1. What were Dr. Cosgrove's most important goals for the Cleveland Clinic at the time he became CEO and in the years that followed? 2. What initiative did Dr. Cosgrove announce in the spring of 2007 that would fundamentally change the way the Clinic was organized and delivered services (see "Restructuring Care Delivery")? Which internal and external stakeholders were affected by the initiative, and in what ways? What do you see as the advantages and disadvantages of the initiative? 3. What is Patients First!, what did it involve, and what impact did it have on the Clinic? 4. What significant strategic and operational initiatives has the Clinic pursued (see the first few pages of the case and "Measurement,""Health System Rationalization," "Information Technology," "Payment," "Medical Education," "Avenues of Growth" and "International Expansion")? Given the types of strategic alternatives described by Ginter, Duncan and Swayne in Chapter 6 of Strategic Management of Healthcare Organizations, how would you label the various initiatives? What were the outcomes of those initiatives (i.e., success, failure or too early to know)? 5. Given the Clinic's internal (i.e., strengths and weaknesses) and external tie., opportunities and threats) circumstances in October 2004 and afterward, what do you think were the five most important strategic issues and five most important operational issues facing the Clinic? List and number the strategic and operational issues separately, beginning with the strategic issues. Following each list, provide a summary of what the issues mean for the Clinic. 6. If you were advising Dr. Cosgrove, what two strategic and two operational issues would you identify as most important, and what would you recommend that he do to address them, and why? 7. Given your review of the case, would you like to work at the Cleveland Clinic? For more information about the Cleveland Clinic, see: http://my.clevelandclinic. org "Cleveland Clinic - History" at http://www.youtube.com/watch? v=14y505y7xeA "What is the culture like at Cleveland Clinic?" http:/www.youtube.com/watch? V=LESHqCi4Fio The Cleveland Clinic Way: Lessons in Excellence from One of the World's Leading Healthcare Organizations by Toby Cosgrove, MD, McGraw-Hill Education, 2014, ISBN 978-0-07-182724-9