Steven Nissen, MD, Chairman of the Robert and Suzanne Tomsich Department of Cardiovascular Medicine at Cleveland Clinic discusses clinical effectiveness with Dr. Umesh Khot, Vice Chairman and director of the Center for Healthcare Delivery Innovation How do the factors of Quality, Operations, and Reimbursement work together to improve effectiveness and efficiency? Dr. Knot provides an example of his work with STEMI patients and how standardizing care improved door to balloon time as well as decreased patient care variability. Other examples are provided. This process has also provided opportunities for research and publications.