Cleveland Clinic’s recent defense of its “journey” through mediocre hospital safety grades to local Hospital District trustees must have struck some as painfully reminiscent of the explanation a parent might get from a teenager at a sit-down about lackluster school marks.
The meeting – at which Cleveland Clinic officials offered a variety of excuses while at the same time arguing the highly respected Leapfrog grades did not fairly reflect its performance and that another grading process was better – seemed to satisfy some trustees, but left others unsettled.
The discussion of the safety grades followed publication of the Nov. 21 issue of Vero Beach 32963, which presented a head-to-head comparison of the performance of Cleveland Clinic Florida’s five hospitals – which include Indian River – against Orlando Health’s seven adult general hospitals in Florida.
The comparison was relevant because Orlando Health has just purchased our county’s other hospital, Sebastian River Medical Center, from bankrupt Steward Health.
The Sebastian River Hospital – which under its new ownership presumably will become a more viable competitor for local patients with Cleveland Clinic Indian River – obviously wasn’t included in the latest Orlando Health group measurement, even though it maintained its solid B grade even under the ownership of its bankrupt parent.
But the news in the story being discussed was that six out of seven of the hospitals owned by Orlando Health – including its “mothership” in Orlando – scored the top A grade in the most recent period, with one hospital scoring a B.
By comparison, Cleveland Clinic’s lauded Florida “mothership,” the hospital in Weston, earned the same C grade it has had the past two years. Cleveland’s Tradition, Martin North and Martin South hospitals also got a C. Cleveland Clinic Indian River Hospital scored the best of the Cleveland brand hospitals in Florida with a B in the most recent ratings.
Dr. Sonya Pease, Cleveland Clinic Florida Chief Quality Safety and Patient Experience Officer, was deputed to defend Cleveland Clinic’s performance in addressing the Indian River Hospital District trustees on Nov. 21, and she urged them to look beyond the Leapfrog grades.
Pease discounted Leapfrog’s heavy reliance on official federal government data collected via the Centers for Medicare and Medicaid Services as limited in scope, even though a full 70 percent of Cleveland Clinic Indian River Hospital’s revenue is derived from Medicare and Medicaid reimbursements.
She held out a company called Vizient as having much more reliable and timely data, but she brought no Vizient data with her, nor provided anything clearly labeled as Vizient data as backup documentation for the meeting.
Vizient is a paid membership organization of hospitals that collects reports directly from hospitals, then compares that data to other facilities and offers the data back to member hospitals in usable forms for management purposes.
Vizient data is not available to the public, or to the media.
Two weeks ago, Vero Beach 32963 requested the most recent two years of the private Vizient hospital safety and performance data from Cleveland Clinic and still eagerly awaits receipt of those documents.
Pease said the Indian River Hospital Leapfrog safety grade especially was dragged down by the conversion of the hospital to the many Cleveland corporate systems, from record-keeping to what patients will remember as an extremely frustrating rollout of Cleveland’s centralized phone system and patient records portal.
“The reporting period reflected in this Leapfrog report actually hit us in the Florida region especially at Indian River, during the time period that we were integrating our electronic medical record (EMR), our EPIC system and it’s very tumultuous for your caregivers as well your patients to have to have everything transition over from one EMR to another, so that period that was reported in there, that was what was occurring in the Florida region.”
Pease also said Cleveland Clinic’s Florida hospitals have implemented a new safety event reporting system which holds great promise.
“It’s something that was not available to our Treasure Coast hospitals before Cleveland Clinic came in,” Pease said. “And so what we’ve seen over the last year is an increase in that safety event reporting, but what we’ve also seen is an actual decrease in actual amount of harm reaching our patients.”
The Leapfrog system, Pease said, looks at the safety reporting ratio of how many safety concerns are lodged and “not necessarily did we harm the patient on the backside of things.”
“I’m very comfortable with the fact that we’re continually driving a safe culture and less harm is actually reaching our patients,” Pease said.
But how much hands-on time does Pease, who is not based in Vero Beach, actually spend at the local hospital?
Cleveland Clinic spokesperson Raquel Rivas said Pease, an anesthesiologist, “has been working at Martin Health (in Stuart) for 16 years. When Cleveland Clinic integrated Indian River Hospital and Martin Health five years ago, she took on the quality, safety, patient experience role.”
When we asked Rivas how many times per month or per quarter Pease spends on the ground at Indian River Hospital (hospital employees have told us her visits are infrequent), she did not offer any quantitative response.
When asked if Pease attends the Mortality and Morbidity (M&M) conferences at Cleveland Clinic Indian River Hospital in-person to review mistakes made, or if Cleveland Clinic Indian River Hospital even conducts M&M conferences (employees tell us it does not conduct M&Ms in Vero), that question went unanswered as of press time.
Vero Beach 32963 also requested the name of the local Cleveland Clinic physician or staffer based in Vero who is responsible for patient safety and infection control. No name of an accountable person was given.
“There is a team of clinicians at Indian River Hospital dedicated to safety and infection control. Dr. Pease meets with them regularly both virtually and in person,” Rivas said.
Though District Trustees Paul Westcott, Dr. Bill Cooney and Board Treasurer Michael Kint seemed inclined to hold Cleveland Clinic’s feet to the fire on the Leapfrog patient safety data, one district trustee, Karen Deigl, seemed quite dismissive of the Leapfrog data and sympathetic to Pease.
“It sounds like Leapfrog is certainly not one we would want to look at,” Deigl said.
It’s not surprising that Pease holds little faith in the Leapfrog scores, or at least seeks to detract from their importance. On her watch at Cleveland Clinic Martin Health, the Cleveland Clinic Martin North and Martin South hospitals where Pease is headquartered went from a B grade, down to four consecutive C grades and then to a dismal D in the Fall 2023 Leapfrog Safety Grades, under her direct leadership and supervision.
Finally, apparently seeing that Pease had not been entirely convincing, Dr. Richard Rothman, Cleveland Clinic Indian River vice president and chief medical officer, stepped up and attempted to present a compelling closing argument.
“Look, we’re on a journey,” he said. “And our journey started in 2019. That journey was interrupted by the pandemic. However, the journey to integrate into the Cleveland Clinic is continuing.”
Seeking to turn attention away from the unimpressive collective performance of Cleveland Clinic’s Florida hospitals – which many found pretty unexpected and concerning – Rothman said he was pleased to see key indicators improving locally in Vero. Rothman said he appreciated the hospital district trustees’ interest in patient safety, as well as their partnership with the hospital.
Rothman said the soonest local hospital officials expect to once again get the Vero hospital back to the Leapfrog A grade it celebrated briefly a year ago is the Spring of 2026.
But he added: “We’re committed to continue to improve quality scores and really meet the demands of both the raters, the rankers and to improve outcomes for the patients in our community.”
What do the patients say? Results of an exit poll of sorts Vero hospital’s leader sent to the hospital district shows that only 6 in 10 Cleveland Clinic Indian River Hospital patients surveyed in 2024 would recommend the hospital.
Most local business owners – knowing four disgruntled customers typically talk a whole lot louder in the community than the six happy ones – would be quite concerned about that metric.
But Rothman, taking the upward-trending data as a whole, told the hospital district in a memo that “Community feedback has been overwhelmingly positive.”
