Issue link: https://beckershealthcare.uberflip.com/i/1034012
159 PRACTICE MANAGEMENT THOUGHT LEADERSHIP Living like a leader: A day with Cleveland Clinic CEO Dr. Tomislav Mihaljevic By Leo Vartorella B etween clinical objectives, financial concerns, patient needs and com- plex payer dynamics, there don't seem to be enough hours in the day for healthcare executives to address the di- verse set of organizational goals they are tasked with accomplishing. Tomislav Mihaljevic, MD, joined the Cleveland Clinic in 2004 as a cardiothorac- ic surgeon and went on to serve as CEO of Cleveland Clinic Abu Dhabi in the United Arab Emirates before becoming CEO of the Cleveland Clinic Jan. 1. Just nine months into his role, he took the time to speak with Becker's Hospital Review for our "Living like a leader" series, which examines the daily routines of influential decision-makers to offer readers an idea of how they manage their energy, teams and time. Editor's note: Responses have been lightly edited for length and clarity Question: What's the first thing you do when you wake up? Dr. Tomislav Mihaljevic: I'm an early bird so I'm usually up by 4:30 a.m. and I either go for a run or to the gym. I work out until 5:30 a.m. and eat breakfast. While I eat, I scroll through the electronic ver- sions of three newspapers: e New York Times, e Wall Street Jour- nal and e Plain Dealer, which is Cleveland's local paper. By 6 a.m., I'm in the car and while I'm on my way to work I like to call over to Europe, where my daughters live. Q: What's the first thing you do when you arrive at work? Is there anything that makes your office setup unique? TM: My office is pretty minimalistic, very clean. I don't keep paper, so I do not have any stacks of paper in my office. I work on a standing desk, which I started about three or four years ago when I was still in Abu Dhabi. e first thing I do at work is sign what I need to sign and review pa- tient letters. I get a lot of patient letters directed to my office, so I make sure to read and answer them. I go over my schedule for the day and do a quick scroll through emails that have arrived over night. Ideally, I like to empty my inbox by the end of the day so in the morning I have only a few messages to take care of. e beginning of the week, and the beginning of the day in particular, is always associated with important operational work for the hospital. Executive team meetings, operating counsel meetings, anything that sets the tone for the rest of the week or sets a tone for the rest of the day is done early. Q: How much of your time is spent with direct reports? TM: A lot. I would say 50 to 60 percent of my time is spent with direct reports in one form or another. ere's a lot of official meetings along with walking into each other's offices and taking care of issues that in- evitably surface at any given moment. e one-on-one meetings with the director board typically happen on a monthly basis, but as I said, we take care of a lot of issues in a real time and I do not heavily rely on a schedule. My door is always open, so people kind of know when and how to find me. ere are a lot of scheduled meetings, but there are a fair amount of unscheduled conversations. Q: How often do you meet with clinical staff or perform rounds? TM: I have daily interaction with the clinical staff. I'm a heart surgeon myself. Everything I do in my current position is viewed through the lens of my prior work as clinician, so I really enjoy interactions with the clinical staff. It gives a lot of perspective in the work that we do as an organization. I typically hold town hall meetings three to four times a week with clinical staff at our various locations. I work for them, they don't work for me. I speak for 10 or 15 minutes and then we converse in an open question-and-answer format for about a half an hour. I try to regularly meet with our institutes and departments and then tour our hospitals. Organizations typically spend a lot of time creating a mission, vision and values for the enterprise but in actuality, at least in my experience, most members of the organization do not remember those. So, what we have decided to do is use a paradigm that is easy to memorize. I told our caregivers, and I use this paradigm daily: "We have to treat our patients and each other as a family, and this place as our home. And if you use this simple framework for any and every decision that you make at your workplace, we are always going to arrive on the right decision. And I will always support you." I reiterate this paradigm of- ten during our town hall meetings. I just really enjoy interaction with caregivers and I learn a lot through our conversations. When I used to run Cleveland Clinic Abu Dhabi, I would always eat lunch in the cafeteria with one rule: I never ate lunch by myself and I never ate it with someone I knew. So, I would always sit down with someone who I had yet to meet and have an informal conversation. I learned a lot during those lunches. Q: How do you think your routine is different from that of other healthcare executives? TM: I cannot really speak to this because I do not know the routine of many of my colleagues, but mine is very focused on interactions with the clinical staff. We have locations around the U.S. and in Abu Dhabi, and we want to ensure patients and caregivers at those hospi- tals feel like a part of the system. at typically involves a lot of direct interaction via teleconference with all of our hospitals twice a week. I have a real-time feed into their activities, so we know every single moment what's happening in every part of our healthcare system. is year, we implemented a Tiered Daily Huddle everyday at 11 a.m. We receive real-time information about the quality and patient safety en- vironment in every one of our hospitals, as well as utilization of our resources. I can tell you everyday whether there are any safety events, complications or issues that would adversely affect the environment and safety of our caregivers and patients. On a day-to-day basis, I know how we are utilizing our resources, how many patients we have served and how successful are we in fulfilling our mission. Q: What is the hardest part of your day? TM: Well, the hardest part of my day is obviously to navigate a num- ber of different priorities that show up in a day. e hardest part of anybody's day who is in a leadership position for such a large organi-