University of Southern California

Center for Effective Organizations

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Ecological Sustainability to Catalyze High Performance

In October, 2008, CEO hosted a conference on "organizing for sustainability" that was attended by the Cleveland Clinic, including leaders from Huron Hospital, one of the hospitals in the Cleveland Clinic system.

Huron is notable because of the severe challenges it faces - it is housed in a very old building in one of the poorest communities in the U.S. - East Cleveland, Ohio, and has for many years been a major provider of charity care and a money-loser.

Huron is also notable because despite serious constraints, it has used the concepts of triple-bottom-line sustainability to effect a great transformation in its own capabilities and performance. It started its transformation with a focus on ecological sustainability, as a lead initiative in achieving its goal to become high performing in every aspect of its functioning.

Dr. Gus Kious became the Medical Director and President of the hospital in 2004. He came to a hospital very low in quality and morale and very high in the waste it generated. He challenged his staff to eliminate 50% of the hospital's solid waste within four years - a very ambitious goal (they achieved a 37% reduction).

To make this goal a reality, he provided several leaders with opportunities to be trained in leadership for sustainability. They in turn set up a "Green Team" made up of Huron employees who quickly became personally committed to environmental sustainability, and rapidly involved many others in the initiatives.

Beyond accomplishments in solid waste management, Huron has had impressive accomplishments in

  • eliminating mercury
  • reducing energy consumption
  • removing toxins from the environment
  • cleaning the air
  • conserving water
  • green procurement
  • and redirecting unused materials and equipment to charity.

It is working to remove latex and styrofoam from the building, and working toward investment in renewable energy systems and energy efficient windows.

A focus on ecological sustainability efforts set the stage for the hospital's staff, physicians and management to think about other ways the hospital could reduce waste, use their resources more efficiently to deliver high quality care and save money. The "green" aspects of sustainability have proved to be a great foundation - and springboard - for Huron Hospital's overall high-performing, sustainable hospital vision.

  • It instilled the value of using resources carefully and with an eye to reducing waste and achieving long-term viability. This value truly began to permeate all decisions.
  • Green sustainability also provided a focus that could be, and was, embraced enthusiastically by a large percentage of the staff in the Hospital--unleashing a positive energy and pride that has spilled over into other areas.
  • It provided a good vehicle for breaking down the barriers with the community, which has been mainly distrustful of large institutions. A major focus was the implementation of a local food initiative including a small local farmer's market, the establishment of a community garden and a composting process to nourish it where staff and community members could work together to grow, harvest, and use very fresh and very local produce. This has exposed community members to healthy eating, while also creating connections and building trust between the hospital and the community.

Beyond "Green"

Huron Hospital has implemented a number of changes to its clinical management processes that build on the same values of resource conservation and promoting a healthy environment. The goal is shorter in-patient stays with better outcomes. Physicians and all departments of the hospital have changed work processes to better coordinate their activities to provide more timely and efficient service.

The hospital has had a positive EBIDA 4 quarters in a row for the first time 2007-2008, is becoming a referral center for chronic illness throughout Cleveland, has greatly increased patient satisfaction, and is feeling positive about its prospects. Huron has created, tested and maintained adaptive capacity while creating opportunities through innovation and middle management leadership.

It is evident and striking that Huron Hospital's employees are continually looking for new ideas that can continue to give Huron the lift and the edge it needs to sustain itself. Huron Hospital is carrying out a transformation to become a high performing and innovative hospital against many odds. It has been guided by core principles of sustainability through high performance--delivering greater value through wellness and prevention approaches, and through efficient care, in a manner that extends life and improves its quality. It operates with the principles of reducing waste, increasing leverage, and continually finding new ways to deliver increased value in all aspects of its functioning.

The hospital's social system--decentralized management, staff involvement processes, and connections to the community--is a core part of its renewal. It provides the motivation and excitement around the transformation, gives people an opportunity to grow and develop, instills pride in accomplishments that a few years ago seemed unattainable, and opens up the system to new ideas and collaborative relationships wherever they may lead to higher performance.

CEO has been working with Huron Hospital to develop a case that will be part of a field manual for sustainable effectiveness in health care.

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