INTRODUCTION
In the summer of 2007, Delos M Cosgrove, CEO of Cleveland Clinic, wrote a letterto the Clinic community.Itread, in part: Here at Cleveland Clinic, we’ve always positioned quality in terms of outcomes. But I have come to understand that there is more to quality healthcare than great outcomes. . .The patient experience encompasses many aspects of care, from the physical environment to the emotional. It is about having rooms that are clean. It is about having people who smile and greet patients at every corner of the hospital. It is about communication and the expression of care and concern at times when they are most needed. Sometimes we forget that patients feel cold in the operating room and could use a warm blanket. Or we forget that they might be hungry at a time when no food is being served. We can no longer do that. We must be aware of patients’ needs from the very moment they entrust us with their care. Everything we do must communicate competence, compassion and caring. The impetus for this shift in purpose had come nearly a year before during Cosgrove’s visit to the Harvard Business School (an experience that was subsequently outlined in a Harvard case study). There, a student described how her father had decided not to seek heart surgery at the Cleveland Clinic, instead opting for the Mayo Clinic, despite the former’s superior overall patient outcomes. The reason? A perceived lack of empathy at the Cleveland Clinic. Her question proved pivotal for Cosgrove: ‘‘What are you doing to teach your doctors empathy?’’ That interaction set Cosgrove on a path toward improving the empathy and compassion with which the organization carried out its work and the level of satisfaction patients derived from their experience. The effort was an unequivocal success. Based on data available from the federal Centers for Medicare and Medicaid Services, between 2007 and 2011 the overall satisfaction reported by the Clinic’s patients improved by fifteen percentage points, an increase of more than three times the national average over the same time period. Even more impressive, patient perceptions of their interactions with care providers increased at nearly five times the national rate for nurses, and more than eleven times the national rate for doctors. The purpose of the present article is to offer a framework forthinking aboutthe role ofleaderlanguage in organizational coordination and performance. Our framework suggests that Cosgrove’s communication to the Cleveland Clinic community likely accomplished much more than merely to convey the new shift in focus. To be sure, Cleveland Clinic’s path to improvement was filled with a variety of programs and initiatives. Our research suggeststhattheir effectiveness was, in part, dependent on the actual language used by leaders to communicate about the ultimate purpose of those efforts. The key is not simply to communicate a meaningful purpose, butratherto do so in a way that creates a shared interpretation ofthat purpose across people in the organization. Before discussing the details of this process, we will first briefly examine the role of meaning-making in management and organizations today.