At Cleveland Clinic, the word employee does not exist.
Every person, in every role, is called a caregiver. The term replaces employee across the organization, and the reasoning is simple: everything a person does, whatever their job title, touches patient care and the patient experience.
The housekeeper is a caregiver. The security guard at the entrance is a caregiver. The person answering the phone at the appointment center is a caregiver.
This is not an internal communications slogan. It is a governance decision, and it reaches the very top of the organization. Cleveland Clinic was the first major academic medical center to make patient experience a strategic objective and to appoint a Chief Experience Officer. Today, the organization has an executive vice president who carries the title of Chief Caregiver Officer, and a dedicated Office of Caregiver Experience.
A C-suite title to say that everyone gives care.
What that one word actually changes
I have been walking hospital corridors for more than 33 years. As a daughter. As a family caregiver. As a mother of four. Today, as a technology partner to health systems.
When I see a process that no longer matches reality on the ground, I say so. I ask the person in front of me to report it, to tell their supervisor. The answer is almost never a word. It is a look. Polite, tired, convinced that nothing will change.
That look does not come from a lack of will. It comes from a lack of legitimacy. That person does not believe that what they observe counts as valid information for the organization.
That is exactly what one word can fix.
An employee performs a task. A caregiver is accountable for an outcome. If everything I do touches care, then what I notice in the corridor is clinical data, as meaningful as a vital sign. And if it is data, someone has to receive it.
What our hospitals measure, and what they do not
Our institutions measure many things. Wait times. Occupancy rates. Satisfaction, by survey, sent after the person has already gone home.
What no one measures is the patient journey as it is being lived.
The parking lot where you circle for fifteen minutes without knowing if a spot exists. The elevator that does not serve the floor you need. The appointment letter that names a clinic but not a location. The junction of three corridors where an elderly person has to decide alone, without reading glasses, with an appointment in eight minutes.
None of this appears on a dashboard. All of it determines whether the person arrives on time, calm, able to listen to their physician.
A new department, and a field squad to feed it
Here is what I would propose to any institution that takes this question seriously.
Create a patient experience function that reports to the CEO, not one buried under communications. Not a committee. A function with a budget, a mandate, and the authority to decide.
Then give it the one thing it will always lack otherwise: living information, arriving every week.
What if every hospital had its own field squad?
Five people. A nurse or front-line receptionist, someone from facilities, someone from IT, a member of the patient and family advisory council, and a family caregiver who has no badge and no reason to be polite about what they see. They keep their jobs. One hour a week, they walk the building the way a patient walks it, and they report to one person who has the power to say yes.
Then give them a single floor to fix. Not a master plan. One floor, one problem, one change tested in weeks rather than fiscal years. If it works, move to the next floor. If it fails, it failed on one floor, and the organization bought real knowledge at the price of a small pilot.
After three months, you are no longer guessing. You have a living list of what actually slows people down, ranked by frequency, with outcomes attached to every change you made.
The predictable objection
I will be told the system has neither the budget nor the time.
One hour a week for five people who already hold their jobs. That is the entire cost of this proposal. Compare it to an eighteen-month external study that describes a building already transformed by the time the report is filed.
I will also be told it is risky to test on patients. But a patient lost for twenty minutes before a cardiology appointment is also a risk. It is simply a risk nobody has to sign for.
Refusing to test is not prudence. It is the status quo with better public relations.
It starts with a word
I do not believe our hospitals lack competent people. I believe they lack a word that gives those people permission to speak.
Cleveland Clinic chose that word long ago, and wrote it into the titles of its most senior leadership. Every person who walks through those doors in the morning is a caregiver.
Every hospital already employs the people capable of doing this work. They are walking those corridors today. No one has asked them.
Why does Cleveland Clinic call employees caregivers? Cleveland Clinic replaced the word employee with caregiver for every role because everything each person does, from housekeeping to security, affects patient care and the patient experience. The commitment is structural: the organization has an executive-level Chief Caregiver Officer.
What is a patient experience field squad? A field squad is a five-person team proposed by Eye-In Media founder Nathalie Azoulay: a front-line clinician or receptionist, a facilities staff member, an IT staff member, a patient advisory council member, and a family caregiver. They walk the hospital one hour per week the way a patient would, and report findings to a single leader with decision-making authority.
How can hospitals measure the patient journey in real time? Most hospitals measure wait times, occupancy, and post-visit satisfaction surveys, but not the journey as it happens: parking, elevators, signage, and wayfinding decisions. Weekly field observation and digital wayfinding data close that gap at minimal cost.
