This month, HealthCare Business News spoke with Dr. Ed Sabanegh, president of the Main Campus and Regional Hospital System for Cleveland Clinic, to learn about his background and what the organization is focusing on in these unprecedented times.

HCB News: Who or what inspired you to follow a career in healthcare?
Dr. Ed Sabanegh: I have long believed that working in healthcare is a calling. No one in my family had any medical background. Along the way in high school and early college, I became fascinated with the privilege to help people, seeing medicine as a crossroad between science and humanity. I was a science-focused engineering student, but I loved the humanity aspects of medicine. I started volunteering as an orderly in college at our local hospital. I saw people at their most vulnerable, and I was very attracted to the concept that you could apply science to improve someone’s life.

HCB News: What was the career path that led to being the president of Cleveland Clinic’s main campus hospital?
ES: I was in the air force for 21 years. I started as a urologic surgeon with a busy clinical practice. During my time in the air force, I moved through the leadership structure and was privileged to lead large medical teams culminating as the chief operating officer of the largest Air Force hospital. I think the key fundamental for the start of my journey was to work hard to become a good clinician. Learn the skills of your field. As you progress into leadership, learn how to listen and communicate with people and understand their needs.

After serving in the Air Force, I was chosen to be department chair of urology at Cleveland Clinic. I had the fantastic fortune to work with a great team, and together we built a department that moved to the top of the national rankings. Together we worked to develop clinical service lines, and manage financials of an organization. I was then offered the opportunity to lead our hospital and ambulatory system here in Ohio encompassing 12 hospitals and almost 200 outpatient locations with over 52,000 caregivers. It has been a terrific journey and I continue to learn new things every day.

HCB News: Do you feel your military experience and its regimented structure has benefited you in the hospital setting?
ES: While many think of the military as an environment where direct orders are required, in the vast majority of situations, it is the same leadership style that you need to be successful in civilian settings. That involves working well with teams, understanding how to listen, how to communicate a vision, how to set strategic course with a group, and how to inspire them. All of those are skills that parlay well into successful leadership in civilian healthcare.

HCB News: What attracted you to Cleveland Clinic?
ES: I think the purity of the mission. The Cleveland Clinic was founded by four clinicians almost 100 years ago. Three of the four founders came out of the same army medical unit in WWI. They valued teamwork and wanted to create an experience where medical experts came together as a unified group. That was embodied in the phrase, “to act as a unit.” What you find at the Cleveland Clinic is that we have three integrated missions. First and foremost is striving for clinical excellence. Second is innovation (research and changing the face of medicine). The third is teaching the next generation. I was inspired by those missions and their amazing legacy. For example, many of today’s commonplace procedures were pioneered at Cleveland Clinic including kidney dialysis and cardiac angioplasty to name a few. It’s a place that continues to be innovative and puts the patient first.

HCB News: Other than being continually ranked as one of the top hospitals in the nation for a number of procedures and specialties, what else sets Cleveland Clinic apart?
ES: Cleveland Clinic continues to have a laser-focus on the patient. There is early recognition in all of our experiences here that the patient is the center of our universe. We were an early system to look at patient experience and to work to improve it.

We also clearly recognize the value of the team in delivering healthcare. Every one of the 52,000 folks who work at Cleveland Clinic are called caregivers. It doesn’t matter if you’re a nurse, doctor, environmental services, administrator, revenue cycle staff or any other employee — we’re all caregivers and play a role in making sure the patient has the best possible experience.

It also goes back to the founders’ vision of medical professionals working together as a team. Cleveland Clinic was built as a clinically integrated system, led by physicians, and doesn’t have some of the silos that you may perhaps observe in other places.

HCB News: What goals do you personally strive for as president of the main campus and regional hospitals?
ES: For me, it’s fairly simple. I want it to be where I want to get care for myself or my family. I want to have no question when I come in the door at any of our facilities that I am going to get the best care. My experience and outcome should be the same whether I go to a facility on the east side of town, or a two-hour drive south. Toward that end, we have worked to standardize our care across our enterprise, culminating in over 90% of our facilities earning a leapfrog “A” safety rating.

The second thing for me is the need to make a big place feel small. We’re a very large network of hospitals, but it is really important that when you come in, you feel like you’re in your family doctor’s office. You should expect that we know your name, and why you are here. We should demonstrate how much we care in everything we do. Bottom line: we need to treat you like you are in our own family.

HCB News: What attracts staff to Cleveland Clinic?
ES: We strive to “keep the main thing — the main thing.” In other words, our focus is on safety and quality. Every leadership team meeting starts with a discussion about how we’re doing on quality and safety. While financials will always be important in healthcare, if you don’t focus on quality, safety and experience right, you will not do well as a system. I think this is the “secret sauce” that attracts the best in the nation and the world to join us.

HCB News: What is the makeup of patients at Cleveland Clinic?
ES: We are the largest outpatient Medicaid provider in the state and second largest inpatient provider in the state. We are a not-for-profit organization and we’re privileged to take care of all different populations. Managed care and commercial makes up about one-third of our patients. Medicare and Medicaid account for almost two-thirds of our patients.

We take care of all patients from birth up through our geriatric population. Roughly 30 percent of our patients are over 65. Our patients come from all 50 states and throughout the world.

HCB News: Has there been any increase in a particular disease or diseases in recent years among patients that you’re particularly concerned about?
ES: There are two. Behavioral health is the most concerning to me. For the past number of years, we’ve seen accelerating growth in those needs. We’re seeing widespread increases in our state in alcohol and substance abuse paired with reduced access nationwide in community mental health walk-in clinics. Behavioral health needs to stay at the forefront of our thoughts and plans for the future. It is a common element in many chronic diseases.

The second is chronic diseases. We continue to see an increase in the incidence of high blood pressure, obesity, and cardiac disease in our community. These will remain a major focus for us.

HCB News: How do you predict healthcare may change due to the lessons learned during the pandemic?
ES: It’s important we preserve the things we cannot compromise on — the focus on safety, quality and experience. We also need to keep care affordable and remember to take great care of our caregivers.

With regard to what needs to change going forward, we need to work relentlessly to keep care at home wherever possible. In every service that we have, one of the questions we need to ask is whether it needs to be done in the facility or can it be taken care of in an outpatient setting? So many things that we do today were not believed to be possible to perform at home as recently as a few years ago. We must accelerate the efforts to keep our patients where they are most comfortable — at home with their families.

We also need to learn to work in new ways. This is evolving, with things like the workforce at home. We need to continue to learn how to stay connected as a team in this new world. All of these things are growing in importance as we adapt to this hybrid of inpatient, outpatient, and home healthcare.

HCB News: Cleveland Clinic is recognized not only as a leader in healthcare, but in environmental stewardship as well. Can you detail some of the work done as far as environmental impact?
ES: We’ve worked hard during the last decade to achieve that recognition. Our operations team is extremely focused on improving the efficiency of our facilities. We’ve reduced energy intensity by 22 percent despite growth over the last nine years. We’ve reduced our carbon footprint in the same period by 30 percent. We’ve built six million square feet of LEED-certified buildings. We’ve improved our recycling to where over one-third of our refuse is recycled.

As we design new facilities, we’re taking progressive approaches. We’re incorporating more natural lighting and we’re increasing the flexibility of how a space can be used. So as we design inpatient space, we intentionally design with the ability to convert to outpatient space with minimal changes required. It allows us to avoid renovations.

HCB News: Are there any recent developments or plans that you’d like to talk about?
ES: We remain focused during this period on growing our understanding of COVID-19. In the past four months, we have published almost 120 publications related to different therapies and ways to approach treating this disease.

We’re also expanding virtual care in ways that were never possible before. Two months ago, almost 75 percent of our outpatient interactions were virtual. We have created navigators to assist with the virtual experience. We have educated our patients and providers on how we can provide value and quality care through a virtual network.

Finally, we have made extensive efforts to extend outreach to our communities. Whether through testing programs or community-based primary care, we’ve worked to take our care to our patients where they live.