When Cleveland Clinic incorporated Cleveland Clinic Florida in Weston into its system in 2007, it not only established a presence in a key Southern state, but it also introduced a unique team-based management philosophy that gave the organization a head start on providing accountable care, a goal many leading health systems adopted only after the passage of the Affordable Care Act in 2010.

Cleveland Clinic Florida’s "Model of Medicine" philosophy of care involves a common-sense approach in which key organizational decisions are made only after all viewpoints of nurses and the rest of the caregiving team are considered. This philosophy helps to reduce issues that may negatively influence patient care.

Kerry Major, RN, MSN, CNO at Cleveland Clinic Florida, said a commitment to this philosophy from everyone in the organization — including chief executives and nurse and physician leaders — is the key to their success, and can be seen in every aspect of operations, from nurse involvement in committees and councils to physicians opening their Grand Rounds to the entire healthcare team.

"It’s the concept that we really are one team," Major said. "The Model of Medicine concept is about physicians and employees all viewed as one team that puts the patient first."

This collaborative team approach was a unique concept to patient care in South Florida at the time it was introduced, Major said. It’s a distinctive benefit that she has used effectively to attract new hires who are interested in expanding their clinical knowledge and skills through the prominent role on the Cleveland Clinic caregiving team.

Equal value

The level of physician involvement in the team isn’t a one-way relationship. Several physicians participate in the facility’s mock codes and mock Joint Commission surveys.

"It helped build great relationships among the team, and it was a great teaching opportunity for our residents, our fellows and our nurses," Major said.

For key projects at the facility, the leadership team gathers to thoroughly discuss the project’s positive and negative ramifications, such as how it affects hospital staff differently in nursing, support services, pharmacy and radiology. Considering the benefits and risks for each integrated department helps the team determine whether the project or action will be successful and a benefit to patients.

This thoughtful approach proved especially helpful when the hospital recently implemented its comprehensive electronic medical records system. The team was able to establish a process to ensure enough technical support was available for each department, which led to a successful launch, Major said.

"Just as physicians are able to bring their perspective to the team, nurses are able to bring their perspective as well — and it’s a valued perspective," Major said. "If you work in partnership all the way along, you’d be surprised how many people embrace the new technology."

Lead and others may follow

Major said she has noticed several other South Florida health organizations shifting to an employee-physician model, like the one in place at Cleveland Clinic Florida. She said this transformation is the first step to installing a true team approach among caregivers because when physicians are employees of the hospital — not independent practitioners — they tend to have a greater level of commitment to the organization and are more interested in activities that ensure future success.

Additionally, their unique Model of Care philosophy has given Cleveland Clinic Florida a head start on the Accountable Care Organization concept, which is transforming the healthcare system from a fee-for-service model to a model that rewards organizations for providing quality patient care and keeping their patients healthy.

"That’s the exciting thing," she said. "We’re ready; we’re poised. We have that entire integration piece. It’s what we live and breathe every day. The Model of Care really has put us in a nice position in terms of preparation for providing accountable care."