Cleveland Clinic

Early beginnings

Cleveland Clinic grew out of the surgical practice of Frank J. Weed (died 1891) at 16 Church Street on the near west side of Cleveland. The practice was purchased by his two assistants, Frank E. Bunts and George Washington Crile. In 1892 they brought Crile's cousin, William E. Lower into the practice. In 1897 they moved to the Osborn Building on Prospect Avenue in downtown Cleveland.

A four-story outpatient building was constructed and Cleveland Clinic was dedicated at a private ceremony on February 26, 1921. It opened its doors two days later to the public and registered 42 patients. In April 1921, Cleveland Clinic had 60 employees, including 14 physicians and four nurses.

In 1922 the founders purchased four private homes nearby for hospitalization, radiation treatment, and administration. A fifth house was acquired as a residence for patients with diabetes receiving insulin treatments. To meet rising patient volume, a 184-bed hospital was built in 1924, located at East 90th Street and Carnegie Avenue. A power plant, laundry, and ice plant were also built. A research laboratory was constructed in 1928.

Cleveland Clinic fire

On May 15, 1929, nitrocellulose x-ray films stored in the basement of the outpatient building ignited. 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 what had caused the fire. Cleveland Clinic's own inquiry narrowed the possible causes down to spontaneous combustion caused by heat; a discarded cigarette or match; or contact with an extension cord light hung over a stack of films.

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

Growth of specialization

Cleveland Clinic built new operating rooms in the early 1970s to accommodate the growth of cardiac surgery. 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 Hospital) was opened in 1966, and a new research building went up in 1974 (demolished in 2007). A pathology and laboratory medicine building was constructed on Carnegie Avenue in 1980.

Willian S. Kiser, chairman of the board 1973–1989, 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.

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.

Reputation

It is nationally recognized as one of the top medical centers in the US and the world, particularly in technological and management systems and in the treatment of cardiovascular disease. For high acuity conditions requiring special expertise or the latest technology, it is ranked as the #2 hospital by U.S. News & World Report (USNWR), with individual rankings in 14 of the 16 specialties as follows:

The U.S. News & World Report 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 in 2014, the Cleveland Clinic received a 8.7 score (1–10 possible, with 10 being the worst), in the bottom 7% of hospitals. In 2012 Consumer Reports rated the Cleveland Clinic 98th among 105 rated hospitals in the State of Ohio for overall safety. In 2015 the rating was 60th among 161 hospitals, with a score of 49 out of 100 possible points. (Nationwide, the top and bottom scores were 79 and 21.)

Leapfrog Group ranked Cleveland Clinic in 2012 as one of 121 hospitals (out of 2,618) with a "barely passing" D rating for safety (25 hospitals had F scores), which Leapfrog described as among the "most hazardous environments for patients in need of care." The different emphases and methodologies of the U.S. News & World Report and other ranking systems explains why teaching hospitals collectively score prominently on one system but rarely feature highly on others.

Between 2010 and 2013, the CMS undertook an extensive series of investigations into the Cleveland Clinic Foundation, with at least a dozen inspections and follow-up visits triggered by patient complaints. An analysis of Medicare inspection data between 2011 and 2014 found that the Cleveland Clinic Foundation 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. Due to numerous serious ongoing safety violations, the Cleveland Clinic Foundation was on payment termination track for 19 months, placing at stake $1B in annual Medicare/Medicaid reimbursement. The citations were reported and analyzed in detail by Modern Healthcare, which posted some of the safety documents.

Locations

Cleveland Clinic's main campus consists of 41 buildings on 160 acres near University Circle, in Fairfax, Cleveland. Cleveland Clinic operates 18 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.

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.

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.