Cleveland Clinic

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Cleveland Clinic logo.png
Cleveland Clinic Miller Family Pavilion.jpg
Geography
Location 9500 Euclid Avenue, Cleveland, Ohio 44195, United States
Organization
Care system Private
Hospital type Academic
Affiliated university Case Western Reserve University School of Medicine Cleveland Clinic Lerner College of Medicine
Services
Beds 1440
History
Founded 1921
Links
Website www.clevelandclinic.org
Lists Hospitals in the United States

The Cleveland Clinic is a multispecialty academic hospital located in Cleveland, Ohio that is owned and operated by the Cleveland Clinic Foundation, an Ohio nonprofit corporation established in 1921.[1] In addition to their flagship hospital in Cleveland, Cleveland Clinic also operates affiliated facilities in Florida, Nevada, Canada, and Abu Dhabi.

History

Early beginnings

Cleveland Clinic grew out of the surgical practice of Frank J. Weed, MD, at 16 Church Street on the near west side of Cleveland.[2] Dr. Weed died in 1891.[3] The practice was purchased by his two assistants, Frank E. Bunts, MD, and George Washington Crile, MD. In 1892, they brought Dr. Crile’s cousin, William E. Lower, MD, into the practice.[4] In 1897, they moved their practice to the Osborn Building on Prospect Avenue in downtown Cleveland.[2][5] Crile, Lower and Bunts all became professors at Cleveland medical schools, and each would be elected president of the Academy of Medicine.[6]

Dr. Crile organized the American military hospital in Paris in 1915, and later led the United States Army Base Hospital No. 4, in Rouen, France. It was the first contingent of the United States Army to see active duty in Europe during the First World War.[7][8] Dr. Bunts and Dr. Lower also served in the Rouen hospital. Dr. Lower later wrote of his admiration for the "teamwork and efficient organization" of military medicine.[9] In his autobiography, Dr. Crile reports that while in France, the three doctors discussed starting a new medical center in Cleveland upon their return.[8][10]

First years of operation
Cleveland Clinic's original building, built in 1921

A four-story outpatient building was constructed on the purchased land. Cleveland Clinic was dedicated at a private ceremony on February 26, 1921.[11] William Benson Mayo, MD, of the Mayo Clinic, delivered the main address.[10][12] On February 28, 1921, Cleveland Clinic opened its doors to the public and registered 42 patients.[6] In April 1921, Cleveland Clinic had 60 employees, including 14 physicians, four nurses, a telephone operator, six cleaners, 22 clerical workers, an art department, and an unknown number of laboratory technicians. In 1922, the founders purchased four private homes nearby for hospitalization, radiation treatment, and administration.[13] A fifth house was acquired as a residence for patients with diabetes receiving insulin treatments.[13][14] To meet rising patient volume, a 184-bed hospital was built in 1924, located at East 90th Street and Carnegie Avenue.[15] A power plant, laundry, and ice plant were also built.[13][16] A research laboratory was constructed in 1928.[13][17]

Disaster and recovery
George Washington Crile, MD, one of the four founders of Cleveland Clinic

On May 15, 1929, nitrocellulose x-ray films stored in the basement of the outpatient building ignited.[18][19][20] An explosion sent a cloud of toxic oxides of nitrogen and carbon though the building. One hundred and twenty-three people lost their lives, including founder Dr. Phillips. A dozen investigating agencies were not able to determine a single cause for the Cleveland Clinic fire of 1929.[19] Cleveland Clinic’s own inquiry narrowed the possible causes down to three: spontaneous combustion caused by heat; a discarded cigarette or match; contact with an extension cord light hung over a stack of films.[19]

Philanthropist Samuel Mather formed a committee of 36 community leaders to help Cleveland Clinic reestablish itself in temporary quarters across the street.[19][21][22] Patient care services resumed five days later.[21] The 1921 building was completely renovated, and a new three story clinic building, with a new main entrance, was added in 1931.[19] All debts were repaid by 1941.[23]

Dr. Crile and Dr. Lower relinquished their administrative duties in 1941.[16] In 1942, Cleveland Clinic’s Naval Reserve Unit, which included George Crile, Jr., MD, son of one of the founders, established a mobile hospital in New Zealand to treat wounded from the Guadalcanal Campaign.[24]

Growth of specialization

Cine-coronary angiography was developed at Cleveland Clinic by F. Mason Sones, MD, in the late 1950s.[25]

In 1954, Cleveland Clinic formally adopted governance by a physician-led Board of Governors. The nine physician governors are elected by the physician staff. They work with the CEO and lay administrators to formulate and carry out policy, overseen by a board of directors and board of trustees.[23][26][n 1]

Cleveland Clinic built new operating rooms in the early 1970s to accommodate the growth of cardiac surgery.[16] The Martha Holding Jennings Education Building opened in 1964, with an auditorium named for Dr. Bunts. A new hospital building (currently home to Cleveland Clinic Children’s) was opened in 1966, and a new research building went up in 1974 (demolished in 2007).[16] A pathology and laboratory medicine building was constructed on Carnegie Avenue in 1980.[28]

Dr. Kiser led the development of a strategic plan to accommodate growing patient volumes in the late 1970s. This resulted in a group of buildings known as the Century Project. Completed in 1985, the Century Project including a 14-story outpatient building (now known as the Crile Building), designed by architect Cesar Pelli,.[29] Until 2007 Cleveland Clinic's largest organizational unit was the division, with the hierarchy division > department > section.[n 2] In 2007 it reorganized patient-care services around disease and organ-system-based institutes.[28][30][31]

Research

The Cleveland Clinic Lerner Research Institute had an annual research expenditure of approximately $250 million in 2008. The Cleveland Clinic Lerner College of Medicine of Case Western Reserve University opened in 2004. Cleveland Clinic’s graduate medical education program is one of the largest in the country.[32]

Reputation

Cleveland Clinic has a mixed reputation. It is nationally recognized as one of the top medical centers in the US and the world, particularly in technological and management systems[33] and in the treatment of cardiovascular disease.[32][34][35] For high acuity conditions requiring special expertise or the latest technology, it is nationally ranked by U.S. News & World Report (USNWR) in 14 adult and 10 pediatric specialities in the US as follows:[35][n 3]

Specialty National ranking
Cancer 13
Cardiology and CT surgery 1
Diabetes and endocrinology 2
Ear, nose and throat 6
Gastroenterology and GI surgery 2
Geriatrics 9
Gynecology 3
Nephrology 2
Neurology and neurosurgery 6
Ophthalmology 7
Orthopedics 3
Pulmonology 3
Rheumatology 2
Urology 1

The USNWR ratings stand in contrast to rankings in models which feature a safety emphasis. In a Kaiser Family Foundation review of Centers for Medicare and Medicaid Services (CMS) data for hospital acquired conditions the Cleveland Clinic received a 8.7 score (1-10 possible, with 10 being the worst), in the bottom 7% of hospitals.[39] Consumer Reports rated the Cleveland Clinic 98th among 105 rated hospitals in the State of Ohio for overall safety, with a score of 39 out of 100 possible points; nationwide, the top 10 hospitals in this survey received scores of 68 to 72, and the bottom 10 hospitals received scores of 16-25.[40] Leapfrog Group ranked Cleveland Clinic as one of 121 hospitals (of a total of 2618) with a "barely passing" D rating for safety (25 hospitals had F scores), which Leapfrog sees as among the "most hazardous environments for patients in need of care."[41] The different emphasis and specific methodology for the USNWR and for the other ranking systems explains why teaching hospitals collectively score prominently on one system but rarely feature highly on others.[36]

Patient Drop-off area at Miller Family Pavilion

Between 2010 and 2013, the CMS undertook an extensive series of ongoing separate investigations of CCF with at least a dozen inspections and follow-up visits triggered by patient complaints.[42][43] An analysis of Medicare inspection data between 2011 and 2014 found that CCF was one of at least 230 instances where validated serious incidents—dubbed “immediate jeopardy” complaints— led CMS to threaten loss of ability to serve Medicare patients unless the problems were fixed immediately.[42] Due to numerous serious ongoing safety violations, CCF was on payment termination track for a period of 19 months, placing at stake $1B in annual Medicare/Medicaid reimbursement.[42] The citations were reported and analyzed in detail by Modern Healthcare, which posted some of the safety documents.[42][43]

Locations

Cleveland Clinic Lerner Research Institute
Cleveland Clinic Taussig Cancer Institute

Cleveland Clinic's main campus consists of 41 buildings on 160 acres (65 ha) near University Circle, in Fairfax, Cleveland.[44] Cleveland Clinic operates 18 [45][46] family health and ambulatory surgery centers in surrounding communities, a multispecialty hospital and family health center in Weston, Florida, an outpatient clinic in Toronto, Ontario.[47]

The Cleveland Clinic operates eleven northeast Ohio hospitals and has affiliates in Florida, Nevada, Canada and Abu Dhabi:

In August, 2015, the Akron General Health System in Akron, Ohio joined the Cleveland Clinic system. Akron General includes Akron General Hospital,Visiting Nurse Service and Affiliates, Hospice of VNS, Lodi Community Hospital, Edwin Shaw Rehabilitation Institute, and three health and wellness centers.[49]

Finances

According to data analyzed by American Hospital Directory, annual gross total patient revenues of $9.14 billion were the second largest in the US in 2011.[50]

See also

Notes

  1. ↑ This is a list of the chairman of the Board of Governors, and their terms of office:
    • Fay Lefevre, MD, 1954-1968
    • Carle E. Wasmuth, MD, 1968-1973
    • William S. Kiser, MD, 1973-1989
    • Floyd D. Loop, MD, 1989-2004
    • Delos M. Cosgrove, MD, 2004–present.[16][27]
  2. ↑ There was a Division of Medicine, Division of Surgery, Division of Anesthesiology, etc.[28] Within each division were departments (Department of Infectious Disease, Department of Cell Biology, etc.).[28] Within each department were sections, (Section of Headache and Facial Pain, Section of Metastatic Disease, etc.). Divisions and departments were led by chairs, and section were led by heads.[28]
  3. ↑ This is based on a statistical model that utilizes factors such as admission numbers and visit volumes, reputational perception by peers, the availability of special equipment,[36][37] and the campus availability of numerous high acuity specialties.[38]

References

  1. ↑ Mission Vision and Values Cleveland Clinic. [1]. Accessed 05/17/2015.
  2. ↑ 2.0 2.1 Journal of Postgraduate Medical Education, The Life and Times of George Washington Crile, RA Kazi, 2003, Volume, 49 , Issue 3, pp. 289-290. Retrieved from http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=3;spage=289;epage=290;aulast=Kazi, August 25, 2015
  3. ↑ Shock, Physiological Surgery and George Crile, Peter C. English, Greenwood Press, 1980, p. 62
  4. ↑ The history of urology in Cleveland, Ohio, KP Sajadi and HB, Goldman, Urology. 2010 Dec;76(6):1293-7. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20810152, August 25, 2015
  5. ↑ Retrieved from http://www.whonamedit.com/doctor.cfm/1959.html, August 25, 2015
  6. ↑ 6.0 6.1 Creating Cleveland Clinicby Brad Clifton and Jessica Carmosino, retrieved from http://clevelandhistorical.org/items/show/603, on August 29, 2015
  7. ↑ The Lakeside Unit: Cleveland Medicine in World War Ihttp://lakesideunit.com, retrieved August 29, 2015
  8. ↑ 8.0 8.1 George Crile, George Crile, An Autobiography, edited by Grace Crile, 2 Vol. (Philadelphia and New York: Lippincott, 1947),274-80.
  9. ↑ Surgery, Subspecialization and Science: A History of Urology at the Cleveland Clinic, 1921-2000, Mark D. Bowles and Virginia P. Dawson, Cleveland Clinic Foundation, History Enterprises, Inc., 2000, p. 19
  10. ↑ 10.0 10.1 Hospital Built Upon Service, Milwaukee Journal, May 16, 1929, page 2. Retrieved from https://news.google.com/newspapers?nid=1499&dat=19290516&id=H5pQAAAAIBAJ&sjid=wCEEAAAAIBAJ&pg=5944,1367390&hl=en, on August 26, 2015
  11. ↑ Retrieved from http://blog.cleveland.com/medical/2008/09/07CGCLINICTIME.pdf, August 26, 2015
  12. ↑ The Emergence of the Egaltarian OrganizationHuman Relations August 1986 vol. 39 no. 8 683-724
  13. ↑ 13.0 13.1 13.2 13.3 The Cleveland Clinic Foundation, by Amy Rowland, William Feather, 1938
  14. ↑ Ohio Memory, Madeleine Bebout and the Nurses at Oxley Homes Photograph, caption. Retrieved from https://server16007.contentdm.oclc.org/cdm4/item_viewer.php?CISOROOT=/p267401coll36&CISOPTR=14140&CISOBOX=1&REC=2, on August 26, 2015
  15. ↑ Encyclopedia of Cleveland History, http://ech.cwru.edu/ech-cgi/article.pl?id=CCF1, accessed August 25, 2015
  16. ↑ 16.0 16.1 16.2 16.3 16.4 Pathfinders of the Heart, the History of Cardiology at Cleveland Clinic, William C. Sheldon, Xlibris, 2008, p.60
  17. ↑ Cleveland: The Making of a City, William Ganson Rose, 1950, Kent State University Press, p.1011
  18. ↑ The Repository (Canton)A Deadly Combo; X-ray films burn noxious fumes at Cleveland Clinic, July 14, 2014
  19. ↑ 19.0 19.1 19.2 19.3 19.4 They Died Crawling: And other Tales of Cleveland Woe, John Stark Bellamy III, Gray & Company, 1995, pp218-232
  20. ↑ Time Magazine, May 27, 1929, pp. 15-16
  21. ↑ 21.0 21.1 Plain Dealer123 Die in Clinic Disaster; Poison Gas Seeps into System; Explosion Rocks Building, August 23, 1998
  22. ↑ Reading Times, May 17, 1929, p2
  23. ↑ 23.0 23.1 Profiles in Performance: Business Intelligence Journeys and the Roadmap for Change, Howard Dresner, Wiley & Sons, 2010, p. 57
  24. ↑ The Way it Was. 1907-1987, Sex, Surgery, Treasure & Travel, George Crile, Jr., Kent State University Press, 1992, p.222
  25. ↑ Hall, Robert J. (1985). "In Memoriam: F. Mason Sones, Jr., M.D". Texas Heart Institute Journal 12 (4): 356–358. PMC 341889
  26. ↑ Specialty Care in the Era of Managed Care, John A. Kastor, MD, The Johns Hopkins University Press, 2005, p.2
  27. ↑ Med City News, The 50 Best Cleveland Clinic Doctors. Ever., December 24, 2011, retrieved from http://medcitynews.com/2011/12/the-50-best-cleveland-clinic-doctors-ever/, on September 11, 2015
  28. ↑ 28.0 28.1 28.2 28.3 28.4 Harvard Business School, Cleveland Clinic:Growth Strategy 2014, Michael Porter and Elizabeth Teisberg, December 29, 2014, pp.4-5, retrieved from , on August 26, 2015
  29. ↑ retrieved from http://pcparch.com/project/crile-clinic, on August 26, 2015
  30. ↑ Crain’s Cleveland Business, In name of streamlined care, Clinic forms 26 institutes, November 05, 2007, retrieved from http://www.crainscleveland.com/print/article/20071105/FREE/311050037/in-name-of-streamlined-care-clinic-forms-26-institutes, August 26, 2015
  31. ↑ Newsweek, What Health Reform can Learn from Cleveland Clinic, November 26, 2009, retrieved from http://www.newsweek.com/what-health-reform-can-learn-cleveland-clinic-76971, on August 26, 2015
  32. ↑ 32.0 32.1 Encyclopedia of Cleveland History: Cleveland Clinic Foundation
  33. ↑ Adler J. The Hospital That Could Cure Health Care. Newsweek. 2009
  34. ↑ Cleveland Clinic tops U.S. News list for heart care 20 years running. Cleveland Plain Dealer. July 15, 2014. [2]
  35. ↑ 35.0 35.1 Best Hospitals 2014–15. U.S. News & World Report
  36. ↑ 36.0 36.1 Lua error in package.lua at line 80: module 'strict' not found.
  37. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  38. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  39. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  40. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  41. ↑ Lua error in package.lua at line 80: module 'strict' not found.
  42. ↑ 42.0 42.1 42.2 42.3 Carlson J. Cleveland Clinic cases highlight flaws in safety oversight. Modern Healthcare. June 7, 2014. [3]
  43. ↑ 43.0 43.1 Carlson J. Selected Cleveland Clinic hospital inspection reports. Modern Healthcare. June 7, 2014. [4]
  44. ↑ Steven Litt for The Plain Dealer. January 22, 2012 Cleveland Clinic's new master plan envisions bigger, greener campus with ample room to grow for decades
  45. ↑ http://www.telegram.com/article/20151130/NEWS/151139973
  46. ↑ http://www.beckershospitalreview.com/workforce-labor-management/cleveland-clinic-to-hire-500-rns-during-3-job-fairs-6-things-to-know.html
  47. ↑ www.clevelandcliniccanada.com
  48. ↑ Bell J. Cleveland Clinic Abu Dhabi opens its doors for first patients. The National, UAE. March 17, 2015. [5]
  49. ↑ "Cleveland Clinic Exercises Option to take full Ownership of Akron General" Akron Beacon Journal, August 28, 2015, accessed at http://www.ohio.com/news/break-news/cleveland-clinic-exercises-option-to-acquire-full-ownership-of-akron-general-health-system-1.619744, on December 31, 2015.
  50. ↑ Oh J. 100 Top Grossing Hospitals in America Beckers Hospital Review. Aug 29,2011 [6]

External links

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