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The Quality Performance Report shows how Cleveland Clinic has been doing at providing the right care for certain common conditions and keeping patients safe.

What is a Heart Attack?

A heart attack (also called AMI or acute myocardial infarction) happens when the arteries leading to the heart become blocked and the blood supply is slowed or stopped. When the heart muscle can’t get the oxygen it needs, the part of the heart tissue that is affected may die.

The symptoms of a heart attack can include:

  • chest pain (often described as a crushing, squeezing or burning pain in the center of the chest and may radiate to your arm or jaw)
  • shortness of breath
  • dizziness or faintness
  • sweating
  • nausea
  • cold or clammy skin
  • a gray or very ill appearance

Sometimes there may be no symptoms, especially if you have diabetes. Women sometimes have different symptoms, such as a different kind of chest pain and/or abdominal pain.

For more information about heart health go to:

What is Heart Failure?

Heart failure is a weakening of the heart's pumping power. With heart failure, your body doesn't get enough oxygen and nutrients to meet its needs. Your heart tries to pump more blood, but the muscle walls become weaker over time. These measures show some of the standards of care provided for most adults with heart failure.

Symptoms of heart failure may include:

  • shortness of breath from fluid in the lungs
  • swelling (such as in legs, ankles or abdomen)
  • dizziness
  • fatigue
  • weakness
  • cold or clammy skin
  • a rapid or irregular heartbeat

Heart failure can be a result of heart condition due to:

  • hardening of the arteries, also known as coronary artery disease a heart attack
  • cardiomyopathy (heart muscle damage from infection or alcohol or drug abuse)
  • an overworked heart (caused over time by conditions like high blood pressure, kidney disease, diabetes, or a defect from birth)

For more information about heart health go to:

What is a Stroke?

A stroke, or “brain attack,” occurs when a blood vessel in the brain becomes blocked or bursts. The brain cannot store oxygen, so it relies on a network of blood vessels to provide it with blood that is rich in oxygen. A stroke results in a lack of blood supply, causing nerve cells in that area of the brain to be cut off from oxygen. When tissue is cut off from its supply of oxygen for more than three to four minutes, the brain tissue begins to die.

There are three kinds of stroke: hemorrhagic strokes, ischemic strokes, and transient ischemic attacks.

  • Hemorrhagic stroke — This type of stroke takes place when a weakened blood vessel in the brain breaks. Bleeding, or hemorrhage from the blood vessel, occurs suddenly. The force of blood that escapes from the blood vessel can also damage brain tissue in that area. Hemorrhagic stroke is the most serious kind of stroke.
  • Ischemic stroke — This type of stroke occurs when a blood vessel in the brain develops a clot and cuts off the blood supply to the brain. A blood clot that forms in a blood vessel in the brain is called a "thrombus." A blood clot that forms in another part of the body, such as the neck or lining of the heart, and travels to the brain is called an "embolus." Blood clots often result from a condition called "atherosclerosis," the build-up of fatty deposits within blood vessel walls.
  • Transient ischemic attack (TIA) — A TIA should be treated as seriously as a stroke. A TIA occurs when blood flow to a certain part of the brain is cut off for a short period of time, usually 15 minutes or less. Although TIA is painless, it is an important warning sign that a stroke may follow.

The symptoms of a stroke can include:

  • Sudden numbness or weakness of the face, arm or leg, mainly on one side of the body
  • Sudden difficulty understanding or speaking – you may have slurred speech or confused speech
  • Sudden difficulty seeing in one eye or both eyes
  • Sudden loss of balance, coordination or the ability to walk
  • Sudden, severe headache

For more information about brain health, go to:

View other publicly reported data about stroke care in hospitals:

What is Pneumonia?

Pneumonia is an infection of the lungs. It is caused by bacteria or a virus. The lungs fill with mucus. This lowers the oxygen level in your blood. Symptoms of pneumonia can include the following:

  • difficulty breathing
  • "wet" cough – mucus may look green or bloody
  • chest pain
  • fever and chills
  • fatigue

You should also be aware that flu shots reduce the risk of influenza, a serious and sometimes deadly lung infection that can spread quickly in a community. Hospitals should check to make sure that pneumonia patients get a flu shot during flu season to protect them from another lung infection and to help prevent the spread of influenza in the community.

For more information about lung health go to:

What is Cleveland Clinic Doing to Prevent Infections?

Cleveland Clinic has an Infection Prevention program designed to improve the quality of health care through the practice and management of infection prevention, education and research. The Infection Prevention team collects data on hospital acquired infections and analyzes the data to identify patterns and trends. Infection rates are shared and discussed with physician and nursing colleagues in an effort to identify and implement best practices to reduce the risks for infection.

Hand Hygiene

Hand hygiene is the best means of preventing the spread of infection. Hand hygiene includes washing with soap and water or using alcohol hand sanitizer before and after each patient contact. An example of Cleveland Clinic’s aggressive hand hygiene efforts is the placement of alcohol hand sanitizers in public areas throughout the hospital including hallways and cafeterias, making them readily accessible to staff, patients, families and visitors.

Environmental Cleaning

An important aspect of infection prevention is environmental cleaning. Cleveland Clinic’s Environmental Services staff use approved disinfectants for cleaning patient rooms and equipment. High level disinfection and sterilization are used according to national guidelines to ensure clean patient care items.

How is Cleveland Clinic Doing at Preventing Infections?

Central Line Associated Blood Stream Infections (CLABSI) Acquired while in Intensive Care Units

A central line is a catheter (small tube) that is inserted and passed into a large vein or the heart. Central line blood stream infections can often be prevented. CLABSI prevention is a priority for all hospitals.

Cleveland Clinic (April 2014 - March 2015) Better than U.S. national benchmark

What we are doing to improve – CLABSI is a priority for all Cleveland Clinic caregivers. A hospital-wide team is dedicated to staff education and promoting best practices that reduce CLABSI. Cleveland Clinic has joined hospitals across the country to keep patients safe by consistently applying a basic, simple set of steps that reduce the risk of infections for patients with central lines, focused on:

  1. Proper line insertion
  2. Proper line maintenance
  3. Removing the line when it is no longer needed

Cleveland Clinic is using the steps above to reduce CLABSI in all areas of our hospital, not just ICUs.

Only regular Medicare patients are included. People in Medicare Advantage (managed care plans) and people who do not have Medicare are not included.

Updated: November 2015

Clostridium difficile (C. diff or CDI) Infections Acquired While in the Hospital

CDI is a bacterial infection that causes diarrhea and more serious intestinal conditions, such as colitis (inflammation of the colon). People who get CDI are usually elderly and are taking antibiotics for another infection. Clostridium difficile bacteria are found in the stool (bowel movements) of an infected person. Other people can become infected if they touch items or surfaces that are contaminated with the bacteria and then touch their mouth.

Cleveland Clinic (April 2014 - March 2015) Worse than U.S. national benchmark

What we are doing to improve – We focus on hand hygiene, patient placement, and environmental cleaning to reduce CDI infections.

Only regular Medicare patients are included. People in Medicare Advantage (managed care plans) and people who do not have Medicare are not included.

Updated November 2015

These scores tell you about how often patients had certain serious, but potentially preventable complications (listed below) related to medical or surgical inpatient hospital care.

Where does the score come from? The information comes from documenting certain events in patient medical records. These events are then “coded” by the hospital for billing Medicare. Coded information is sometimes called “administrative” data.

This information is important because one way to tell if a hospital is doing a good job is to look at how often patients experienced certain complications that might have been preventable.

Lower numbers are better.

How is Cleveland Clinic doing with preventing certain serious complications?

July 2012 – June 2014 Rate per 1,000 Hospitalized Patients
Serious Complication U.S. National Average Cleveland Clinic
Death among surgical patients with serious treatable complications 117.75 125.07*
Collapsed lung due to medical treatment


Blood clot in the lung or large vein after surgery 4.35 6.91**
Wound that splits open after surgery 1.7 1.2*
Accidental cut or tear during surgery or other procedure 1.81


Eight different complications (combined) 0.81


Includes only people with “regular” Medicare. People in Medicare Advantage (managed care plans) and people who do not have Medicare are not included.

* The difference between Cleveland Clinic and the national average is not significant. This means that Cleveland Clinic’s rate is basically the same as the national average.

** Cleveland Clinic’s rate is higher (worse) than the national average.

***Cleveland Clinic's rate is lower (better) than the national average.

For details, visit | Hospital Compare.

What is Cleveland Clinic doing to improve?

Cleveland Clinic has many initiatives underway to keep patients safe. Standard “best” practices are the key to success. Examples:

  • To prevent collapsed lungs due to medical treatment, Cleveland Clinic implemented a standard procedure for placing and checking central lines (small tubes inserted and passed into a large vein or the heart).
  • To prevent blood clots in the lung or large vein after surgery, Cleveland Clinic implemented a standard approach that includes checking each hospitalized patient’s risk for blood clots and providing medications or other treatment as indicated.

Updated: June 2015

Keep in mind that you should not choose a hospital based solely on reported data.
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