Talk:Cleveland Clinic/Archive 1

Respected Doctors
I added a few resprected doctors that I am aware of. However, I'm sure there are more at a hospital as large as the Clinic. If anyone knows of more, feel free to add. 69.40.240.140 23:52, 8 January 2007 (UTC)

Trauma center question
Can anyone confirm that the Cleveland Clinic's Emergency Department is a Level-II trauma center, as it says in the article? As far as I know, the ER at the Main Campus is not accredited as a trauma center. The only trauma centers in the Clinic system are Huron Hospital, Hillcrest Hospital and Fairview Hospital.
 * I'll look... Spencer  T♦C 00:05, 21 April 2008 (UTC)

Facts and Figures
This article may need a bit of a cleanup. It has figures without citation ($2.7 billion endowment...where did this number come from?) and broken links among the references, including my favorite reference #5: "Story Not Found". No kidding.

Does this deserve the cleanup tag, or can someone who is familiar with the Clinic address some of the issues with the article?

User:Saerko —Preceding undated comment was added at 15:01, 8 January 2009 (UTC).

Departed Faculty
It is notable that three top-level heart researchers have recently been let go from this well-respected research institution. The article currently reads as a puff piece without any depth of information. I tried very hard to make the addition from a neutral point of view but would welcome suggestions on holding the article to the highest standard of neutrality. Chicagolive (talk) 15:35, 6 August 2009 (UTC)

Affiliation with Case Western Reserve University
We need to clarify what is meant by affiliation. Case Western's teaching hospital is Case Western University Hospital, the Cleveland Clinic's largest local competitor. The connection between the university and the Cleveland Clinic is that medical students can rotate at the hospital. 2,3-DPG (talk) 21:14, 13 February 2010 (UTC)

LeBron James
I think all cleveland sports players go to the Cleveland Clinic. LeBron, to me, would only be notable if he came back to the Clinic now that he's no longer playing in cleveland. Dizzizz (talk) 04:00, 28 October 2010 (UTC)
 * I agree. Furthermore, I do not believe notables being treated at any hospital is merits any distinction for the hospital.

Historical Information
I think the article should be expanded in order to allow more of the historical actions of the Cleveland Clinic, which could include pictures like this 1. Anyone agree with me?



IBHMC 01:43, 8 December 2006 (UTC)

This section ends by claiming that Cleveland Clinic "is currently the second-largest medical group practice in the world, after the Mayo Clinic." The Wikipedia article titled "Group medical practice in the United States" actually lists it as larger than Mayo Clinic, but also lists two even larger group practices in the United States, let alone what might exist in the rest of the world.

So apart from the fact that "currently" is not historical information, the statement seems to be of very questionable veracity. (It is quite possible that at one time in the past it may have been the second largest in the world.)

RayTrimble (talk) 09:18, 1 March 2010 (UTC)

I can't find a good, public/free, online, secondary source which provides the Cleveland Clinic's size rank relative to other similar organizations. I did find this from 2009 which doesn't even put Cleveland in the top 20: http://www.darkdaily.com/large-medical-groups-are-best-positioned-to-provide-integrated-care-113#axzz28Gf2Kqx5

The Grumpy Hacker (talk) 20:40, 3 October 2012 (UTC)

Notable visitors
Is there a reason why the citations for this section don't work? 2,3-DPG 21:09, 1 June 2007 (UTC)

This seems to have been renamed notable patients, and goes on to list The Prince Charles of Wales. Yet searching only reveals evidence of a 1970s visit to the hospital - i can't see anything about him attending as a patient. The citation does not suggest he received treatment, only that he visited. I haven't checked the others, but it's possible that more than one of these was a visitor, not a patient. — Preceding unsigned comment added by 75.75.4.251 (talk) 03:07, 2 July 2014 (UTC)

Why is so much content being blanked?
I will need to keep rolling back the edits that blank so much comment unless the anonymous user is better able to explain its deletion. Without an edit summary that makes sense, it appears to resemble vandalism.
 *  Bfpage &#124;leave a message 18:45, 16 May 2015 (UTC)

More Independent Sources
Cleveland Clinic “Reputation” needs some “clarification to provide readers accurate and unbiased information.
 * 1. The National Ranking Chart is based upon three references 4, 5, 6. "5" and "6" references are from US News and World Reports.  Reference “4”, a Time Magazine reference, quotes rankings from US News and World Reports.
 * 2. US News Rankings are not unbiased nor independent. Hospitals pay US News large sums to use the US News Rankings and logo.  Cleveland Clinic is one of the largest payers for licensing fees to US News for this marketing tool.
 * http://www.healthcarecommunication.com/Main/Articles/Should_hospitals_pay_to_promote_a_US_News_World_Re_10577.aspx
 * 3. The references to independent ratings (no quid pro quo payment) should be included under reputation.
 * CMS data for Hospital Acquired Conditions (HACs) gave Cleveland Clinic a score of 8.7 (1-10 possible with 10 being the worst) placing Cleveland Clinic in the bottom 7% of all hospitals.
 * Ref:          http://cdn.kaiserhealthnews.org/attachments/HACPenaltyChart.pdf
 * Leapfrog Group awarded Cleveland Clinic with the first ever “D” rating for patient safety.
 * Ref:          http://www.healthleadersmedia.com/page-1/LED-286906/Leapfrogs-New-Safety-Report-Card-Alarms-Hospitals%29
 * In August 2012, Consumer Reports rated Cleveland Clinic 98th among 105 rated hospitals in the State of Ohio for overall patient 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.
 * Ref:          http://www.leapfroggroup.org/media/file/CRHospitalSafetyRatings.pdf
 * 4. Modern Healthcare singled out Cleveland Clinic for the egregious safety violations, harm to patients, and cover-up during the CMS investigations.  The Medicare/Medicaid reimbursement termination track is not based upon a the “immediate jeopardy” violation (imposed because of six unreported operating room fires in which three patients were burned, also not reported) but on violations of Conditions and Standards repeatedly during nearly a dozen CMS Surveys.

The documents in link below are the cover letters attached to each CMS Survey Form 2567 describing the survey findings shown in the Modern Healthcare article. These cover letters are the ONLY documents of CMS issuing to the Cleveland Clinic notice of termination date of Medicare/Medicaid reimbursement.
 * Ref:          https://drive.google.com/file/d/0B6FohU_aOdk5WXEyZjBfTlJpaWs/view?usp=sharing

Patient 32 (talk) 14:21, 4 June 2015 (UTC)
 * Hello. There has been discussion among and  and me at Jytdog's talk page. As a courtesy I am signalling them here, and either they can comment or I can solicit other review for the proposals below. We had talked about how Wikipedia responds to people who have ongoing disputes off-Wikipedia with organizations and who wish to edit Wikipedia articles about that organization. I think we came to consensus that Wikipedia policy and practice is that anyone is welcome to propose changes on an article's talk page and on the talk page, content can be reviewed for its merit without undue examination of the proposer. Historically, Wikipedia has sought to avoid hosting biased contributions, particularly from editors with a conflict of interest. Patient 32 has reported bad experiences with this hospital. I have some amount of conflict in this because I am employed by Consumer Reports, which rated this hospital. I would say more if asked, but moving on, I would like to address the content proposals.
 * I formatted the references you presented into citations. I also appended all but the last reference to some of the statements you made. See here -


 * Hospitals, including Cleveland Clinic pay U.S. News & World Report large sums of money to use the US News Rankings and logo.
 * A Kaiser Family Foundation review of data from the Centers for Medicare and Medicaid Services considered the number of patients who got hospital acquired conditions from many hospitals. In this review, Cleveland Clinic got a score of 8.7 (1-10 possible with 10 being the worst) placing Cleveland Clinic in the bottom 7% of all hospitals.
 * In August 2012, Consumer Reports rated Cleveland Clinic 98th among 105 rated hospitals in the State of Ohio for overall patient 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
 * Leapfrog Group awarded Cleveland Clinic with the first ever “D” rating for patient safety. In this rating scheme, The D and F grades "represent the most hazardous environments for patients in need of care."


 * I did not format the last source because as a WP:PRIMARY source, it alone cannot be used as a source for including information into Wikipedia. I understand that you may have a journalist's reporting of this letter, and if you provide that, then that may be eligible for referencing on Wikipedia.
 * In my opinion, your suggestion is a good faith attempt to suggest sources and claims which can be summarized and referenced on Wikipedia. Let's see what others think of these statements.  Blue Rasberry   (talk)  20:20, 10 June 2015 (UTC)


 * In reference to only the last source (https://drive.google.com/file/d/0B6FohU_aOdk5WXEyZjBfTlJpaWs/view?usp=sharing) which requires outside references to subject documents, I offer the following references:

Reference to termination notice to the Cleveland Clinic is made in several articles:

1. The violations were all reported to Cosgrove. According to the report he was cited for systemic management failure after not informing patients that a robot would be used in procedures. http://www.washingtonpost.com/blogs/post-politics/wp/2014/06/07/ceo-of-cleveland-clinic-withdraws-name-from-consideration-as-va-secretary/

2. Last year, the Cleveland Clinic was cited for 23 health and safety issues. Plus, it received two letters warning that reimbursements for Medicare patients would be stopped if corrective action wasn't taken within days. http://www.ideastream.org/news/cleveland-clinic-cited-federal-safety-violations

3. A three-month Modern Healthcare analysis of hundreds of pages of federal inspection reports reveals the 1,268-bed hospital spent 19 months on “termination track” with Medicare between 2010 and 2013 as a result of more than a dozen inspections and follow-up visits triggered by patient complaints. http://www.modernhealthcare.com/article/20140607/MAGAZINE/306079939/cleveland-clinic-cases-highlight-safety-oversight-flaws

4. The chief quality officer of the Cleveland Clinic Health System says he was startled the first time he read a formal threat from Medicare saying the government might cut off the funding for the system's flagship hospital for management failures that limited the hospital's capacity to render safe and adequate care. “The first time I got one of those, I said, 'Oh my God, what's all this about?'” Dr. Michael Henderson, the system's top quality executive, said in an interview with northeast Ohio's National Public Radio affiliate, WCPN. Over time, though, Henderson came to learn that such language in Medicare's termination warnings is just a part of "the standard forms" following hospital inspections with adverse findings. The Cleveland Clinic declined to make Henderson or any other executive available for interviews for Modern Healthcare's June 9 cover story, "Cleveland Clinic cases highlight flaws in safety oversight." The story reported that Medicare's only recourse for failing hospitals is to cut them out of the program, which officials are loath to do. The result, experts say, is that some hospitals end up cited repeatedly for the same types of violations, even after claiming to have resolved the problems. Medicare threatened the Cleveland Clinic with termination at least four times between 2010 and 2013, CMS documents say. http://www.modernhealthcare.com/article/20140613/BLOG/306139998/medicare-termination-really

Each one of the articles above refers to the CMS notification letters sent to the Cleveland Clinic found in this shared link. Patient 32 (talk) 15:36, 16 June 2015 (UTC)
 * Comment: I am responsible for previously removing the content based on both US News and World Reports and the other rankings. All of the facts laid out above appear proper. However, that said, and apologies for a long statement here, but I think there are several aspects to mention.
 * The USNWR-based data was redacted because I believe that the problems with that system of rankings are not confined to the payment by hospitals to use the US News award badge, something that I understand is entirely non-obligatory, but more significantly extend to appreciable questions of methodology. My policy-based rationale for non-inclusion was that I question whether USNWR rankings are really WP:RS. However, upon reflection, the purist approach of removing the USNWR content is perhaps going to be a Sisyphean uphill battle on behalf of WP:RS policy. What I have now done is keep the rankings that were added back in, and contextualize them by stating some of the limitations, particularly those self-acknowledged by USNWR.
 * The other rankings were removed because WP:UNDUE seemed to apply if the USNWR rankings are redacted. It seemed to fail WP:NPOV if one methodology was accepted and another was turned back. In my opinion, none of these models can be rigorously scientifically objective because in essence simpler acuity is being compared to more complex. The data never reflects random assignments (of similar comparator test groups), and the results of multivariate acuity score correction models are capriciously sensitive to modeling assumptions, and thus methodologically suspect. I've added these rankings back, on the grounds of "if USNWR is in, the other similar quality type of data is in too", and I added sourced contextualization as to how, for example, a D is "not good but isn't the very worst either". (For example, it overreaches to say it was "the first ever D rating". It WAS one of 121 D ratings in the first Leapfrog ranking that used D and F rather than a withheld score, and as dark as that is, it's not exactly the same.)
 * In the CMS content, I think the present article text is a mildly disengaged, neutral, but accurate summarizing paraphrase, that points to the sources, but does not degenerate into blow by blow metaphrase literalism of every minutely nuanced complexity, big and small. In my opinion (but then I wrote it up !) it is WP:NPOV presently. I would expect that over time the CMS situation will be in evolution, in that I would imagine the concerns are subject to a plan of corrective action, and moreover the 19 months is not rolling on up at this juncture.
 * The Advocacy issues that have been under discussion elsewhere engender my sympathy. They are separate from this commentary and the edits made.
 * In summary, I would have preferred that both the USNWR and other rankings both be omitted for the policy based reasons I've given, but the content is perhaps more reflective of a mid-road view now. I've made the explained edits, and I am done with this, and I will let others take it up from here forward. FeatherPluma (talk) 04:25, 21 June 2015 (UTC) and subsequently modified. FeatherPluma (==Affiliation with Case Western Reserve University== 10:10, 23 June 2015 (UTC)

Rankings
The Rankings section was taken out, both the U.S. News and the Leapfrog and CMS, for promoting apples and oranges comparisons. Johns Hopkins' Wikipedia page does not include its U.S. News rankings.HealthMonitor (==Affiliation with Cleveland Clinic== August 28, 2015)
 * Can you say more about why you think US News, Leapfrog, and CMS are not reliable sources for reviewing the services provided by Cleveland Clinic? Wikipedia tries to summarize the best available sources. What about these makes them unreliable?  Blue Rasberry   (talk)  20:18, 28 August 2015 (UTC)
 * Bluerasberry: Thanks for your reply. US News, Leapfrog and CMS are all reliable in their own way. But I was worried that they were being presented as competitive yardsticks, when really they measure different things. It seemed like some kind of argument was starting up. The validity and comparability of hospital rankings is a huge subject and could easily be an article in its own right. HealthMonitor —Preceding undated comment added 03:16, 29 August 2015 (UTC)
 * Fortunately Wikipedia does not concern itself with validity of information - it only judges sources by reliable source criteria. There is supposed to be a summary of the coverage which reflects the weight of the publications. I agree that the weight and presentation of the ratings was problematic, and it might be good to remove everything that was there. But I am not ready to say that the sources were invalid, or that the publishers were not authorities in their field. Some of the information there did have standing as expert point of view, whatever criticism there may be of the experts.
 * Was there anything there that you found salvageable? I will look again, but I thought I would get your opinion first. All of those organizations have some esteem as reviewers of hospitals, and their reviews are the best that have been provided. Do you know of better reviews of the clinic?  Blue Rasberry   (talk)  11:16, 29 August 2015 (UTC)
 * Bluerasberry: There is no question that the sources are valid. It would be possible to post many third party evaluations that make the Clinic look good. But one of my goals in revising the Cleveland Clinic site was to remove anything that might seem promotional or puffy. In the same way, someone could post many evaluations that put the Clinic in an unfavorable light. Both positive and negative would be based on selective data. So it might be best to set the whole question aside, or address the issue of hospital rankings in a separate article.HealthMonitor (talk) 12:43, 29 August 2015 (UTC)HealthMonitor
 * Thanks. No hurry for any of this and you are doing great.  Blue Rasberry   (talk)  14:24, 29 August 2015 (UTC)

New First Paragraph with Additional Data
A new paragraph has been inserted to provide a more substantial introduction to the organization. I work for Cleveland Clinic and am voluntarily fixing up this page to make it as useful as possible to Wikipedia users. There will be more to come. I am a Wikipedia editorial neophyte and look forward to the help of other editors and the those who have already given this page such thoughtful consideration.HealthMonitor (==Affiliation with Cleveland Clinic== August 25, 2015)
 * Thanks for stopping in. I noticed that you are citing a book self-published by Cleveland Clinic - o Act as a Unit: The story of the Cleveland Clinic. Because it is self-published, its content probably falls under self-published sources guidelines, so be mindful that Wikipedia usually disallows information from these kinds of sources. I appreciate your bringing this source and its content here - some of it is a great foundation for presenting basic information about the organization.
 * If you have any questions about using Wikipedia then feel free to ping me. Also, consider saying hello at WikiProject Medicine where most of the health editors meet.  Blue Rasberry   (talk)  20:24, 28 August 2015 (UTC)
 * Blue Rasberry: I'm in a quandary regarding "To Act as a Unit". Most of the information sourced to that book is available in other publications or websites, but they all cite "To Act as a Unit" as their primary source. I have access to the sources from which "To Act as a Unit" was derived, but that would mean citing unpublished archival material, or even less accessible published sources. What do you think? HealthMonitor —Preceding undated comment added 03:26, 29 August 2015 (UTC)
 * These things may not be relevant - the issue is that Wikipedia should be a summary of what reliable sources have said on a topic. "Reliable sources" is Wikipedia jargon and means something specific - in this case, it means sources which are not written/published/funded by Cleveland Clinic for the purpose of Cleveland Clinic promoting itself. Wikipedia takes the position that when information only appears in self published sources (which are not "reliable"), that information should not appear in Wikipedia, because it disrupts neutral point of view.
 * Since most information about any given organization is self published, and never appears in other sources, that also means that most information about any given organization is not appropriate for Wikipedia. The line which makes information appropriate for inclusion is when someone not paid by an organization published the information. So if independent writing has not covered a topic, then that topic should not be included in Wikipedia, even if the topic is fundamental to the organization's own self-published branding.
 * Back to the book - the book can clarify details, but since the book was published by Cleveland Clinic as a promotional tool, the article should not cover information only found in the book and not in independent sources.
 * What do you think? Is the book promotional? Who funded its creation and publishing? The details which other writers outside the clinic have covered based on the book are appropriate for inclusion.  Blue Rasberry   (talk)  11:12, 29 August 2015 (UTC)
 * Bluerasberry: I understand what you're saying. I'm going to go over the points that cite "To Act as a Unit" and find other sources. In defense of "To Act as a Unit", though, while it was published by the organization, it is not promotional,. It includes historical material that does not necessarily make Cleveland Clinic look good. It's a very sober and dry account. But I'll try and replace it going forward. HealthMonitor (talk) 13:54, 29 August 2015 (UTC)HealthMonitor
 * Dual sourcing is nice too - the book, and also some independent commentator which either cite the book or which says the same thing.
 * There are a handful of clinics in the world which have a documented history like the one you have in this book. It is dry, but the very existence of a work like that is promotional, especially when it is funded in-house, and especially in the absence of external publications. If you want to establish the book's credibility, then bring some information from the book which covers a scandal in Cleveland Clinic's history. If there is nothing like that in the book, then either Cleveland Clinic has never had a scandal, or whomever wrote the book was influenced to adhere to an agenda. Group Health Cooperative produced one of these histories also - I worked with that text for weeks but ultimately could not reconcile it with criticism and had doubts about several parts of it. It was published by a historical society, but it still had ties to the organization. Thanks for being thoughtful about this - your contributions here are great.  Blue Rasberry   (talk)  14:23, 29 August 2015 (UTC)

Bluerasberry: Thanks for the advice. There is in fact a lot of material from the book that is unflattering enough to establish its credibility. There is still a lot to add to this article. Thanks again. — Preceding unsigned comment added by HealthMonitor (talk • contribs) 21:28, 29 August 2015 (UTC)

Beautiful images - uncertain copyright status
An employee of the organization just added some beautiful facility images with uncertain copyright status. I am discussing this on that person's userpage at User_talk:HealthMonitor.  Blue Rasberry  (talk)  15:37, 16 September 2015 (UTC)

Reversion?
Elvey: May I ask, why the reversion? — Preceding unsigned comment added by HealthMonitor (talk • contribs) 01:36, 13 October 2015 (UTC)
 * Why do you ask I question I already answered in my edit summary? Did you not read it?--Elvey(t•c) 08:22, 13 October 2015 (UTC)
 * Elvey: Thanks for your reply. I have removed all references to books, publications and websites controlled by the subject of the article. All facts are referenced by third parties. I have posted a request for edits below. I hope this has been done properly. HealthMonitor — Preceding unsigned comment added by HealthMonitor (talk • contribs) 17:02, 13 October 2015‎
 * deleted 40kb of content and dropped a changed version of those 40kb of content here on this talk page. I reverted both of these changes. Let's all talk before making big changes.
 * Elvey - good call in demanding an explanation from HealthMonitor. Obviously this person has a relationship with Cleveland Clinic because they say on their talk page that they work there. Healthmonitor - thanks for coming to Wikipedia and making a good faith effort to comply with the rules. We all are aware that Wikipedia has a troubled history of being attacked by public relations staff of every organization on earth, and that the volunteers tire quickly of arguing with paid employees who have an agenda and push against Wikipedia rules. I would like to give my personal opinion that HealthMonitor has made an attempt to comply with Wikipedia rules, and has been in good communication with this talk page, and has responded well to criticism in the past.
 * Elvey - can you elaborate on your complaint that "Revert edits which consist of undisclosed paid/sponsored advocacy. Disclosure within an article is not allowed by Wikipedia policy; authorship attribution is normally limited to edit histories. Undisclosed paid promo. content violates FTC regulations", which you wrote in the edit summary? Can you point out 1-2 specific things which conflict with Wikipedia rules? Are you really asserting that this content is problematic in entirety, or do you see some particular problems?
 * I could criticize this content also. I like to see references after every sentence per Wikipedia's verifiability rules, and I like for all references to go to reliable sources (meaning not self-published by Cleveland Clinic), but among the content which I think needs development I see also some things that I like.
 * May I ask for a little deeper criticism? It is not efficient to bat around 40kb of text, and I wonder if we can focus on specific problems as we examine this.  Blue Rasberry   (talk)  19:46, 13 October 2015 (UTC)
 * I don't dispute that HealthMonitor has made an attempt to comply with Wikipedia rules, however, undisclosed paid promo. content violates FTC regulations and thereby conflicts with Wikipedia rules. (What part of "Revert edits which consist of undisclosed paid/sponsored advocacy. Disclosure within an article is not allowed by Wikipedia policy; authorship attribution is normally limited to edit histories. Undisclosed paid promo. content violates FTC regulations" DO you understand?)  I would certainly be open to offering deeper criticism - however first the criticism I already offered ought be responded to more substantively.  Until then, you're edit warring by reverting and more importantly, you need to be aware that adding undisclosed paid promo. content that violates FTC regulations and thereby conflicts with Wikipedia rules - even if it's you adding the content by reverting my revert.  I ask that you reconsider and undo your revert while discussion continues.   I see you saw my comment on User_talk:HealthMonitor where I've already offered deeper criticism.


 * Contributions that violate US law are not welcome here. For information on how to contribute to Wikipedia when you have a conflict of interest, see the conflict of interest guideline and frequently asked questions for organizations. In particular, HealthMonitor has failed to
 * avoid editing or creating articles related to this organization. And Bluerasberry has edited to perpetuate edits that fail to do that!
 * exercise great caution so that not to violate Wikipedia's content policies.


 * Finally: All contributors must not contribute content that violates conflict of interest laws (just as all contributors must respect copyright). The Unfair Commercial Practices Directive is valid throughout the European Union. In a German court decision in 2012 (that also relied on the directive) regarding Wikipedia: "The court held that when a company edits a Wikipedia article, the resulting text falsely creates the impression that the edit has no business-related purpose. By implication, the judges found that the average reader of Wikipedia articles expects to find objective and neutral information" rather than content written by a paid advocate such as yourself.  That is a very very important condition, comparable to the FTC Guide" that consumers are likely to believe reflects the opinions, beliefs, findings, or experience of a party other than the sponsoring advertiser”. This expectation by consumers of neutral information on Wikipedia, requires that companies not write "their" WP articles for PR/marketing purposes. It is essential to achieve consensus on the conflict between this content that I removed and FTC Guide and policy.  Understood?  --Elvey(t•c) 20:27, 13 October 2015 (UTC)

Elvey: Please point out where the content was not factual or poorly sourced, and I will be happy to correct or remove those sentences. — Preceding unsigned comment added by HealthMonitor (talk • contribs) 23:13, 13 October 2015 (UTC)
 * It is against site policy to attempt to apply law to Wikimedia guidelines. Talking about the FTC ruling is out of bounds. Wikilawyering and No legal threats say more about this. If you do have a legal concern then site guidelines are to escalate it to the Wikimedia legal team immediately, which I would help you do, but I hope we can come to agreement to not talk about what is legal or illegal. So far as I understand, the options are leaving this part out or contacting WMF legal. Do you see other options?
 * We can talk about Wikipedia conflict of interest rules. You called healthmonitor's edits "Undisclosed paid promo", but this person has disclosed their work affiliation on his user page and all over this talk page. In my opinion they are complying with disclosure policy beyond what the Wikipedia community expects. This person has been responsive to feedback for weeks in a way that I have rarely see as compared to problem contributors listed at WP:COIN. Beyond disclosure on the user page and this talk page, what more do you request? Also - this person is not an official representative of the organization. They are presenting themselves as someone with a work affiliation who is a fan of the organization, which is different than being an official PR spokesperson. Healthmonitor has been very human in conversation and not at all like the usual uncompromising corporate brick wall.
 * Assuming that we put aside discussing legal issues, and assuming that we can keep compliance with disclosure guidelines, what do you have to say about the content? I have already critiqued a bit of it as it was slowly developed. Healthmonitor kept some things and removed others. All of the changes can be discussed, but to do this I would like to get to a point where we confirm that the user is acting in compliance so that the content can be considered for what it is. How can we examine the content? Do you want it copied here to the talk page and considered piecewise? Should we consider it from the edit history? I do not intend to burden you with reviewing the content, especially when you have doubts about it, but if there is a review process, I want it to happen in a way that makes you feel safe in a process which has Wikimedia community support. How would you feel about considering the content by section, and my seeking feedback from WP:COIN, WP:HOSPITAL, and maybe WP:MED?  Blue Rasberry   (talk)  11:48, 14 October 2015 (UTC)
 * Assuming that we put aside discussing legal issues, and assuming that we can keep compliance with disclosure guidelines, what do you have to say about the content? I have already critiqued a bit of it as it was slowly developed. Healthmonitor kept some things and removed others. All of the changes can be discussed, but to do this I would like to get to a point where we confirm that the user is acting in compliance so that the content can be considered for what it is. How can we examine the content? Do you want it copied here to the talk page and considered piecewise? Should we consider it from the edit history? I do not intend to burden you with reviewing the content, especially when you have doubts about it, but if there is a review process, I want it to happen in a way that makes you feel safe in a process which has Wikimedia community support. How would you feel about considering the content by section, and my seeking feedback from WP:COIN, WP:HOSPITAL, and maybe WP:MED?  Blue Rasberry   (talk)  11:48, 14 October 2015 (UTC)

Restore

 * Also see "Cleveland Clinic", COIN.

Would anyone object to the restoration of the article as it stood on (I believe) October 13, 2015? That was a version that was shorn of any references that sourced books, magazines, or websites controlled by the subject of the article, in response to editor Elvey's comments. HealthMonitor —Preceding undated comment added 14:17, 15 October 2015 (UTC)
 * In this edit at the conflict of interest noticeboard discussion, advised using edit request to propose changes. SV said "the best way forward is to break the rewrite down into individual edit requests", which I am doing below. Can anyone who has criticism for these sections please speak up?   Blue Rasberry   (talk)  00:08, 19 October 2015 (UTC)

Propose to add this content from   Blue Rasberry   (talk)  00:08, 19 October 2015 (UTC)


 * I have moved this to Talk:Cleveland Clinic/edit requests, because it was overwhelming this page. Please see WP:COITALK. The best thing is for HealthMonitor to post his draft on a user subpage, such as User:HealthMonitor/Cleveland Clinic, then to break it down into individual edit requests on this talk page. But do it separately: gain consensus for one issue, add it to the article or not, move onto the next issue, and so on. Otherwise it is too much for people to check all at once. Sarah (talk) 00:39, 19 October 2015 (UTC)

Let's start with this. Thoughts, anyone?

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. Dr. Weed died in 1891. 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. In 1897, they moved their practice to the Osborn Building on Prospect Avenue in downtown Cleveland. Crile, Lower and Bunts all became professors at Cleveland medical schools, and each would be elected president of the Academy of Medicine.

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. 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. In his autobiography, Dr. Crile reports that while in France, the three doctors discussed starting a new medical center in Cleveland upon their return.

First years of operation.

A four-story outpatient building was constructed on the purchased land. Cleveland Clinic was dedicated at a private ceremony on February 26, 1921. William Benson Mayo, MD, of the Mayo Clinic, delivered the main address. On February 28, 1921, Cleveland Clinic opened its doors to the public and registered 42 patients. 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. 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.

Disaster and Recovery

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 a single cause for the Cleveland Clinic fire of 1929. 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.

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.

The years 1941-1989

Dr. Crile and Dr. Lower relinquished their administrative duties in 1941. 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.

Growth of Specialization



Leadership

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 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.

Organization

Up until 2007, Cleveland Clinic's the largest organizational unit was the division, with the hierarchy being: division > department > section. There was a Division of Medicine, Division of Surgery, Division of Anesthesiology, etc. Within each division were departments (Department of Infectious Disease, Department of Cell Biology, etc.). 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. In 2007, Cleveland Clinic reorganized patient care services around disease and organ-system-based institutes.

Growing Facilities

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) 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.

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,.

 Blue Rasberry  (talk)  10:28, 19 October 2015 (UTC)

I requested comment at Wikipedia_talk:WikiProject_Hospitals.  Blue Rasberry  (talk)  23:59, 20 October 2015 (UTC)


 * You raised concern about this page saying that it was inappropriate for Wikipedia, but never said why, except that you worried about COI. I have reviewed this content again just as I reviewed it before. I identify nothing here that strikes me as inappropriate for Wikipedia.
 * You seemed very passionate before about voicing an objection but I failed to understand what your objection was. Can you please state any concerns you have with the content above? If there are not standing objections, then I would like to add this back to the article. Are you aware of any objections having been posted anywhere? Are your concerns addressed, and have you gotten every response that you wanted? Thanks.  Blue Rasberry   (talk)  14:51, 4 November 2015 (UTC)

✅ I added the history section.
 * At Conflict_of_interest/Noticeboard/Archive_93 there was a complaint that, an employee of Cleveland Clinic, had violated WP:COI guidelines. I was unable to understand what this person did that was inappropriate. I read their submissions, talked with them on this userpage, and with the usual sort of review approved their edits. They made mistakes and corrected them when I asked them to do so. I was pleased with their contributions and willingness to communicate and follow Wikipedia's rules.
 * At this point, I am unable to identify any standing complaint about the proposed content other than it having coming from a staff person of Cleveland Clinic who followed all Wikipedia guidelines in submitting it. I was asked to break the content into sections for review, but got no comment at all from the people who originally complained. Now that there has been time to review the added content for this one section, and no comments, now I would like to propose to re-add all the removed content from this version. Of course, anyone can make a request to delay this or give a reason why the content should not be added, but when no one has offered any reason to delay adding the content, I fail to see a reason for delay.
 * I continue to invite criticism of the content. At a glance, I like that so much of it is sourced to third party sources. I see some parts that are backed with self-published sources, or press release content (like lists of specialty services cited to WebMD but obviously provided by Cleveland Clinic), and I will remove that myself while keeping what I judge to be good content.
 * Thanks for raising concerns everyone. I appreciate your protecting Wikipedia. I am ready to respond to criticism and requests for changes, but so far I think there are no outstanding requests for changes. I will proceed in ~10+ days unless directed otherwise.  Blue Rasberry   (talk)  20:08, 17 November 2015 (UTC)

Facts Need Updating
The following paragraph in this article could be made more factual and up to date: "The Clinic has since then expanded overseas, with the phased opening in 2015 of Cleveland Clinic Abu Dhabi, constructed at the cost of approximately 1.5 billion USD. After completion, the Cleveland Clinic Abu Dhabi will become one of the largest medical centers in the Middle East. October 2015, The Cleveland Clinic will lease a building in London, United Kingdom creating Cleveland Clinic Europe."

Here are the reasons I think this paragraph should be changed: According to the source cited below, Cleveland Clinic Abu Dhabi is now fully open and operational. Cleveland Clinic Abu Dhabi and Shaikh Khalifa Medical City have their own substantial Wikipedia articles that cover their cost, services and ownership in detail. No reference to a "Cleveland Clinic Europe" can be found on the internet or Nexis.

May I suggest that an editor to replace the paragraph cited above with the paragraph below (or something like it):

I cannot do this myself because of a perceived conflict of interest.

Thank you HealthMonitor (talk) 19:40, 29 October 2015 (UTC)

I hope someone (Elvey?) can remove the reference to "Cleveland Clinic Europe" in the article. There is no such thing as "Cleveland Clinic Europe". As the referenced paragraph above states, the Cleveland Clinic has "signed a long-term lease for a six-story office building at 33 Grosvenor Place in London, England." That is all. The reference is cited above. Thanks HealthMonitor (talk) 14:19, 4 November 2015 (UTC)

Nine days ago, I proposed that some editor replace this paragraph:

"It's expanding overseas with Cleveland Clinic Abu Dhabi (2015) built for 1.5 billion USD and Cleveland Clinic Europe (2016) in London. [4]"

with this:

"Cleveland Clinic has expanded overseas. Since 2007, Cleveland Clinic has managed Shaikh Khalifa Medical City (SKMC), in Abu Dhabi, for SEHA, the Abu Dhabi Health Services Company. Cleveland Clinic Abu Dhabi, a specialty hospital and clinic, opened in 2015. In October, 2015, Cleveland Clinic signed a long-term lease for a six-story office building at 33 Grosvenor Place in London, England. "

Here's the reason I believe this change would be appropriate: Cleveland Clinic Abu Dhabi is now open and up and running. The action has been completed, and the hospital has been opened. The verb tense should reflect that. Also, there is an inaccuracy in the current paragraph. It mentions something called "Cleveland Clinic Europe", but the article it cites does not mention anything called "Cleveland Clinic Europe", and there is in fact no source that I can find anywhere cited the existence of a "Cleveland Clinic Europe". This new paragraph would correct that mistake. I hope some editor can help and make this change. Thank you. HealthMonitor (talk) 15:11, 6 November 2015 (UTC)
 * See WP:COIN in the "Help answer requested edits" box. That is sort of a queue for companies requesting assistance. The backlog might be 1-2 months to get to Cleveland Clinic. You are welcome to further engage in discussion there, or any other assistance forum. Corporate branding is typically not a priority for Wikipedia community volunteers because of the long history of negative outcomes. You are very strange - a one in a thousand that has a history of trying to talk things through.
 * I care about Cleveland Clinic too, but I am in no hurry, and the usual flow of things is making a request, notifying concerned stakeholders (which is the proposer's responsibility), waiting ten days, then executing the action if there is no objection. The grey space is huge and sometimes there is no obvious process for going forward. Elvey had a concern and requested a pause for conversation. I cannot say what is right to do but I certainly want to make everyone here feel respected and acknowledged. You are welcome to do what you think is appropriate. Whatever is polite to do off-Wikipedia is polite to do in-Wikipedia. The social construct to imagine as you make your choices is that other Wikipedians who have given comment are your colleagues and you treat their feedback accordingly. A strange aspect of Wikipedia is that sometimes colleagues give comment and it is hard to understand what they meant or wanted, and also sometimes hard to get clarification. Thanks for continuing to talk.  Blue Rasberry   (talk)  15:32, 6 November 2015 (UTC)

Thanks, Blue Raspberry. Once ten days has elapsed, I'll execute the action and see how it goes over with everybody. HealthMonitor (talk) 16:25, 6 November 2015 (UTC)


 * Hi HealthMonitor, please don't replace any more of the text. There are problems with the history section (too detailed), and perhaps similar problems with any other new text. If you feel there are problems with the article, it would be better to start by listing them here. Perhaps they can be fixed without a complete rewrite. SarahSV (talk) 03:46, 26 November 2015 (UTC)

U.S. News & World Report Rankings Are Out of Date
These are not the most recent U.S. News & World Report rankings. May I request that some editor update them? Thank you.HealthMonitor (talk) 18:34, 20 November 2015 (UTC)


 * Hi, I went to update it, thinking it could be done quickly, but it seems that each area has to be looked at separately and the hospital searched for. If you're willing to do that below, with links to the sources, I'd be happy to check it and update the table. SarahSV (talk) 03:43, 26 November 2015 (UTC)

Thanks SarahSV. Here are the new rankings, taken from the U.S. News website:

These updated data can replace the current table. HealthMonitor (talk) 20:27, 9 December 2015 (UTC)
 * I am still around and thinking of hospital ratings and have been talking with others about how hospital articles on Wikipedia can present them. I probably will not make a proposal on this before January. I do not oppose your editing the article or continuing discussion. Another option for further discussion is talking with people at WP:MED.  Blue Rasberry   (talk)  20:31, 9 December 2015 (UTC)

I look forward to your proposal, Blue Raspberry. HealthMonitor (talk) 20:57, 9 December 2015 (UTC)

While waiting for Blue Raspberry's recommendations, I restored some public domain pictures of Cleveland Clinic from Wikimedia Commons, and replaced the incumbent image (pale, beige and uncharacteristic). I also added mention of the acquisition of the Akron General Health System. HealthMonitor (talk) 23:31, 31 December 2015 (UTC)

Quality and Safety
May I propose that the current section headed Reputation in the Cleveland Clinic article be replaced with a section headed Quality and Safety. This could report current CMS, Joint Commission, Leapfrog, UniversityHospitals Consortium data relating to quality and safety. This would be more current and objective than copy that is now under the Reputation heading, some of which is out of date. So for instance:

Quality & Safety

''As of 2015, Cleveland Clinic meets or exceeds CMS benchmarks in four of six hospital acquired infection measures and has active projects underway improving performance across all measures. Cleveland Clinic’s Leapfrog Group Hospital Safety score was C in 2015. The Joint Commission currently accredits Cleveland Clinic hospital with its Gold Seal of Approval. Cleveland Clinic participates in Joint Commission improvement initiatives for reducing clostridium difficile infections, surgical site infections and venous thromboembolism prevention. In 2014, the University HealthSystem Consortium gave Cleveland Clinic its Quality and Accountability study Leadership Award. Past safety issues at Cleveland Clinic were analyzed in a 2014 article in Modern Healthcare. In 2012 Consumer Reports gave Cleveland Clinic and some other large academic medical centers low scores for hospital acquired infections. '' What do people think of this? HealthMonitor (talk) 20:17, 13 January 2016 (UTC)

U.S. News Rankings Update
I'm planning to update the U.S. News rankings for this page. They are out of date. The accuracy of this update can be easily checked by going to the U.S. News website. I am merely updating the data that is already there. It is not an attempt to promote and aggrandize the subject of this article. If one feels that this is inappropriate, please indicate what information in this update may be incorrect or unsourced, so that I or someone else may be able to post the correct information. If this information is correct, does not promote or aggrandize the subject of the article, and is soundly sourced, I hope it will be allowed to remain on the page. — Preceding unsigned comment added by HealthMonitor (talk • contribs) 14:52, 16 February 2016 (UTC)
 * Please post your proposed update here. It is OK for you to directly edit only to remove blatant vandalism or to make simple factual updates (like the number of employees), as long as those factual updates are very reliably sourced and are noncontroversial, broadly construed.  This is all discussed clearly in the WP:COI guideline.  What you are talking about is neither of those.  Thanks. Jytdog (talk) 17:16, 19 February 2016 (UTC)

Request edit on 28 January 2016
Quality and Safety[edit] May I propose that the current section headed Reputation in the Cleveland Clinic article be replaced with a section headed Quality and Safety. This could report current CMS, Joint Commission, Leapfrog, UniversityHospitals Consortium data relating to quality and safety. This would be more current and objective than copy that is now under the Reputation heading, some of which is out of date. (The current quality and safety data could be kept as a note. ) So for instance:

Quality & Safety

As of 2015, Cleveland Clinic meets or exceeds CMS benchmarks in four of six hospital acquired infection measures and has active projects underway improving performance across all measures. [1] Cleveland Clinic’s Leapfrog Group Hospital Safety score was C in 2015.[2] The Joint Commission currently accredits Cleveland Clinic hospital with its Gold Seal of Approval. Cleveland Clinic participates in Joint Commission improvement initiatives for reducing clostridium difficile infections, surgical site infections and venous thromboembolism prevention.[3][4][5]In 2014, the University HealthSystem Consortium gave Cleveland Clinic its Quality and Accountability study Leadership Award.[6] Past safety issues at Cleveland Clinic were analyzed in a 2014 article in Modern Healthcare.[7][8] In 2012 Consumer Reports gave Cleveland Clinic and some other large academic medical centers low scores for hospital acquired infections.[9]

What do people think of this?

Jump up ^ http://www.medicare.gov/hospitalcompare/profile.html#profTab=0&ID=360180&cmprID=360180&dist=25&loc=CLEVELAND%2C%20OH&lat=41.4994954&lng=-81.6954088&cmprDist=5.0&Distn=5.0 Jump up ^ http://www.hospitalsafetyscore.org/about-us/newsroom/display/50703 Jump up ^ http://www.centerfortransforminghealthcare.org/projects/detail.aspx?Project=11 Jump up ^ http://www.centerfortransforminghealthcare.org/projects/detail.aspx?Project=4 Jump up ^ http://www.centerfortransforminghealthcare.org/projects/detail.aspx?Project=13 Jump up ^ https://www.uhc.edu/membership/quality-accountability-study Jump up ^ Carlson J. Cleveland Clinic cases highlight flaws in safety oversight. Modern Healthcare. June 7, 2014. Jump up ^ Carlson J. Selected Cleveland Clinic hospital inspection reports. Modern Healthcare. June 7, 2014. Jump up ^ http://www.cleveland.com/healthfit/index.ssf/2012/07/northeast_ohio_hospital_get_lo.html

- HealthMonitor (talk) 20:17, 13 January 2016 (UTC)


 * I looked at the first source, which is rich and complicated. If you are drawing this from the "Complications" tab, and the "Healthcare associated infections" within that, there are 8 measures there, and CC is par on three, better than the national benchmarks on 3, and below par on 2.   And I found nothing there about "and has active projects underway improving performance across all measures.".  So the content is not supported by the source.   Also it would be useful if you properly format references so we can implement them more easily.  Thanks. I don't think the average reader knows what the "Joint Commission" is.  The "University HealthSystem Consortium" appears to have been absorbed by a private company called Vizient - see here. The content summarizing the 2014 Modern Healthcare article, says nothing and is not helpful.


 * This is not useful content as it stands... Jytdog (talk) 17:27, 19 February 2016 (UTC)


 * Jytdog: Thank you for checking those references. I accept your judgement on the usefulness of the content. Your feedback is much appreciated. HealthMonitor (talk) 17:44, 19 February 2016 (UTC)
 * My pleasure. Thanks for working with me. Jytdog (talk) 17:47, 19 February 2016 (UTC)