University Hospitals Strategy for the Future of Health Care

Reflections on what has allowed UH to grow and thrive for 155 years and our plan for the years ahead

UH Clinical Update | December 2021

By Cliff Megerian, MD, Chief Executive Officer, University Hospitals

As 2021 winds down, there is nothing more important I can do than to thank all of you. During this holiday season, I personally am extremely grateful for your hard work and dedication, and for the way you met the challenges we’ve all faced as a result of COVID-19.

It is only because of everyone’s hard work that we are able to deliver very effective care to our community and that is being recognized. I also have a feeling of hope, and that is because of the therapeutics, particularly oral therapeutics, that are being clinically trialed – some of them here at UH. I think their approval and use may be around the corner, and that provides a light at the end of the tunnel that will take us to a brighter 2022.

I think it’s reasonable and important to give you an update and a summary of what I’ve been talking about in my nearly two dozen entity visits and town halls at our UH medical centers, which began in November and continue through part of January. This message to you is an amalgamation of my talk to caregivers in those visits.

As I prepared for these, I often reflected on what has allowed UH to grow and thrive for 155 years. And I’ve come to believe the answer lies in our uniquely collaborative culture that is grounded in compassion – already in the 19th century this was stated as, “The most needy are the most worthy.”

Throughout our history, UH has worked to improve the state of medicine and the well-being of our families, friends, and neighbors. And we’ve been successful in part because what we believe is different. What we do is different. And who we are is different.

You may have heard me mention before that the four factors that differentiate UH from its competitors are:

• Providing compassionate and equitable care;
• Pioneering medical research and breakthroughs;
• Improving the quality of care while reducing costs; and
• Serving as the hometown team.

But it’s important that we consider our strategy, because that will guide our future – as the framework for how we will grow and thrive. Our focus is on leveraging our vast resources “as one UH,” to enhance outcomes, improve the experience of our patients, and bring down the high costs of care.

In other words, by working as one and achieving what we now call “systemness,” UH can provide even higher-quality, compassionate care for our patients, and do it at lower costs. By maximizing our healthcare value, we sharpen our differentiation.

So we identified six capabilities we will focus on, and invest in, as part of our ultimate goal to become the most trusted healthcare partner in Northeast Ohio.

Like gears that move together in a coordinated fashion to make an engine run, these capabilities – Culture of Trust, Scientific Discovery, Patient First, Exceptional Care, Partnerships and Mission Investment – also move to unite our many parts and function as one integrated health system that is able to fully leverage our vast talents and resources.

Each gear that begins turning connects with and spurs the rotational energy of the next.

The first gear is about having a culture of trust. This inspires talented caregivers who excel, and help us drive scientific discovery by advancing the science of health. Having a culture in which learning and caring are priorities allows us to put patients first – which means providing access to them and then delivering exceptional care. This then attracts new partners, including independent physicians and other healthcare players, which allows us to grow our investment in our mission and our community.

However, we cannot do any of these things unless we embrace our core values, which have evolved. They are Service Excellence, Integrity, Compassion, Belonging and Trust.

And they are what shape our behaviors, and here are some examples of how:

Service Excellence means we anticipate, actively listen, ask clarifying questions, and strive to exceed expectations.

Integrity empowers our people to speak up when they have a concern or ideas on how to improve the quality of care and the work environment that surrounds us.

Compassion manifests in being motivated to understand the experiences and perspectives of others while practicing acts of kindness.

Belonging means we accept people for who they are and welcome new ideas, differences of opinion and beliefs that strengthen our sense of community.

Trust is exhibited when high-performing teams demonstrate it through honesty, open communication and delivering on commitments.

An institution like ours also is driven by scientific discovery and here we excel, as the numbers demonstrate.

The promise of tomorrow’s medicine – including treatment for COVID-19 - is offered through clinical trials at UH. We have $177 million in funding and about 3,000 clinical trials and research studies underway.

The Harrington Discovery Institute at University Hospitals advances our discovery efforts even more. Since its founding in 2012, the Harrington Discovery Institute has supported nearly 150 drugs-in-the-making in the U.S., Canada and the U.K.

We also have academic affiliations with four organizations – CWRU, NEOMED, Technion and Oxford.

Our future goals for advancing science include:

• Improving healthcare outcomes with evidence-based practices and giving hope to patients who believe they have exhausted all options
• Creating a competitive advantage by attracting new patients seeking cutting-edge care, such as new drugs, devices and cell therapies
• Enhancing the differentiation of our health system
• Attracting healthcare leaders, researchers, innovators, industry partners and trainees

All of this – as most things at UH – is ultimately about putting patients first. What does that mean?

• Providing individualized care – including through UH Connor Whole Health and our new Hospital@Home program, which has had 46 patients to date who have given us fantastic feedback.
• Emphasizing easy access – this means patients will have flexibility to manage the appointment process with state-of-the-art AI technology designed to create a frictionless experience. We’ve also implemented steps to significantly increase patient self-scheduling.
• Meeting patients where they are – a new systemwide telehealth platform, VisuWell, will offer the best technology. Telehealth totals for 2020 were more than 400,000; through Oct. 2021, 264,300 virtual visits were completed
• Continuity of care – Our Meds to Beds initiative provides patients with far greater convenience in getting the medicine they need before they leave the hospital; an ongoing central fill / mail order prescriptions process and telepharmacy also ensures patients can get the medicine they need, even if they have barriers to transportation.

Putting patients first also means providing exceptional care.

Our Exceptional Care capability means continuously improving our care delivery outcomes, the patient’s total experience and the cost of care – what we also refer to as “value-based care”

A key part of this is our Zero Harm initiative, which means exactly what it says:   

• Eliminating physical harm to patients, which covers areas such as reducing incidence of C. diff, sepsis, falls, pressure ulcers, CAUTI, and CLABSI.
• Ensuring patients have an exceptional experience and that they feel respected and heard – and their access to care is improved
• Eliminating defects in value –  UH saved Medicare $22 million in 2020 and received an $8.8 million shared savings payment
• Eliminating inequities for all patients

Finally, there is our mission is to improve the health of our community and therefore connects to our goal of being financially viable. That is what allows us to invest in our mission. Over the past decade, UH provided $3.24 billion in community benefits through the deployment of targeted programs and initiatives, including $483 million in 2020 alone.

Now, we are building on this legacy by implementing a thoughtful, bi-directional, data-driven, community investment strategy, one that allocates resources where needs are greatest. We will have a more significant impact by focusing on three areas:

Anchor & Social Venture Investments

These are large scale, place-based initiatives by “anchor institutions" such as UH, that have the ability to catalyze change in the regions where they are located. They include UH Rainbow Babies & Children's Ahuja Center for Women & Children, UH Otis Moss, Jr. Health Center, and the Food for Life Market^®.

Regional Community Health Investments

These are selected after we perform a Community Health Needs Assessment. The five impact areas we will focus on are workforce development, anchor strategies, well-being & safety, food security, and maternal & child health, scaling them in a way that takes them to more of the communities we serve.

Social Service Investment

We do this by leveraging the power of our 30,000-plus caregivers to make a difference in our communities through volunteerism and board service. We will further encourage this through a new program slated for 2022, the Voluntary Time Off program for all UH employees.

Then there is a topic that is undoubtedly of great interest to you as it relates to the clinical realm - our move to the EPIC system, which will enable us to do better in many areas. Strategically, EPIC will:

• Promote our differentiation in the communities we serve
• Support our core values
• Advance systemness
• Help us remove variability in our workflows
• Enhance our ability to better engage our patients through a robust patient portal
• Position us to increase our revenue stream
• Increase caregiver efficiency, which will increase the amount of time with our patients

The first wave of the shift to EPIC will begin in the spring of 2023.

I’ve covered a lot here about UH’s strategy and values. As a reference tool, we’ve created a new webpage on our UH intranet – the Digital Workplace – that will provide more details about each of the initiatives supporting our strategy. (Please note that you must be on the UH network to view material on the DWP.)

The portal will also include the logo for our new values, and various materials that you can download and display around your work areas.

Also on our Digital Workplace home page, you can find the nomination forms, criteria and upcoming deadlines for the Cliff Appreciates Bravo Award and Dinner with the Doc opportunity.

These awards are an excellent way for us to demonstrate gratitude for the great work you all do. They also help reinforce the kind of culture we want that recognizes and values our success and further reinforces Belonging. I encourage you to submit a nomination.

This is a time of tremendous and positive change and I wanted you to have all the details you may need.

And with that, I wish you a very happy holiday season, and for all of us, a promising 2022.