How Toby Cosgrove engages employees to expand The Cleveland Clinic while keeping patients first

Track progress Even after creating plans, it’s important to stay close to them as you move forward. “It’s an ongoing process,” he says. “I don’t think you make a plan, put it on the shelf, and come back five years later and make another plan. It’s constantly revised and constantly updated.” With so many updates and revisions going on for those initial plans, it could be easy for Cosgrove to lose track of things, so it’s important to have metrics to gauge progress along the way. “You have to measure what you’re doing, and you begin to turn the art to the science,” he says. “Art is about feeling. Science is about measuring.” Creating metrics is something that not every organization does well, but Cosgrove has put a huge emphasis on it in leading the organization. “We have an enormous number of metrics that we put together,” he says. “That’s one of the things that health care hasn’t been good at in the past. We’ve spent a terrific amount of time now developing these metrics.” The key to determining your metrics is to look at where you’re trying to take your organization. For example, he says if you’re a for-profit business, then your main metric is simply the dollars. But when you’re a nonprofit like The Cleveland Clinic and your whole reason for existence is to help people, you have to look at other areas. For example, Cosgrove doesn’t simply know the number of patients in the hospital on any given day. He can tell you where the patients are, what they’re doing, what the trends are by how long they’re staying, where they’re coming from, what their demographics are, and how long it takes to turn over a bed from one patient to another. “We have huge numbers of demographics that we look at on a regular basis,” Cosgrove says. “Some are on a daily basis, some on a weekly basis, some on a monthly basis, and some on an annual basis, and we trend those. We measure by numbers.” He says that some metrics are just plain common sense. For example, he’d want to know every day how many people are in the hospital. But on the flip side, he can’t track employee satisfaction every day, so that’s something he’d do annually. In terms of the ones that fall in between, that comes down to how important they are. “The ability to measure and the speed with which you can respond to these measurements is the ultimate determinant of how successful you’re going to be,” Cosgrove says. “The only real competitive advantage that you’re going to have is speed.” The quicker you have that information, the faster you can respond and address problems. For example, if he has an infection outbreak in the hospital, the quicker he can find the reasons for it, the faster he can address it and stop it. “You need to be able to respond quickly and have as much information as you can as fast as you can,” he says. Out of all the measurements that Cosgrove — and any leader — utilizes, again, it’s important to keep one at the forefront more than anything — your customer. “The main thing we are here for is patients,” he says. “The only reason that you have a hospital or doctors or anybody else who works here is for patients, so the ultimate measurement of how we do is how our patients do and how they feel about what we’ve done for them.”