Taking the "jobs no one else wants"

Cleveland Clinic's CEO discusses his career climb, management philosophy at Grand Rounds

From his beginnings as a medical student, Dr. Tomislav Mihaljevic always looked for new opportunity and experiences in unlikely places - a habit that eventually led him to capture the CEO role at the prestigious Cleveland Clinic. Extending far beyond Cleveland, Ohio, the Cleveland Clinic's national and global presence includes regional hospitals, health centers and international facilities in Toronto, London and Abu Dhabi - located in the United Arab Emirates. In his own words, he found purpose and professional advancement in taking 'the jobs no one else wanted'.

In January, Mihaljevic spoke at NIH about his career path, mentors, eventual move from the operating room into management and his principles for expanding a well-regarded medical brand into a global powerhouse - all while maintaining optimal patient care along with professional regard for caregivers of all types employed in all locations.

Starting as a medical student in Croatia, moving to Switzerland, and then to the U.S., - first at Brigham and Women's Hospital in Boston - he next arrived at the Cleveland Clinic where he saw an opportunity in robotic heart surgery.  It was a relatively new field at the time that few others were interested in pursuing, but Mihaljevic took the challenge and built a department that would in time become the world's largest and most successful robotic heart surgery program.

Not wanting to remain too long in a specialty he helped advance, he sought and secured the opportunity to oversee the planning and opening of the Cleveland Clinic's new hospital in Abu Dhabi. This new facility of four million square feet houses an internationally recruited staff of 5,500 and features education and research divisions in addition to world-class patient treatment.

When the Cleveland Clinic's top spot became available, Mihaljevic applied for and accepted the ultimate challenge of running the entire organization.

The focus for Mihaljevic is managing a large medical facility that centers on the foundational principles of care for patients, respect for individual employees and the organization as a whole and concern for the immediate communities where every facility is located. Beyond that, all special and routine decisions are based on the goals of being the best healthcare organization for patients and the best organization in healthcare to work for. Mihaljevic summarized his management priorities in three parts:

Setting goals based on a collective vision for the future

Gathering a team of leaders across the organization, Mihajevic and his team examined current operating principles, looking for changes where a need was identified. "We needed to describe what we stand for, what our jobs are and our collective vision for the future," he stated. One such area was the concept of event or visit-based care becoming longitudinal patient care across a lifetime, aided by increased use of digital technology.

Continually enhancing quality care and patient safety across all sites

Translating general goals into specific activities, each day across all Cleveland Clinic sites, 15 minute meetings, also known as huddles, are held to report on activities and statistics, call attention to existing problems and spot potential problems. In addition, "leadership rounds" add those in leadership roles to medical rounds to observe daily operations first-hand.

Offering research and training opportunities for young professionals and established leaders

Along with optimal patient care, research and educational activities remain part of the Cleveland Clinic's mission. For students, there's medical, nursing and dental training, (in partnership with Case Western University) and a leadership training program for certain established employees bring along a new group of future leaders.

"We at the Cleveland Clinic, and from what I see here at NIH, believe in a sense of collegiality and togetherness. It's of fundamental importance to the work that we both do."

- Robert Burleson