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Back to: Clinical Center Home Page > About the Clinical Center > News and Events
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This file is provided for reference purposes only. It was current when it was produced, but it is no longer maintained and may now be out of date. Persons with disabilities having difficulty accessing information may contact us for assistance. For reliable, current information on this and other health topics, we recommend consulting the NIH Clinical Center at http://www.cc.nih.gov/.
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Clinical Center News, Building 10, Room
1C255, National Institutes of Health, Bethesda, Maryland 20892. (301)
496-2563. Fax: 402-2984. Published monthly for CC employees by the
Office of Clinical Center Communications, Colleen Henrichsen, chief. News,
articles ideas, calendar events, letters, and photographs are welcome.
Deadline for submission is the second Monday of each month. |
Tuberculosis, once infrequently seen among Clinical Center patients,
is no longer a rare disease here. As a result, a CC multi-departmental team
has developed an extensive TB control plan to help keep the potential for
transmission of this airborne infection to a minimum.
A key aspect of this plan is the newly mandated employee TB surveillance
program conducted by the Occupational Medical Service (OMS).
Although OMS had provided testing for years, CC officials note, compliance
has been mandatory only for newly hired workers. According to Dr. David
Henderson, deputy director for clinical care, "Compliance with the
OMS TB surveillance program can no longer be considered optional. The CC
is no longer a safe place to hide from TB. In addition, the Occupational
Safety and Health Administration is currently enforcing compliance with
mandatory annual skin testing, and the Joint Commission on Accreditation
of Healthcare Organizations expects 100 percent compliance."
Tuberculosis control is currently one of the hot topics in hospital infection
control. NIAID scientists are studying alternative treatments for patients
who have multi-drug-resistant TB in protocols currently active here. Other
protocols are designed to evaluate and treat patients whose immune systems
are weakened. These patients are at higher risk of developing unrecognized
TB.
Under the new surveillance program, employees who may be exposed to TB here
must be skin tested with purified protein derivative (PPD) during their
pre-employment physical or when applying for clinical privileges, and then
at least annually.
Employees who work in certain higher-risk areas are tested more often. Persons
who have already had positive reactions to the PPD test will be evaluated
annually by OMS.
Information from the surveillance program will be crucial to conducting
periodic TB risk assessments in the CC, which help epidemiologists evaluate
the effectiveness of the overall TB control program.
CC department heads will be asked to identify employees who may be exposed
to TB in the Clinical Center and need to be enrolled in the OMS program.
Employees who are credentialed for patient care, those who routinely have
patient contact, or anyone who enters patient rooms will be included. More
than 1,000 employees are currently enrolled in the program, and newly identified
employees will be added. OMS has dedicated nurses who will make work site
visits where possible to make it convenient for busy health-care workers
to be tested.
Other measures to protect against TB infection among CC patients and employees
include recently constructed patient isolation rooms and diagnostic/treatment
rooms with special ventilation systems that effectively and efficiently
remove infectious TB bacteria from the air. Employees who may be exposed
to TB patients are also fitted with and trained to use special respirators
to prevent inhaling the organisms. (by the Hospital Epidemiology Service)
Return To CC News Contents
What is tuberculosis?
Tuberculosis-TB-is an infection caused by bacteria called Mycobacterium
tuberculosis. The disease, which most often is seen in the small air sacs
of the lungs, can take many years to develop.
What are the symptoms?
There are no obvious symptoms at first. The bacteria can remain dormant
for many years and may never cause disease. This is called the passive phase.
If the bacteria do grow, these symptoms will be seen during the active phase:
cough, low fevers, weight loss, and night sweats. If a chest x-ray is taken,
it will usually be abnormal.
How can I tell if I have TB?
A simple skin test-the Mantoux tuberculin skin test-will tell if you are
infected with tuberculosis bacteria. Purified protein derivative (PPD) is
injected under the skin of the forearm. If the person is infected, redness,
swelling, and hardness at the spot should show up about two days after the
test. This test only shows infection and cannot prove, by itself, that a
person has active disease. Other tests are necessary to determine who has
active disease.
Initial screening will be a two-step process, where the CC worker will have
a second PPD test one week after the first PPD. This is because infection
from the distant past may require two doses of PPD to stimulate the body's
dormant TB immune response.
How is it passed to someone else?
When a person in the active phase coughs or sneezes, the bacteria that cause
TB are spread through the air on tiny droplets. The bacteria can remain
in the air for a long time. Other people can get infected if they breathe
these bacteria. Persons in the passive phase of TB cannot spread the bacteria
through the air.
Is there a treatment?
Antibiotics are used to treat people in the passive phase. This helps prevent
symptoms from developing. The treatment, usually with the drug isoniazid,
lasts at least six months.
Is there a treatment for people with active TB?
There are several antibiotics for people who have active disease, including
isoniazid, pyrazinamide, ethambutol, and rifampin. Since resistant mycobacteria
can be "selected" when a single-drug therapy is used, multi-drug
treatment is necessary. The person must take all the medicine and is not
considered non-infectious with TB until the chest x-rays clear up, the coughing
stops, and the lab tests come back negative. Treatment must be continued
for at least six months. Unfortunately, multi-drug-resistant strains have
become more common recently because many persons have failed to complete
the prescribed course of therapy.
Where can I get more information?
Contact the Hospital Epidemiology Service at 496-2209.
The news on parking in the Clinical Center's garage is this: Stay tuned.
Parking is going to be tight, and CC officials are working on ways to help
patients and staff deal with the crunch.
Urgent and extensive repairs to the three-story, 1,550-space garage got
under way last month. That project has claimed and will continue to claim
about 400 spaces in different areas at any one time. The work is expected
to last three years. The new Clinical Research Center will begin to take
its toll on all campus parking, most dramatically the hospital's underground
spaces, late next year.
"There will never be a single, three-year solution to the garage parking
problem," said Scott Robinson during a Nov. 27 meeting between NIH
and CC officials to discuss parking solutions. "There will be a combination
of short-term and long-term solutions." Robinson is a team chief in
the design and construction branch, NIH Division of Engineering Services.
The first of those short-term solutions came on Nov. 25 when the CC Outpatient
Department extended its patient shuttle contract to provide shuttle service
for employees hardest hit by the parking crunch.
It's a direct shuttle primarily designed to provide transportation for patient-care
shift workers. The CC parking shuttle's route begins at the Clinical Center's
front door, stops at the multi-level parking buildings 6 and 8, and loops
through Lots 41 A, B, and, C. After 8 p.m., the shuttle will take employees
to any parking lot on campus and to the Metro.
The CC shuttle is expected to run 6:30 a.m. to 3 p.m. and 4 p.m.-12:30 a.m.,
with most service offered during morning, afternoon, and evening rush hours,
explains Steve Groban, Outpatient Department chief. "This is for the
interim, until we can review the data on ridership."
It supplements NIH's regular campus two-bus shuttle, which make a 40-minute
circuit of stops 6:30 a.m.-6:30 p.m. weekdays.
In concert, NIH police have stepped up ticketing of cars illegally parked
in P3 areas reserved for patients, patient visitors, CC volunteers, and
handicapped employees and patients. One walk-through in late November resulted
in 36 tickets.
The lack of garage parking is a safety concern for the shift workers whose
ranks are made up primarily of nurses. "We'd like to see a consolidated
area set aside for staff who use the shuttle. It's safer when a group of
people can travel to their cars together," noted Kathy Montgomery,
CC associate director for nursing.
CC officials are looking at several other short-term answers to the parking
questions, including:
·Move patient parking from P3, which is the lowest parking level,
to P2 and relocate P2 employee parking to P3. Since the garage repairs require
extensive shoring from below and most of the contractor's equipment is stored
on P3, that level will be most consistently disrupted during the repair
project.
NIH is looking at longer term solutions, noted George Williams, acting
assistant director for design and construction, NIH Division of Engineering
Services. On the table are ideas to open new temporary parking lots on campus;
offer valet and attendant parking; provide pay-parking areas for visitors;
and lease more off-campus spaces.
Even with the loss of 400 parking spaces in the garage repairs, NIH is still
more than 400 parking places over the limit allowed on federal installations
in this area. This month there are about 8,500 on-campus spaces for 15,800
employees. (by Sara Byars)
by Dr. John I. Gallin, CC director
Clinical research is at the heart of the Clinical Center's mission and we
do it well. Health professionals from around the country look to the Clinical
Center as a model for the design and conduct of clinical research as well
as for information on research and patient care in general.
In the past year, we have put into place several programs to strengthen
our outreach to the health-care community. One is our partnership with the
Association of Academic Health Centers and their television network, CenterNet,
that has resulted in live broadcast of the Clinical Center's grand rounds
to about 50 health sciences campuses around the country. Five grand rounds
were broadcast during last year's pilot. This year's schedule includes 10
broadcasts.
This program, which gives those watching from around the country a chance
to question presenters by phone, has been well received. We hope to expand
our work with CenterNet and the association next year by developing for
broadcast a round-table discussion program featuring NIH physicians and
scientists.
Another program that has been enormously popular is the Clinical Research
Core Course. It is a series of seminars designed to teach researchers how
to effectively conduct clinical research. More than 260 physicians, mostly
fellows, are enrolled in the program this year. We also plan to offer the
classes through live video conferences and by video to other campuses. The
first video-conference presentation was to researchers at the National Institute
of Environmental Health Sciences in North Carolina in October. We are working
with Dr. Michael Fordis, director of the NIH Office of Education, on some
exciting additions to the program, which I will share once the details are
final.
There's also our new affiliation with Johns Hopkins Medicine and Suburban
Hospital. A major benefit of this collaboration is that it will give medical
students and community physicians the opportunity to learn more about the
clinical research process and how to participate in it. It also gives our
staff a venue to expand clinical skills and collaborations with clinical
colleagues.
If you're homeless, an exercise program might be the last thing you'd
consider, but improved fitness could be an important step in restarting
a stalled life.
During National Physical Therapy Month in October, CC physical therapists
Jacqueline Gilbert and Micheale Smith presented a workshop to D.C. homeless
women at the House of Ruth. Healing the Generations was the theme for the
presentation on exercise, fitness, and the benefits of healthier living.
CC Rehabilitation Medicine Department physical therapists also visited an
elementary school, a nursing home, and an AIDS clinic. For each audience
the message was the same-moderate increase in activity improves health and
the quality of life.
"Exercise can help someone who is homeless," says Earllaine Simpler,
CC physical therapist. Even though it seems to be the last thing they should
worry about, if homeless people improve their fitness level with walking,
for instance, they'll be less prone to have colds or musculo-skeletal injuries."
Gilbert and Smith led a lively discussion with about 25 women at the House
of Ruth Empowerment Center-a place where classes and workshops are held
to help the residents learn new skills. Many women at the shelter are fighting
drug and alcohol addiction, some are there to escape domestic violence.
All need help turning their lives around and moving in a positive direction
toward independence.
The therapists discussed ways to improve health, fitness, and self-confidence.
Topics like depression, high blood pressure, and obesity were mentioned
as reasons to exercise.
"Listen to your body," Gilbert said. "It talks to you. If
you never liked riding a bicycle, then don't chose a stationary bike as
your mode of exercise. Dance, walk and talk, do what you enjoy and fitness
is fun." (by Laura Bradbard)
You're a patient with a chronic disease and no available treatment in
your community. Or, you're a physician looking for a clinical trial for
your patient. What do you do? How do you find out about medical research
that could benefit you?
The Patient Recruitment and Referral Center (PRRC), located in a refurbished
residence on West Drive, answers 350 to 500 phone calls a month from physicians
and patients looking for clinical trials.
Working with institute principal investigators and protocol coordinators,
the center was recently opened as a pilot project to develop a more centralized
approach to recruiting patients.
"We aren't working in isolation of the institutes. Our strategies involve
cooperation and participation to increase patient recruitment for studies,"
says Dottie Cirelli, director of the center.
Four institutes-NIDR, NHLBI, NICHD, and NIAMS-have signed on with the project
to attract patients to 29 pre-selected studies. Pretrial screening for these
four institutes is conducted by two full-time registered nurses, Dinora
Dominguez and Elaine Robinovitz, who also answer those hundreds of phone
calls.
"We provide information about the Clinical Center and NIH research,"
says Robinovitz. "We describe protocols, send summaries of the studies,
and in some cases, contact a patient's physician."
Most of the calls coming in to the center are from patients, but in most
cases, patients need a physician's referral. The center mails or faxes information
patients can give to their doctors so that the physicians can contact the
institute to determine if the study is a good match for the patient's condition.
Physicians calling about research studies usually are transferred directly
to the institute contacts who then provide more information about the studies
and complete the patient evaluation.
"The Patient Recruitment and Referral Center will make it easier for
physicians to refer patients to clinical trials and for patients to participate
in them," says Dr. John I. Gallin, CC director. "In turn, clinical
investigators here will have the patients they need to conduct their quality
trials more easily. We're excited about the possibilities of this initiative."
"This is not a short-term project," Cirelli notes. "It'll
take time and resources to develop a large referral base. We are determining
what is doable, what will provide the greatest return for the investment,
and what support services are necessary for retention."
Community outreach is another aspect of the recruitment center's mission.
As a Spanish-speaking nurse, Dominguez is the point person at the center
for the Hispanic patients who need clinical trial details in their native
language. Information about the center is printed in Spanish and English.
The center is also reaching out to physicians and patient communities with
information about the Clinical Center and participating in the clinical
research here.
"One of the upcoming outreach efforts will involve contacting rural
internists and family practitioners. We want them to think of us when they
have a patient who could benefit from research conducted here. Nationally,
only two percent of chronically ill patients are involved in clinical trials
and the number of clinical trials has increased 10 percent in the last year.
We have to make it easier for patients to come to us," Cirelli says.
Flow charts line the walls as the nurses retool their strategies for handling
phone calls and email inquiries. "We try something, such as a form
or question series, and if it doesn't yield results, we can change it. That's
the beauty of a pilot program. We're not stuck, we can change how we work
things," says Dominguez.
The CC Information Systems Department is designing a database, Cirelli notes,
that will enable the center to keep track of previous patients, patients
looking for specific drug trials, and patients interested in certain types
of studies. Most of that information is now gathered manually. Having this
information will help the center track the number of calls, the number of
patients screened, the number of referred patients and those accepted into
trials, and will help in evaluating the recruitment strategies.
As part of the recruitment initiative, the Clinical Center Communications
Office developed a booklet, Becoming a Patient at the NIH Clinical Center,
created a recruitment exhibit, and works with the recruitment center to
exhibit at conferences all over the country.
"Patient recruitment is a complex issue and involves much more than
placing a couple of newspaper ads. Strategies are being initiated that will
help recruit in the short term, but the PRRC staff are cognizant of the
fact that we need to do things that will position the CC for the long term,"
says Cirelli. (by Laura Bradbard)
Next month: A look at the Clinical Research Volunteer Program
Return To CC News Contents
Samuel Stewart is director of environmental services for Sodexho.A contract to provide housekeeping services to the CC's clinic wing is
strengthening efforts to keep the Clinical Center clean.
The contract was awarded to Sodexho USA, a management company that provides
maintenance, engineering, and food services for businesses, hospitals, and
universities. The company is headquartered in Waltham, Mass.
"Seamless, quality service is the goal of this contract," says
Walter L. Jones, CC deputy director for operations and management. "The
new workers join a team committed to providing the best in housekeeping
services."
"This contract allows us to improve housekeeping services without costing
jobs for department members," notes Henry Primas, Housekeeping and
Fabric Care Department chief. "The contract workers fill positions
that have been left vacant as people have retired or moved on to other jobs."
With the new contract workers now on board, CC housekeeping staff can better
cover other areas of the building, Primas adds. "The contract allows
us to retrench CC housekeeping staff to provide better services for the
hospital and lab areas and to cut overtime costs. I'm very pleased with
the way our housekeeping and office staff have worked with this contractor
during the transition."
Samuel Stewart is Sodexho's director of environmental services. He's been
on site since the contract began Oct. 1. "This is a very important
contract for us. We have 45 full-time employees and 15 who serve in on-call
and relief positions. All were hired locally."
Stewart and his assistants, Lloyd Booze and Tom Clolletion, have visited
each of the hospital areas Sodexho covers meeting department members and
surveying the physical space. "Departments can call us to come through
again. Learning the facility is a priority for us."
Stewart added, "We exect to bring a quality effort throughout the hospital"
Stewart's office is in B1N305. The phone number is 496-2417.
The new workers cover: ACRF floors 3-13; the main entry lobby; Lipsett Amphitheater;
the Nuclear Medicine Department and the cyclotron area; the Department of
Diagnostic Radiology, including the film library, ultrasound, CT scan, MRI,
and special procedures; the Department of Transfusion Medicine; phlebotomy
and the echo lab; Social Work Department; Safety; the Outpatient Department,
including the travel and voucher offices; Communications; Clinical Pathology;
elevators 21-24 and 26-33 and stairwells 6, 10, and 13-19.
Return To CC News Contents
The Department of Transfusion Medicine will honor administrative officer Betty Colbert on her retirement. CC staffers are invited to a reception for her on Dec. 20. Stop by the Visitors Information Center between 2 and 4:30 p.m.
Return To CC News ContentsDecember will be a month of celebrations at the Clinical Center, including
a party spotlighting children's holidays around the world, which is set
for Dec. 11 at 6:30 p.m. in the 14th floor assembly hall.
A holiday concert featuring traditional and seasonal music will be presented
Dec. 12 at 7 p.m. in the 14th floor assembly hall. Musical selections will
be presented by the Oratorio Society of Washington, D.C.
A holiday open house is planned for Dec. 17, 2-3:30 p.m., in the 14th floor
hall. The Young Dancers of the Washington Ballet will be featured, along
with a photo opportunity with Santa and singing around the piano.
Both events, open to patients, guests, and staff, are hosted by the recreation
therapy section of the Rehabilitation Medicine Department.
Return to CC News Contents
A musical adaptation of "Scrooge" and a special visit with
Santa will be presented in Masur Auditorium at 7:30 p.m. on Saturday, Dec.
21. It's the fourth annual AIDS benefit show staged by the Performing Arts
Ensemble, founded to showcase talent and benefit worthy causes. Proceeds
will support CC patients and their families through the Friends of the Clinical
Center.
The cast includes actors, singers, musicians, and dancers. For ticket purchase
and information, call 496-4600.
If taking advantage of education opportunities is on your New Year's
agenda, give the education and training section a call at 496-1618. Offered
in January is:
·Communication: Understanding the Basics. This course, based on real
work situations, will help participants recognize, identify, and remove
barriers to effective communications; recognize non-verbal behavior that
impedes communication; and build assertiveness skills. Jan. 17, 9 a.m.-4
p.m., 6100 Executive Blvd.
Want to make changes to your federal health benefits or Thrift Savings
Plan? You can now do it through Employee Express. Call (912) 757-3088 or
stop by the kiosk that's located in the lobby outside the second floor cafeteria.
You'll need your Employee Express pin number to make changes. If you've
lost or forgotten yours, call 496-4556. There's more information on Employee
Express on the World Wide Web: <http://helix.nih.gov:8001/ohrm/express/>.
Services were held Nov. 12 in Washington for Lanita Jones-Austin, who
died on Nov. 7. She had worked in the CC as an x-ray technician from 1987
until her illness earlier this year. Survivors include her companion, Steven
Austin, Sr.; their son, Steven, Jr.; and her father, Arthur Jones.
Two new resources for staffers are available on the Clinical Center's
home page. The Medical Record Department has added a directory of credentialed
members of the active medical staff. The information can be searched or
browsed. Users can send an email to medical staff members from within the
directory. There's also a new listing of symbols and abbreviations approved
by the Medical Board for use in medical records. Both are located in the
NIH Staff Resources Section on the Clinical Center's home page, <http://www.cc.nih.gov/>.
Dr. John Gallin, CC director, was among the 55 new members elected to
the Institute of Medicine recently. Also named from NIH this year were Dr.
Mitchell H. Gail, head of the epidemiologic methods section and chief of
the biostatistics branch, division of cancer epidemiology and genetics,
NCI; Dr. Richard Klausner, NCI director; and Dr. Judith Vaitukaitis, director
of NCRR.
New members are elected by the institute's 545 active members from candidates
chosen for their major contributions to health and medicine or to related
fields such as social and behavioral science, law, administration, and economics.
Institute of Medicine topics that members are currently working on include
studies on care at the end of life; on genetics, health, and behavior; and
on new vaccine development.
The winter holiday season, with its rushing, planning, and parties, sometimes
isn't so jolly. Common causes for those holiday blues include:
Want to learn how to cope with the downside of the holidays? Check out
the Employee Assistance Program's seminar on dealing with holiday issues.
The program, which will be offered four times this month, is free and requires
no registration. It will be presented in the Visitors Information Center's
Little Theater on Dec. 10 and 17. On Dec. 11, stop by conference room E
at Executive Plaza North, or conference room F on Dec. 18. All sessions
will be noon-1 p.m.
Thirty social workers from across the country attended the first educational
forum sponsored in October by the CC Social Work Department. The forum focused
on the bio-psycho-social approach in working with persons with HIV and AIDS.
The department plans to present three forums for social workers each year,
explained Dan Kavanaugh, with topics covering aspects of HIV, cancer, and
chronic illness. Social Work's staff development committee coordinated the
conference.
Karen Morrow, chaplain in the CC Spiritual Ministry Department, has been
certified as an associate supervisor for pastoral education by the Association
for Clinical Pastoral Education. Morrow trains two groups of pastoral education
students each year. "After training here, the students go on into the
world with an excellent exposure to Clinical Center research and how it
concerns people. These students can speak well of this place and encourage
others to consider NIH as a place to come for treatment. Here, the chaplains
are part of the health-care team."
Comments? webmaster@cc.nih.gov
National Institutes of Health (NIH)
Last modified 12/12/96
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