Part III: What Can Higher Education Learn from Healthcare, Specifically the Cleveland Clinic?

Series Title: Learning from Outside of Higher Education to Build an Agile Campus (A four-part series)

A roundtable discussion with Dr. Doug Guthrie, Elliot Felix, and Dr. Scott Bass

Series Overview

The landscape of higher education is undergoing a pivotal transformation, one that demands a fresh perspective on how we approach the student experience. Drawing parallels from places outside of higher education and the evolving needs of students, we’re embarking on a journey to explore how institutions can adopt and adapt these lessons. This series will delve into the innovative strategies of leading retail, healthcare, and other institutions that could enable a more agile campus, and help shape the future role of the campus in an increasingly online world.

What Can Higher Education Learn from Healthcare, Specifically the Cleveland Clinic?

‍In the third installment of our conversation, we venture into the healthcare sector with Dr. Bass as our guide. We delve into how top-tier healthcare institutions have revolutionized their organizations, putting patients at the heart of everything they do and embodying a culture of care.

‍Key Takeaways

‍Takeaway 9: Large, complex hospital systems experience are rather similar to higher education in how they operate and also in that they are regulated and their primary objective is not profit but rather different outcomes.

‍“One example that is akin to Higher Ed is the healthcare hospital industry complex. They house people, perhaps for shorter terms. They feed people, particularly food. They have complex finances. They have physicians who can be just as independent and opinionated as professors. Many doctors are also professors because many of the teaching hospitals are university affiliates. You have to go down the list, but they are also a siloed specialized entity like colleges and universities. However, they have moved forward in terms of their enterprise systems in ways that we can’t imagine. It’s much, much more advanced in terms of keeping records, and their ability to exchange records legally. Within higher education, only authorized individuals -can have access to certain financial or healthcare information based on  HIPAA and FERFA regulations.. But, the hospitals have identified policies and systems that provide access to authorized caregivers including those in other hospitals or offices.”  

‍Takeaway 10: There are examples of best practices in healthcare, in particular the Cleveland Clinic, where their commitment to patient experience is reflected at the highest executive levels.

‍“The most remarkable model, which is more than 20 years in transition is the Cleveland Clinic. The President of the Cleveland Clinic, Dr. Tony Cosgrove looked to the private sector. Besides the obvious need to develop collegiality, he wanted to stress a model of more holistic care centered around empathy for a patient. This was a principle he drew upon from the private sector which had a history of focusing on the end-user experience. Following this model, he hired a Chief Experience Officer (CXO) to assist in this institutional transformation. Now it’s ubiquitous in the private sector. But that was uncommon in hospitals at the time.” ‍

‍“To assess hospital performance the Centers for Medicare and Medicaid Services requires an annual patient survey – the Hospital Consumer Assessment in Healthcare Providers and Systems (HCAHPS) survey.  The findings from the survey include scores associated with cleanliness, nursing care, doctor/physician care, pain management, etc. They are reported and shared nationally. At the Cleveland Clinic, as a direct result of the addition of the CXO who reported directly to Cosgrove, HCAHPS scores moved in some cases from quite low to the top tier over six years. Cleveland Clinic’s patient experience had a fundamental transition because of these systematic organizational changes. Colleges and universities are tiny in size compared to the scale that a Cleveland Clinic or a Mayo Clinic manages worldwide. It’s just a much larger operation.” ‍

‍“The Chief  Experience Officer (CXO) is one of the pieces that improved the patient experience. The responsibility of the CXO is to enhance institutional – linkages and help mitigate siloed boundaries.”

‍Takeaway 11: Participation and buy-in were non-negotiable for every employee at the Cleveland Clinic, regardless of role, level, etc.

‍“The Cleveland Clinic also did workshops with all employees. In the same session, doctors would interact with others in an inclusive manner independent of their job duties including those, for example, who provide custodial support. All participated in the same way in these sessions to provide greater insight into the patient experience. Everybody had to participate in these workshops, with no exceptions, crossing all levels of the organization.  Doctors report that as a result of the workshops they make additional time to listen to a patient, to talk with the patient, and to hear their fears and concerns. Consequently, many believe their medical care has improved. The patients also think the doctors do a better job. So, the Cleveland Clinic CXO helps serve as  the voice and message of the President through the various divisions of the hospital.” 

‍Takeaway 12: The leaders at the Cleveland Clinic didn’t wait for external factors to act, they recognized the responsibility they had to patients and committed to improving how things worked.

“If the Mayo Clinic or the Cleveland Clinic waited for government regulation, we’d still be there. This was a result of strong leadership. What I see is the Cleveland Clinic wanted to be better in putting the patient first and improving the quality of the care experience. More recently, as Cosgrove notes, it’s not just the patient  — it’s also enabling your staff, your workers, to feel good about their jobs and the setting itself. That can then snowball to influence the caregiving and the end-user experience. Additionally, it can intensify  a sense of loyalty to the brand, fostering pride in the institution and public recognition that the setting is committed to offering a quality encounter.”

‍Takeaway 13: Leveraging tactical solutions like case managers, could be an effective step for higher education to make incremental improvements.

‍“Another component that is more common elsewhere is the establishment of a case management system. We now can put together a case management system with the support of  AI. For example, this can be helpful if the student’s financial aid changes during the duration of their tenure due to family income changes or a sibling leaves college (or enters a college) altering the determination of need and eventually affecting a student’s financial aid allocation. So, a student who may have higher financial aid suddenly finds that it’s been reduced could find it difficult to cover the increased cost. Within most colleges and universities, nobody really knows about the change and technical rationale except the student and the financial aid officer, However, this change has all kinds of downstream implications for its impact on the student’s mental health to what happens in the classroom. A student could become worried, even obsessed, about their family and the ability to cover the college costs should financial aid be reduced.  A case manager would not need to know the confidential details about the student’s or family’s finances but what they need to know is that there’s been a big change in the student’s financial situation. A case manager just needs to know that something’s happened so they can begin dealing with the implications of the changed circumstances. This is the same with health care where the case manager could be alerted if something has happened to the student’s health. If we had a case management system, an appropriate message of the changing situation could instantly be extracted through AI, to immediately provide an alert to the case manager and the student, but without the private financial and health details reaching the case manager. Fortunately, academic case managers, if they have this responsibility included in their job description, could have the authority to receive this information to provide appropriate advice and support to the student while in compliance with FERPA and HIPAA rules. This must be part of the case manager’s  job description.”