Makeover: ‘Employees’ to ‘Caregivers’

How Cleveland Clinic got rid of its “employees” and made them all “caregivers”

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By: Toby Cosgrove, MD

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Six years ago, Cleveland Clinic got rid of all its employees. This was no small task. Cleveland Clinic is the second largest private employer in Ohio. We had 40,000 people on our payroll. But as of 2006, we no longer called them “employees.” They became “caregivers,” because each one of them plays a role in patient care.

There are no minor tasks in healthcare. Every action contributes to patient outcomes, which is why we’re working toward total engagement. Studies have shown that workforce engagement is linked to patient safety, quality, outcomes and patient satisfaction. Caregivers need to be engaged to have a positive impact on patients – and their fellow caregivers.

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How do you tell if your workforce is engaged? We invited Gallup to come in and assess us. They administer surveys that measure factors like whether caregivers have the opportunity to do their best every day, whether they have the materials and equipment to do their work right – and even whether they have a best friend at work.

We made it the responsibility of every manager to know their caregivers’ engagement scores and to move those scores in a positive direction. It has been a valuable learning experience that has led to countless changes across our organization. So far, the biggest and most ambitious part of our engagement initiative has been something we call “The Cleveland Clinic Experience.”

This is a series of half-day learning sessions attended by every one of our 43,000 caregivers – not all at the same time, but over a period of months. It’s a combination motivational workshop, brainstorming session and mixer. Caregivers from every level come together around tables to share stories and best practices across jobs and disciplines. You’ll find a phlebotomist in a group with an electrician, housekeeper and radiation oncologist. All new caregivers go through it now as part of their orientation. I did it myself. You come away with a new appreciation of the variety and complexity of the healthcare workplace.

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If all this seems like a lot of trouble, remember that patient satisfaction is a function of caregiver engagement. HCAHPS scores (the federal government’s measure of patient satisfaction) closely track engagement scores. Our goal is to make Cleveland Clinic a place where if you asked anyone from the storeroom to the operating room, “What’s your job?” the answer would be: “I’m taking care of patients.”

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