE; and London, England. In 2020, there were 8.7 million total outpatient visits, 273,000 hospital admissions and observations, and 217,000 surgical cases throughout Cleveland Clinic’s health system. Patients came for treatment from every state and 185 countries.
Founded in 1866, University Hospitals serves the needs of patients through an integrated network of 23 hospitals (including 5 joint ventures), more than 50 health centers and outpatient facilities, and over 200 physician offices in 16 counties throughout northern Ohio. The system’s flagship quaternary care, academic medical center, University Hospitals Cleveland Medical Center, is affiliated with Case Western Reserve University School of Medicine, Oxford University and the Technion Israel Institute of Technology. The main campus also includes the UH Rainbow Babies & Children's Hospital, ranked among the top children’s hospitals in the nation; UH MacDonald Women's Hospital, Ohio's only hospital for women; and UH Seidman Cancer Center, part of the NCI-designated Case Comprehensive Cancer Center. UH is home to some of the most prestigious clinical and research programs in the nation, with a total research portfolio of $289 million and more than 3,000 active clinical trials and research studies underway. UH Cleveland Medical Center is perennially among the highest performers in national ranking surveys, including “America’s Best Hospitals” from U.S. News & World Report. UH is also home to 19 Clinical Care Delivery and Research Institutes. UH is one of the largest employers in Northeast Ohio with more than 30,000 employees.
This blog post is sponsored by Cleveland Clinic and University Hospitals, Advisory Board member organizations. Representatives of both institutions helped select the topics and issues addressed. Advisory Board experts developed the blog post, maintained final editorial approval, and conducted the underlying research independently and objectively. Advisory Board does not endorse any company, organization, product or brand mentioned herein.
This blog post is sponsored by Cleveland Clinic and University Hospitals. Advisory Board experts developed this blog post independently and objectively.
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