More on Quality and Safety

Cleveland Clinic teams with United Airlines on cleanliness standards

Both the airline and the hospital system need to develop trust to be able to say, "It's safe to come back."

Susan Morse, Managing Editor

The Cleveland Clinic's main campus.The Cleveland Clinic's main campus.

The Cleveland Clinic has partnered with United Airlines on disinfection protocols for the safety of passengers and staff.

In a message on the airline's website, CEO Scott Kirby said that, in addition to aircraft interiors being disinfected using the same equipment used to clean hospitals, United has teamed with experts from Clorox and the Cleveland Clinic to set a new standard for cleanliness and healthy flying.

"Physicians and scientists at the Cleveland Clinic will advise us on new technologies and approaches, assist in training development and create a rigorous quality assurance program," Kirby said of efforts being called United CleanPlus. "And, as scientists learn more about how to fight COVID-19, Cleveland Clinic experts will help us use those discoveries to quickly implement new ways to keep our customers safe."

HIMSS20 Digital

Learn on-demand, earn credit, find products and solutions. Get Started >>

The Cleveland Clinic is not charging for the service.


The disinfection and other safety protocols are being offered at no cost to any business looking for help, according to Dr. Jim Merlino, Chief Clinical Transformation Officer, who is part of the team led by Cleveland Clinic CEO and president Dr. Tom Mihaljevic.

"It's not a revenue stream," Merlino said.

Rather, Dr. Mihaljevic has directed the clinic to help organizations get restarted during the reopening phases of the coronavirus pandemic, as part of the health system's philosophy to care for the community.

"We've been active in saying, if we have something we can do to help, we want to do it," Merlino said. "We started having conversations with United and they asked us to help. It was an opportunity to get people flying again."

Also, the Cleveland Clinic already had a relationship with United. The airline recently flew Cleveland Clinic physicians to New York to help out with the crisis.

The partnership on COVID-19 best practices began at least two weeks ago.

"We've been translating what is being used across the country, to put together a package of things," Merlino said.

One is based on a safety model known as Swiss Cheese. The model was developed around 1990 and is widely used in healthcare. Basically, Merlino said, it assumes all of the things that can hurt people and puts in place processes for prevention. But every process has holes in it.

"If you get enough processes together, you can close the number of holes," Kirby said.

What Cleveland Clinic brought to United was a team of experts who could advise on all of the known science of COVID-19, to put in place processes to prevent the spread of infection.

"We don't know a lot," Merlino admitted. "We're also struggling with what's real and accurate, to provide clarity to some of the things coming out."

There's been debate about who should be required to wear masks and have their temperature checked.

"People are arguing we don't need to do it," he said. "Again, let's look at the evidence. When you put them together you have a stronger case and more defense."

United passengers with illness symptoms are asked not to travel and are also being requested to wear masks and to social distance when boarding the plane.


The Cleveland Clinic has about 230 caregiver staff who became infected with COVID-19, but none got the infection through a COVID-19 positive patient, Merlino said.

The health system knows this through contact tracing.

Financially, the system is holding its own and is in better shape than other hospitals that experience a significant surge of COVID-19 patients.

Cleveland Clinic had an influx of patients, but it and Ohio didn't get the expected surge, Merlino said. The number of cases appears to have reached a plateau without the 11 hospitals in the system being overwhelmed. It also didn't do the layoffs of furloughs that other hospitals have been forced to do.

Now that hospitals are trying to return to a new normal by rescheduling postponed elective procedures and surgeries, reactivating is harder than deactivating, according to Merlino.

People need to be able to trust that the hospital is safe as patients have missed cancer screenings and delayed appointments for chronic conditions that need to be addressed.


"To bring people back in we want to provide the same level of safety," Merlino said. "We need to say, it's safe to come back."

Twitter: @SusanJMorse
Email the writer: