STATE OF THE CLINIC 2017

Transcription

1 STATE OF THE CLINIC 217 Treat the patient and fellow caregivers as family, and the organization as your own. Tom Mihaljevic, MD, CEO and President

2 STATE OF THE CLINIC Caregivers 1 Cleveland Clinic Health System 19 Quality & Safety 23 Patient Experience 27 Market Analysis 28 Research 31 Innovation 32 Education 36 Community 39 Financial 43 Cleveland Clinic Abu Dhabi 45 Growth

3 217 State of the Clinic 3 CEO S ADDRESS Dear Friends: Welcome to the 217 State of the Clinic. We publish these statistics annually as part of our commitment to transparency and accountability. Under the leadership of CEO and President Toby Cosgrove, MD, Cleveland Clinic had a notable year in 217. We saw a record number of patients; our researchers advanced the science of medicine; and we led one of the nation s largest graduate medical education and training programs. Cleveland Clinic was ranked the No. 2 hospital in America, and ranked the best hospital for heart care (for the 23rd straight year) and urology by U.S. News & World Report. In Cleveland, we opened the new Taussig Cancer Center, along with new rehabilitation centers in the southern and eastern regions. Cleveland Clinic Florida will open a new patient bed tower and family health center in 218. To improve access to our services, we opened new urgent and Express Care centers, and logged thousands of telemedicine visits. Cleveland Clinic remains deeply committed to the communities that we serve. We continue to increase our community benefit, and charity and uncompensated care. I began my service as CEO and President on Jan. 1, 218. This is an incredible honor, and I look forward to working alongside our 52, caregivers. Cleveland Clinic will continue to deliver the highest-quality, most-affordable patient care to as many people as possible. We will treat patients and caregivers as family and this organization as our own. Thank you for your interest and support of Cleveland Clinic. Sincerely, Tom Mihaljevic, MD CEO and President

4 CLEVELAND CLINIC FACTS & FIGURES Founded in 1921 by four physicians with the mission of providing better care for the sick, investigation into their problems, and education for those who serve. A not-for-profit, physicianled multispecialty group practice and healthcare system. Care provided through 2 patient-oriented institutes organized around diseases and organs. Caring for 2 million unique patients with over 7 million outpatient visits in locations around the globe. TORONTO NEVADA CLEVELAND LONDON (22) ABU DHABI FLORIDA Locations include a 1,4-bed tertiary care main campus in Cleveland, 1 regional hospitals and over 15 outpatient locations in Northeast Ohio, 155 beds in Southeast Florida, a brain center in Las Vegas, a wellness outpatient practice in Toronto, and a 364-bed hospital in Abu Dhabi. A 2-bed hospital will complete construction in London in 22.

5 CAREGIVERS 52K 3,676 Caregivers Physicians and scientists PATIENT CARE 7.6M 229K 27K Outpatient visits Admissions and observations Surgeries and procedures EDUCATION 1, Residents and fellows Accredited residency training programs RESEARCH $272M $18M Research funding Federal funding COMMUNITY $89M $17.8B Community benefit Economic impact OHIO

6 6 217 State of the Clinic CAREGIVERS Caregiver Employees 55, 52,82 45, 35, 25, In 217, the number of caregivers increased to 52,82 at year-end, an increase of 1% compared with 216. Professional Staff 4, 3,676 3, 2, 1, In 217, the number of professional physician staff and scientists increased by 2.6% to 3,676.

7 217 State of the Clinic 7 CAREGIVERS Advanced Practice Providers 2, 1,936 1,5 1, In 217, advanced practice providers across the health system increased 19% to 1,936. Nurses 12, 11,889 11, 1, 9, 8, Cleveland Clinic employs 11,889 nurses.

8 8 217 State of the Clinic CAREGIVERS Female Professional Staff 4 37% 3 % The percentage of women on Cleveland Clinic s professional staff remained at 37% in 217. Employee Turnover Caregiver Staff 13% % % In 217, staff turnover for the enterprise increased to 7.2%, while enterprise turnover for caregivers in support roles averaged 13% in 217. Cleveland Clinic s caregiver turnover was lower than the national benchmark of 13.8%.

9 217 State of the Clinic 9 CAREGIVERS Caregiver Survey %-ile Rank Engagement High Reliability 59th 66th 68th 68th 76th 85th In the caregiver survey, caregiver impressions of both engagement and high-reliability culture improved. A survey was not conducted in 216. Employee Health Costs 4 35 á2.8% á.8% $ 3 á7.9% Collaboration among our chronic disease care coordination programs and wellness initiatives has helped Cleveland Clinic flatten the cost curve for its caregivers and beneficiaries.

10 1 217 State of the Clinic CLEVELAND CLINIC HEALTH SYSTEM Patient Distribution Ohio 13.1% U.S. 16.1% 7 Counties 7.7% International.2% The majority of Cleveland Clinic patients in 217 came from Northeast Ohio. Outpatient Visits Millions M The number of outpatient visits for Cleveland Clinic health system exceeded 7.6 million in 217, an increase of 7%.

11 217 State of the Clinic 11 CLEVELAND CLINIC HEALTH SYSTEM Acute Admissions and Observations 25 2 Observations Acute Admissions 229,132 Thousands In 217, adult acute admissions across the health system increased by 3.9% and observations increased by 2.6%, for a total of 229,132. Average Length of Stay Days Days Average inpatient length of stay across the health system decreased to 5.16 days.

12 State of the Clinic CLEVELAND CLINIC HEALTH SYSTEM Surgeries & Procedures 25 2 Inpatient Outpatient 27,354 Thousands Inpatient surgeries rose to 61,529 in 217, while outpatient surgeries decreased slightly to 145,825, for a total of 27,354. Average Daily Census 2,5 2,45 2, 1,5 1, The health system had an average daily census of 2,45 patients in 217.

13 217 State of the Clinic 13 CLEVELAND CLINIC HEALTH SYSTEM Emergency Department Visits 7 644,575 6 Thousands With the opening of lower-acuity access options, including Express Care and virtual visits, emergency department visits decreased 1% to 644,575 in 217. Emergency Departments Door-to-Care Time 3 Minutes 2 1 Target = 12 Minutes 1.7 Minutes The time it takes a patient to be seen by a physician or licensed independent practitioner in the emergency department (ED) is a key quality and throughput metric. Across the system, the EDs improved to 1.7 minutes in 217, below the national target of 12 minutes.

14 State of the Clinic CLEVELAND CLINIC HEALTH SYSTEM Urgent and Express Care 3, 25, Urgent Care Express Care 275,773 2, 15, 1, 5, In 217, urgent care visits increased to 13,894. Express care visits across the system increased by 32% to 261,879. Cleveland Clinic has 2 urgent and Express Care clinics. Critical Care Team Transports Thousands 7, 6, 5, 4, 3, 2, 1, 6, In 217, the critical care transport team transported more than 6, patients to Cleveland Clinic.

15 217 State of the Clinic 15 CLEVELAND CLINIC HEALTH SYSTEM Hospital Transfers 3 27, Thousands Internal and external hospital transfers decreased to 27,931 in 217. The opening of Avon Hospital provides a full spectrum of specialties and programs to meet the local medical needs, decreasing the number of transfers. Same-Day Visits M Millions Cleveland Clinic continues to enhance access through same-day appointments. In 217, same-day visits increased 7% to 1.35 million.

16 State of the Clinic CLEVELAND CLINIC HEALTH SYSTEM Virtual Visits 3, 25, 25,52 2, 15, 1, 5, Cleveland Clinic provides patients with 24/7 access to care through the Express Care Online platform. In 217, the number of virtual visits increased 163% to 25,52. Shared Medical Appointments 3, 25, 26,12 2, 15, 1, 5, Shared medical appointments bring patients with the same diagnoses together in a setting that encourages asking questions and sharing concerns and experiences. In 217, shared medical appointments grew 47% to 26,12 visits.

17 217 State of the Clinic 17 CLEVELAND CLINIC HEALTH SYSTEM International Patients 5 Thousands , In 217, main campus unique international patients decreased 16% to 3,265. International Patients Distribution Turkey 2% Mexico 3% Middle East 41% Europe 5% Central America 5% South America 6% Caribbean 6% Asia 7% Other 15% Canada 11% The Middle East accounts for over 4% of all international patient visits.

18 State of the Clinic CLEVELAND CLINIC HEALTH SYSTEM Case Mix Index Case mix index reflects the clinical complexity of hospitalized patients. Cleveland Clinic health system s average case mix index rose to 1.85 in 217. Comparative Case Mix Index Cleveland Clinic Stanford UCLA Mayo Duke UCSF Clinic Cleveland Clinic main campus has the highest overall case mix index in the country.

19 217 State of the Clinic 19 QUALITY & SAFETY Readmissions 14 % % 12 Goal 12% Through patient-focused clinical and operational initiatives, Cleveland Clinic has reduced all-cause readmissions within 3 days after discharge. The metric is now approaching the target of below 12%. Patient Safety Indicators (Complications) 8 7 per Month Goal per Month Cleveland Clinic is working to reduce adverse events, which are measured by patient safety indicators. We continue to improve and outperform national patient safety benchmarks through clinical and documentation enhancements.

20 2 217 State of the Clinic QUALITY & SAFETY Hospital-Acquired Infections 5 per Month 4 3 Goal per Month Cleveland Clinic is committed to reducing preventable infections below the target based on national benchmarks. Hospital-Acquired Infections C. difficile 1 per Month Goal per Month We continue to focus on decreasing C. difficile infections.

21 217 State of the Clinic 21 QUALITY & SAFETY Hand Hygiene 1 9 Goal = 1% 93% % Hand hygiene is the most effective intervention to stop the spread of infections. Hand hygiene compliance continues to increase, reaching 93% in 217, as measured by independent observers. Controlled Diabetes 9 Goal = 9% 83% % Cleveland Clinic initiatives to improve diabetes diagnosis, prevention and control have reduced diabetes-related strokes, heart attacks and mortality.

22 State of the Clinic QUALITY & SAFETY 16 Care Paths Guides Developed Technically Enabled A care path is an established, multidisciplinary care plan used to optimize the value of care by reducing unnecessary practice variation. As of 217, 144 care path guides have been developed, with 3 fully embedded in the electronic health record.

23 217 State of the Clinic 23 PATIENT EXPERIENCE Web Contact Requests Thousands , In 217, there were over 155, online appointment and information requests submitted through the clevelandclinic.org website. Social Media Millions M Increasing numbers of people are interacting with us through social media. The combined number of Cleveland Clinic Facebook fans and Twitter followers totaled 3.5 million at the end of 217.

24 State of the Clinic PATIENT EXPERIENCE DrConnect Users 12, 1, 1,537 8, 6, 4, 2, DrConnect now provides over 1,5 referring physicians with secure online access to real-time information about their patients treatment progress while at Cleveland Clinic. 1. MyChart Users 1M Millions MyChart is a secure, online health management tool that connects Cleveland Clinic patients 24/7 to portions of their electronic medical record. More than 1 million patients had MyChart accounts in 217.

25 217 State of the Clinic 25 PATIENT EXPERIENCE Electronic Medical Record Patients 1 8 8M Millions Cleveland Clinic s secure electronic medical record system has 8 million patients. Patient Experience 1 Goal = 9th %-ile %-ile Rank nd In 217, patients rated Cleveland Clinic in the 62nd percentile in patient experience surveys. The goal is to reach the 9th percentile of all hospitals nationwide.

26 State of the Clinic PATIENT EXPERIENCE Hospital Ratings %-ile Rank Florida Main Campus Avon Akron General Lutheran Fairview Euclid Hillcrest South Pointe Marymount Medina Cleveland Clinic Florida and main campus are rated at the top of all U.S. hospitals in patient experience scores. Avon Hospital, which opened in 216, has a high rate hospital score of 85th percentile. Complaints and Grievances Rate per 1, The rate of patient complaints and grievances continues to trend downward, now at 1.2 per 1, patient encounters.

27 217 State of the Clinic 27 MARKET ANALYSIS Brand Awareness % % Mayo Clinic 79% Johns Hopkins 41% Cleveland Clinic 3% Mass General Brand awareness is measured by a survey of name recognition. Nationwide, 41% of the general population recognizes Cleveland Clinic. Market Share Cuyahoga County % % Cleveland Clinic s inpatient and outpatient market share in Cuyahoga County increased to 47.1%.

28 State of the Clinic RESEARCH Research Staff In 217, the Lerner Research Institute had 141 research staff. Research Activity 2.8 2, Thousands Research activity increased 6% to 2,632 active projects in 217. Active projects are those in progress with the Institutional Review Board (IRB).

29 217 State of the Clinic 29 RESEARCH Citations 13, 129,698 12, 11, 1, Cleveland Clinic research citations rose to 129,698 between 212 and 216. High-Impact Publications 5, 4,979 4,9 4,8 4, High-impact publications are those in the highest-rated scientific journals. Between 212 and 216, Cleveland Clinic researchers published 4,979 high-impact papers.

30 3 217 State of the Clinic RESEARCH Research Funding 3 $272M 25 $ Millions Research funding from all sources was $272 million in 217. This represents a 4.6% increase from 216. NIH Funding 12 $18M 1 $ Millions National Institutes of Health (NIH) funding for Cleveland Clinic research projects was $18 million in 217, an increase of 5.9% from 216.

31 217 State of the Clinic 31 INNOVATION Spin-Off Companies Cleveland Clinic Innovations spun off five new companies in 217, bringing the total to 82 since Patent Activity 4, Filed 3,954 3, 2, 1, Granted 1, More than one-third of the 3,954 patents Cleveland Clinic has filed since 2 have been granted.

32 State of the Clinic EDUCATION Lerner College of Medicine Applications 2, 1,98 1,5 1, The Lerner College of Medicine received 1,98 applications for 32 positions in the 218 class. Lerner College of Medicine Comparative MCAT Scores Wash Univ Univ Columbia 25 Cleveland Johns U Penn Yale Chicago Clinic Hopkins Harvard Duke The 216* MCAT scores of accepted Lerner College of Medicine medical students remain among the highest in the nation. *The most recent validated year for MCAT scores data is 216.

33 217 State of the Clinic 33 EDUCATION Residents and Fellows 2, 1,965 1,8 1,6 1,4 1,2 1, There were 1,965 clinical and research residents and fellows in 17 accredited training programs across the health system in 217. Board Pass Rate 1 96% % In 217, 96% of residents and fellows passed annual board exams.

34 State of the Clinic EDUCATION Continuing Medical Education Activities 2, 1,864 1,5 1, Cleveland Clinic is the world s largest provider of continuing medical education (CME) in all formats. We offered 1,864 CME activities in 217 to more than 18, participants worldwide. Global Leadership and Learning Participants 5, 4,64 4, 3, 2, 1, Global Leadership and Learning courses, designed to build professional competencies and leadership skills, attracted 4,64 caregivers in 217.

35 217 State of the Clinic 35 EDUCATION Civic Education Interns Cleveland Clinic welcomes community high school students to five internship programs for careers in healthcare, science and technology. In 217, there were 183 participants.

36 State of the Clinic COMMUNITY Economic Impact 2 $17.8B 15 $ Billions Cleveland Clinic has created positive economic impact and growth for the region. In 217, the local impact for Ohio was 41% higher than the previous study in 214, with a total of $17.8 billion. Economic Impact Jobs 13, 119,72 11, 9, 7, 5, In 217, Cleveland Clinic brought over 119, direct and indirect jobs to the region.

37 217 State of the Clinic 37 COMMUNITY Community Benefit 216* 8 $89M 6 $ Millions Cleveland Clinic is firmly committed to the communities we serve, providing a total community benefit of $89 million in 216. Community Benefit 216* Clinical Services $473M Research $64M Education $272M Cleveland Clinic provides community benefit through clinical services (charity care, financial assistance and subsidized health services), education of the next generation of healthcare professionals and funding of medical research. *The most recent validated year for community benefit data is 216.

38 State of the Clinic COMMUNITY Energy Usage Index Cleveland Clinic is committed to reducing source energy usage by 2% by 22. Our progress improves air quality, making our patients, caregivers and communities healthier. Supplier Diversity % % Supplier diversity decreased in 217, with 5 percent of supply chain and construction spend going to certified businesses owned by women, minorities, veterans and LGBTs.

39 217 State of the Clinic 39 FINANCIAL Operating Revenue $ Billions $8.4B Operating revenue increased 5% to $8.4 billion in 217. Operating Income 5 $ Millions $328M Unaudited earnings based on current operations totaled $328 million in 217.

40 4 217 State of the Clinic FINANCIAL Days Cash on Hand Days Days cash on hand measures Cleveland Clinic s financial stability. In 217, this metric increased to 383 days, the highest in Cleveland Clinic s history. Cash, Investments and Debt 1 8 Cash and Investments Debt $9.1B $ Billions $4.2B Cash and investments increased to $9.1 billion as outstanding debt decreased.7% to $4.2 billion. Cleveland Clinic uses debt to invest in capital growth.

41 217 State of the Clinic 41 FINANCIAL Long-Term Investments 1 8 $8.5B $ Billions Long-term investments totaled $8.5 billion at the end of 217. This increase from the prior year is attributable to strong cash flow from operations and positive investment return. Malpractice Costs $ Millions $72M Malpractice costs increased slightly to $72 million in 217 due to the growth of the health system.

42 State of the Clinic FINANCIAL Care Affordability Savings 8 $775M 6 $ Millions Care Affordability, the enterprise-wide cost transformation initiative, has delivered over $775 million of cumulative financial benefit. Philanthropy 3 25 $238M $ Millions Pledges and gifts from generous donors increased 7% to $238 million in 217.

43 217 State of the Clinic 43 CLEVELAND CLINIC ABU DHABI CCAD Caregiver Employees 6, 5,477 5, 4, 3, 2, 1, Cleveland Clinic Abu Dhabi (CCAD) opened in 215, and the number of caregivers increased to 5,477 in 217. CCAD caregivers represent 77 nationalities. CCAD Professional Staff The number of physicians at Cleveland Clinic Abu Dhabi increased to 34 in 217. Of these, 24% have been trained or have worked at Cleveland Clinic in Ohio.

44 State of the Clinic CLEVELAND CLINIC ABU DHABI CCAD Outpatient Visits 4 47,32 3 Thousands Annual outpatient visits for Cleveland Clinic Abu Dhabi have increased 38% to 47,32. Currently, patients travel from over 72 countries for care at CCAD. CCAD Inpatient Census per Day 18 per Day At the end of 217, Cleveland Clinic Abu Dhabi had an average of 27 patients per day.

45 217 State of the Clinic 45 GROWTH Taussig Cancer Center A new, multidisciplinary outpatient cancer center on main campus was completed in March 217. Designed around a new patient-centered care model, the 377,-square-foot building has 126 exam rooms, 98 infusion rooms, six linear accelerators, Gamma Knife and a meditation room. Rehabilitation Hospital Beachwood, Ohio An inpatient rehabilitation hospital was completed in Beachwood, Ohio, operated in partnership with Select Medical. The 6-bed, 6,-squarefoot facility is located adjacent to the Cleveland Clinic Administrative Campus.

46 State of the Clinic GROWTH Edwin Shaw Rehabilitation Hospital Bath, Ohio Akron General s Edwin Shaw Rehabilitation Hospital has a new home. The 6-bed, 75,-square-foot inpatient facility is a joint venture with Select Medical. Cleveland Clinic and Select Medical now have 18 rehabilitation beds in three facilities across Northeast Ohio. Stow-Falls Medical Outpatient Center Cuyahoga Falls, Ohio A 33,-square-foot family health center was completed at 857 Graham Road. The medical outpatient center provides express care, family medicine, dermatology, children s therapy and lab services.

47 217 State of the Clinic 47 GROWTH IBM Watson Health The two-story, 43,-square-foot building at 15 Cedar Ave. will house the Cleveland arm of IBM Healthcare s data analytics enterprise. Three hundred people are expected to work in the new building, which is sited at the northern end of the Opportunity Corridor. The building is scheduled to open in 218. Family Health Center Lakewood, Ohio Designed as part of the Lakewood medical neighborhood, the three-story, 64,7-square-foot facility includes 6 exam rooms and 16 emergency department treatment bays. The building is scheduled to open in July 218.

48 State of the Clinic GROWTH Cleveland Clinic Akron General Emergency Department A new Emergency Department and Level I Trauma Center will open in summer 218 at Akron General Hospital. The 6,-square-foot facility will have 6 treatment rooms, four high-acuity trauma rooms, imaging, and special sexual and domestic assault healing areas. Family Health Center Coral Springs, Florida Ground was broken for a 73,-square-foot outpatient facility. Scheduled to open in July 218, it will have six operating rooms, 24 prep and recovery bays, two endoscopy suites, imaging and 4 exam rooms.

49 217 State of the Clinic 49 GROWTH Bed Tower Weston, Florida To meet increasing patient volumes, Cleveland Clinic Florida is building a five-story tower with 75 beds, three operating rooms and an expanded emergency department. It is scheduled to open in August 218. Cleveland Clinic Children s Outpatient Center Pediatric outpatient services are being consolidated in the former Taussig Cancer Center on Euclid Avenue. The 12,-square-foot building will have 6 exam rooms, four procedure rooms, child-focused amenities and an expanded drop-off area. It is scheduled to open in fall 218.

50 5 217 State of the Clinic GROWTH Health Education Campus The new home of the Cleveland Clinic Lerner College of Medicine, Case Western Reserve University School of Medicine, School of Dental Medicine, and Frances Payne Bolton School of Nursing was designed by Foster + Partners, London. It opens in July 219. Dental Clinic Ground was broken for a three-story, 126,-square-foot Dental Clinic at 961 Chester Ave., across the street from the new Health Education Campus. A joint venture with Case Western Reserve University, the building is scheduled to open for dental services in 219.

51 217 State of the Clinic 51 GROWTH Cleveland Clinic London Cleveland Clinic is expanding globally with a location at 33 Grosvenor Place, London. This eight-story, 323,-square-foot facility includes 2 beds and eight operating rooms. Scheduled to complete construction in 22, it will offer major medical specialties, imaging, endoscopy and more.

52 95 Euclid Ave. Cleveland, OH Please visit our website at clevelandclinic.org. 17-CCC-4795