Report provides road map for changeSweeping changes in the way the Clinical Center is governed, funded, and managed were put on the table for employees during a Feb. 29 CC-wide meeting.
Dr. John I. Gallin, CC director, detailed proposals outlined in a report to HHS Secretary Donna Shalala that concluded a year-long evaluation of how the Clinical Center could work better and smarter.
The changes, which empower a governing body and provide a separate budget, would be carried out under the umbrella of legislative actions and waivers. CC designation as a federal demonstration site for changeknown as a reinvention labprovide a road map for the change. (Related stories follow.)
"For the first time the Clinical Center will have an organizational group experienced in health-care management advising on the management of the hospital," Dr. Gallin told the nearly 500 CC employees attending the address and awards ceremony in Masur Auditorium. "That¹s never happened before. We now will have the chance to interact with the best managers in the country.
"Our budget for this fiscal year is $223.7 million," he said. While federal streamlining requirements have not gone away, the Clinical Center is actually ahead of FY96 personnel targets. There are 1,920 FTEs currently on board. The goal for this year was 1,991.
"My objective is to meet our requirements regarding streamlining without anyone losing their job or being downgraded without cause. Decreases have come by attrition because the hospital is getting smaller. The number of patients and patients days are decreasing."
Activity at the Clinical Center is not decreasing, Dr. Gallin pointed out, but the delivery of medical care is changing. The number of active protocols has remained steady at about a thousand over the past 25 years, but the number of days a participating patient spends in the hospital has dropped from 25 to nine.
Among other major projects and initiatives Dr. Gallin covered in his address were:
Core Curriculum in Clinical Research. "As the largest clinical research facility in the world, we recognized the need for uniformly well-trained physicians in the discipline of clinical investigation and have worked over the past year to design and implement [this]," Dr. Gallin said. Twenty-five clinical associates completed the eight-week pilot course last year. Some 250 are enrolled this year.
Patient Recruitment. A Patient Recruitment Service Center will fortify overall awareness of the Clinical Center and clinical research in general while helping institutes with recruitment efforts.
Protocol Coordination. This new service center will make more efficient the administratively complex and review-laden protocol-approval process.
NIH Guest House. "This will be a hotel-like facility for housing outpatients, patient families, clinical research volunteers, and visiting lecturers and consultants," Dr. Gallin said. The apartments across Center Drive will likely be used as a temporary location.
New Hospital. "We have received funding from Congress in the FY96 NIH budget to begin design of the clinical research center," Dr. Gallin noted. "Dr. Varmus has made this his number one construction initiative on campus."
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The Options Team: What was their mission?Early last year the Clinical Center¹s structure and organization went under the microscope of Vice President Gore¹s Reinventing Government II initiative. HHS Secretary Shalala formed an Options Team to perform the scrutiny.
The year-long effort¹s primary goal was to develop ways to improve efficiency here without compromising the quality of patient care in this unique clinical research environment.
A secondary goal was to consider the designation of the CC as a reinvention laboratory, a federal demonstration site empowered to explore how best to streamline procedures that often are stumbling blocks to working efficiently .
The team¹s findings and recommendations are contained in their report, "Opportunity: Revitalizing the NIH Clinical Center for Tomorrow¹s Challenges."
Dr. Helen L. Smits, deputy administrator of the Health Care Financing Administration, chaired the Options Team.
Members were Dr. Alan Breier, chief of the unit of pathophysiology and treatment, NIMH; Dr. Gregory A. Curt, NCI clinical director and immediate past chair of the NIH Medical Board; Dr. John Gallin, CC director and NIH associate director for clinical research; Michael Goldrich, NIAID deputy director for management and operations; Dr. Christine Grady, acting clinical director, NINR; Dr. David Henderson, CC deputy director for clinical care; Dr. Jeffrey M. Hoeg, chief of the cell biology section, Molecular Diseases Branch, NHLBI; Dr. Steven M. Holland, tenure track investigator, NIAID; Walter L. Jones, CC deputy director for management and operations; Dr. Ruth Kirschstein (ex-officio member), NIH deputy director; Dr. Harvey Klein, chief of the CC Department of Transfusion Medicine; Francine V. Little, director of the Office of Financial Management, NIH; Kathryn Montgomery, CC associate director for nursing; Edward McManus, NEI deputy director; Dr. Griffin Rodgers, chief of the molecular hematology section, Laboratory of Chemical Biology, NIDDK; and Dr. Judith L. Vaitukaitis, director, NIH National Center for Research Resources.
What did the Options Team recommend?
On governance:Put into place a clear and logical governance structure.
Formally use the expertise of leaders in health care administration from outside the government.
Make sure that internal representation reflects the entire NIH community.
The Clinical Center is now governed by a series of NIH committees and groups. It¹s a cumbersome structure that leads to confusion and costly delays in decision-making. It also means that there is no formal way to benefit from the experience of outside experts in hospital and research management.
Secretary Shalala will appoint a 17-member Board of Governors based on recommendations from institute directors, the NIH director, and the Clinical Center director. This Board, which will meet at least quarterly, will report to the NIH director. An external appointee will serve as chair.
Nine non-federal and eight federal members will comprise the Board. The federal members will be from NIH, but not the Clinical Center. The CC director and the chair of a newly structured Medical Executive Committee will serve in an ex-officio capacity.
NIH members will be representative of the institutes, not only institute directors. External board members will be chosen based on their expertise in health-care governance and management as well as clinical research. At least one Board member will be a registered nurse.
An executive committee of the Board, made up of both internal and external
members, will meet during months the entire board does not convene and will
act with full authority of the Board of Governors except in areas related
to approval of the strategic plan or annual budget.
The Medical Executive Committee will:
A Board of Scientific Counselors will also report to the Board of Governors.
On budget:Give the Clinical Center a separate budget.
Allow any savings generated through efficient operations to be retained and reinvested from year to year.
Move funds among budget categories depending on where the money is needed.
Seek legislative authority to solicit private donations and insurance company billing for some patient services.
The proposed budgeting system will:
The CC budget process currently is an unwieldy, indirect one. All budgeted money has to be spent in the current year, so there¹s no incentive for saving. Institutes can change the amount of money earmarked for the Clinical Center at any point during the year, which hampers budget planning.
On planning:Develop a strategic plan.
Outline how the CC will respond to long-range institute needs, extramural pressures to reduce costs, and competition from alternatives to intramural research.
Individual institutes and the NIH director establish overall scientific policy and strategy. The CC¹s strategic plan will define ways these policies are translated into day-to-day operations here. It will include specific, measurable goals and objectives.
On reinvention:The umbrella for these proposed changes is the Options Team recommendation that the Clinical Center be designated a Reinvention Laboratory under the government¹s initiative to re-engineer agencies for maximum efficiency.
That designation as an official federal demonstration site will allow the CC to continually seek new legislation and waivers from existing regulations, which will help to reduce bureaucratic barriers to efficiency.
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Awards ceremony honors CC staffersClinical Center staffers were honored at the Feb. 29 CC director¹s annual address and awards ceremony held in Masur Auditorium.
CC Director¹s Awards were given in five categories: administration, customer service, patient care, teaching, and technical excellence.
Jerry King, Medical Record Department director, and Lynda Ray, PET/Nuclear Medicine administrative officer, received the Director¹s Award for Excellence in Administration.
Sonia Macewicz, Clinical Pathology Department phlebotomist, selected for the Director¹s Award for Excellence in Customer Service, was recognized for her calming influence on CC pediatric patients who often require numerous daily blood draws under difficult circumstances.
Maurice Butler, Housekeeping and Fabric Care Department staffer, received his Customer Service award for leadership and willingness to go beyond the call of duty.
A third Customer Service award recipient, Jesse Ferguson, Outpatient Clinic administrator, won for his part in establishing the CC Computerized Appointment System.
The Award for Excellence in Patient Care went to Marsha Moore, Nursing Department, for leadership in the electrocardiograph improvement project, and to Critical Care Medicine Department Deputy Chief, Dr. James Shelhamer, for his superior dedication to NIH patients.
Two from the Department of Transfusion Medicine (DTM) received the Director¹s Award for Teaching and Training. Janet Pavel, DTM nurse, was recognized for a decade of transfusion education for nurses. And for outstanding leadership in the fellowship program, Dr. Cathy Conry-Cantilena also received the Teaching and Training Award.
The award for technical excellence went to James Vucich, Diagnostic Radiology Department medical physicist, for improvements in imaging technology.
A special tee shirt was created to thank those CC staffers who went to extraordinary means to work during the Blizzard of 1996. Many of those weather-braving souls slept overnight in the CC to assure continuous patient care during the storm.
Also recognized at the ceremony were the CC recipients of the 1995 NIH Merit and Honor awards.
A reception was held in the Visitors Information Center immediately following the ceremony.
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Participants sought for neuro studyHealthy females between the ages of 18 and 45 are needed for a neuropsychiatric research project on personality disorders. The study, which includes limited risk and no radiation exposure, involves screening evaluation, neuropsychological testing, and single-dose administration drug studies. Intravenous access will be needed for drug challenge. Ample payment is provided for participation. The study is located on the campus of St. Elizabeths Hospital in Washington, D.C. Free parking is available in monitored lots. The hospital is also accessible by Metro. If interested, call Dr. Eric Watsky, M.D., at the Neuroscience Center at St. Elizabeths (202-373-6112) or email him at email@example.com.
Treasures needed for auction salesThe Friends of the Clinical Center and the R&W are collecting items for their annual white elephant treasures and collectibles sale set for April 30 as part of the Patient Emergency Fund Auction. Bring glassware, dishes, lamps, games, sports equipmentalmost anything except clothingto the Red Cross desk in the CC lobby.
Up for bid at the auction will be great escape weekends, theater tickets, and restaurant dinners. Also planned are a $500 cash raffle and a bake sale.
All proceeds directly benefit the Patient Emergency Fund. For more information, call 496-6061.
Classes setThe education and training section, Office of Human Resource Management, will sponsor these training classes in April:
Illness Across the Life Span: An Interdisciplinary Education Series. Learn how special needs, behaviors, and issues related to specific age groups apply to patient care. April 16, noon-1 p.m., Lipsett Amphitheater.
Individual Differences in the Work Place: An Introduction to the Myers-Briggs Type Indicator. Participants learn how they perceive and relate to the world, and how to develop skills in building relationships. April 19, 9 a.m.-3:30 p.m., 6100 Executive Blvd.
Writing KSAs. Tailor your experience and training in sharp, clear KSAs (Knowledge, Skills, and Ability), April 23, 9 a.m.-noon, 6100 Executive Blvd.
Call 496-1618 to register.
Service notedJohnny Carter ended 30 years of federal service recently and the Department of Transfusion Medicine marked the occasion with a special ceremony and a plaque given by Dr. Harvey Klein, department chief. A Housekeeping and Fabric Care Department team leader, Carter had been assigned to DTM for the last seven years. "He is the best," says Janice Carr, DTM clinical nurse. "He is like a part of our family and we¹ll miss him." Fishing, church and community work, and travel top Carter¹s retirement plans.
Eating smarter gets easierWant to make better food choices, but don¹t know how to start? Start by observing National Nutrition Month in March. Check out the new DeLITEful entrees and NCI¹s 5-A-Day program foods, both available in the B1 cafeteria.
The entrees are low in fat, saturated fat, cholesterol, and sodium. The 5-A-Day program includes a variety of fruits and vegetables prepared without added salt, sugar, or fat.
The programs are presented by the cafeteria managerGSIin cooperation with the NIH Worksite Health Promotion Committee and the CC dietetic interns.
Events on tap for childrenClinical Center celebrations for Children and Health Care Week are set for March 17-23.
Preparing children, their families, and even professionals for health-care experiences is an important part of the total healing process, program planners say.
Among events on tap are:
For details on these and other events, call Kristin Johnsen or Myra Woolery-Antill at 496-3103.
Learn how to avoid poisoningThe Pharmacy Department marks Poison Prevention Week March 17-23. During March, they¹ll give away Ipecac syrupcommonly advised to counteract poisonand educational materials on preventing poisoning. Stop by the Outpatient Pharmacy in 1N248, 9 a.m.-4 p.m.
Pharmacists offer these tips to prevent accidents:
Keep items in original containers with original labels and read the
labels before using the products.
National Institutes of Health (NIH)
Warren Grant Magnuson Clinical Center (CC)
Bethesda, Maryland 20892
Last modified 3/14/96
This page last reviewed on 09/9/09