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

When Dr. Delos “Toby” Cosgrove took the reins as president and CEO of The Cleveland Clinic four years ago, he wasn’t just a world-renowned heart surgeon stepping into a new role. He was also a leading doctor about to take a leading hospital to a whole new level of excellence. For 14 straight years, U.S. News & World Report has recognized The Cleveland Clinic as the No. 1 heart hospital in the country, and last year, the hospital finished as the overall No. 4 hospital in the country, with 10 of its specialties being ranked in the top 10 by the report. “We’ve had an enormous growth over the last decade, and I think the growth has been secondary to a recognition for the quality of the product that we produce,” Cosgrove says. “Unless you’re producing an excellent product, there isn’t a lot of demand for your services. The excellence that The Cleveland Clinic has been known for, both locally, nationally and internationally, has created increasing demands for our services.” With more demand being placed on the organization, Cosgrove couldn’t simply coast by resting on the clinic’s laurels. Instead, he has pushed his executives, managers and doctors to innovate and find ways to make the things that were already great even better. His doctors have continued cutting-edge research and pioneered new procedures. He’s also expanded the clinic by establishing hospitals in Toronto and another to open in Abu Dhabi in 2011. And last fall, the clinic opened up The Sydell and Arnold Miller Family Pavilion and the Glickman Tower in Cleveland to house its Heart & Vascular Institute and the Glickman Urological & Kidney Institute. Big ideas also require big budgets. All of these projects and expansions wouldn’t be possible if Cosgrove didn’t keep the financial side running well, which he has, as the clinic’s total 2007 operating revenue climbed to $4.8 billion from $4.4 billion the year before. Despite everything he’s done to take the clinic to that next level of excellence, Cosgrove also wants his people and the community to know that while he has big ideas for the future, he is also grounded in reality. While the keys to successful growth have been to create a plan, lead people through the changes and track the progress, you also have to stay grounded in your core values and reasons for existence. “I started out four years ago, when I told in my initial talk to the community, that it’s the only reason that we’re here is for patients and patients come first, and everything flows from that,” he says. “The reason that we’re building these facilities is for patients. It’s not for doctors. It’s not for administrators. It is for patients. You have to keep your core values as your anchor, and once you have those established, then everything else flows from there.”