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past issues

 Published monthly for CC employees by Clinical Center Communications

January 1999

CC researchers visit

New Year's wishes


The Way to Go

Award recipient

CC Roundtable

Cost-savings program

Holiday celebrations

News briefs

Celebrating quality



A patient's wish

Sharing his Christmas wish with Santa Claus is CC patient Montrail Neil. He was among numerous patients, staff, and visitors to chat with Santa during Rehabilitation Medicine's Holiday Open House last month. To find out how other departments celebrated the season, see Holidays.





The sickle cell anemia pilot is an outgrowth of collaborative research between several Institutes and departments. Shown here are (from left) CCMD's Dr. Mark Gladwin, Jim Nichols, R.N., Nursing; Dr. Alan Schechter, NIDDK; and Dr. Frederick Ognibene, CCMD.

CC researchers visit the community

It seemed quite fitting that during the season of giving a roomful of people at Howard University were contemplating giving unarguably the most a person can ever give--of themselves to advance science.

The room was dressed with a holiday theme and filled with attendees ranging from babies to the elderly. All had at very least two things in common. For one, as members of the Parents Support Group for Children with Sickle Cell Disease, they all were affected in one way or another by sickle cell anemia, a painful and debilitating disease, which affects one in every 400 African Americans. And secondly, they all listened intently to the promising words of their guests, Dr. Mark Gladwin and Jim Nichols, R.N., with the CC Critical Care Medicine and Nursing Departments, respectively, as they discussed a new project.

The project, co-sponsored by the Critical Care Medicine Department (CCMD) of the CC and the NIDDK, has taken researchers out of their labs and into the local community to study a new treatment for the disease.

"This pilot provides a unique opportunity because there is clearly a need for more and better treatment options for people living with this debilitating disease," said Dr. Frederick Ognibene, senior investigator in the CCMD. "We have been lucky enough to find people in our community who want to see an end to this disease and have been caring enough to participate in our pilot project."

"This research initiative and outreach efforts demonstrate the Clinical Center's commitment to identifying and meeting the health needs of our community," said Dr. John I. Gallin, CC director.

"Clinical research is essential to the discovery of new knowledge that leads to better health for everyone," said Dr. Gallin.

Researchers from the Clinical Center and the NIH have visited local churches, hospitals, and support groups to talk with community members about the promising treatment and elicit participation in the study. In addition to Howard University, the group is also working with Children's National Medical Center, as well as organizations such as the Armstead-Barnhill Foundation, which serves the community by developing new medical research options for sickle cell anemia patients.

That Saturday afternoon presentation at Howard University not only gave the presenters an opportunity to explain the study, but more than an hour-and-a-half after the meeting began, questions on the latest research advances in the area were still being fielded by Dr. Gladwin. "It is very exciting to go out into the community and be accepted as we have been," said Dr. Gladwin. "Many people have been very supportive of our efforts and it is truly gratifying to see the response from community members excited to have an opportunity to participate."

Despite the name of the support group, they provide resources to more than just parents of sickle cell anemia patients, said Pauline Davis, president of the group. Their membership often includes siblings, friends, families, and patients themselves. Their goal is to educate those affected by the disease, and they often find presentations such as the one conducted by the CC representatives very useful to the group. "We try to educate ourselves about the disease and some of the newest treatments that can help our kids lead normal lives," said Davis.

More specifically, the treatment involved in the CC pilot is looking at the effects of nitric oxide on hemoglobin, which is the molecule in red blood cells that carries oxygen from the lungs throughout the body. Not to be confused with nitrous oxide, or laughing gas as it is commonly known, nitric oxide is a colorless, tasteless, and odorless gas that is the focus of this pilot.

"We have seen some pretty impressive early data and strong scientific support that indicate nitric oxide could be effective, " says Dr. Gladwin, the study's principal investigator. "It's an avenue of clinical research and treatment we want to explore."

The pilot, under the CC's leadership, is a collaboration among the NIDDK, NHLBI, and the NCI. "This has been a unique opportunity for our Institutes to work together as a team," said Dr. Ognibene. "It is inspiring to see so many Institutes investing in this project to advance our knowledge of the disease."

The CCMD plans to continue presenting to local community organizations regarding the pilot project. "Our goal is to continue to achieve a strong community presence so that when we are ready to move into a clinical research study of a specific treatment, we will have a strong patient base," said Dr. Ognibene.

-by LaTonya Kittles

About the study

The Clinical Center pilot examines the effects of nitric oxide, a colorless, tasteless, and odorless gas, on hemoglobin. Hemoglobin is the molecule in red blood cells that takes oxygen from the lungs and carries it throughout the body. Red blood cells usually have a rounded shape. In sickle cell anemia, the cells become elongated and "sickled." Those irregularly shaped cells tend to clog arteries, which slows the flow of oxygen-rich blood throughout the body. That slowing of the blood flow causes the often-debilitating pain that sickle cell anemia patient's experience.

At the heart of the Clinical Center study is this question: Can nitric oxide contribute to better blood flow that will decrease the pain? Time and more research will tell.

For specific information concerning the pilot, contact Dr. Gladwin at 6-9320.



New Year's wishes from the director

At midnight on Jan. 9, one door closes and another opens, signaling a new year of change for the Clinical Center. Closing is the Clinical Center's familiar front door on Center Drive. Beginning on Sunday, Jan. 10--and for the duration of construction for the Mark O. Hatfield Clinical Research Center--the Clinical Center's main entrance will shift to the south.

Consider that a signal, too, for a new year filled completely with challenge and opportunity. The plans and preparations for our new research center will begin to take shape over the next months and years. We'll all more fully see and feel the effects of construction. As we begin a new year, I'd like to outline some of the major accomplishments the Clinical Center has realized over the past 12 months.


Clinical Center programs

Creating efficiencies while expanding services and programs is never easy, but that's what the Clinical Center staff did during 1998. As a result, $3.1 million from our FY98 budget will be "carried over" for reinvestment in new programs under the FY2000 budget. The CC Advisory Council will evaluate proposals from the Institutes on how to use the money. Their recommendations will go to Dr. Harold Varmus, NIH director, for a final decision.

We initiated exciting new programs during 1998, including one in organ transplantation. This will be a joint effort with NIDDK, Walter Reed Army Medical Center, the Naval Medical Research Center, and the Diabetes Research Institute of the University of Miami. Trials in the transplantation of pancreatic islet cells and kidneys will test new treatments for patients with type 1 diabetes or kidney failure.

The NIMH clinical brain disorder research program, previously carried out at St. Elizabeth's Hospital in Washington, moved to the Clinical Center's 4 West patient-care unit early in 1998. That transition was a smooth one thanks to the splendid planning and coordination of all involved.

On Aug. 31, the Clinical Center's contract for anesthesia and surgical services with Georgetown University was brought in-house and a new Department of Anesthesia and Surgical Services created. Dr. Karen Williams, who had led the department while it was under contract, was named chief of the new department. Dr. Thomas Fleisher was chosen to lead the Clinical Pathology Department. Dr. Ezekiel Emanuel, an advisor to the CC Department of Clinical Bioethics for two years, joined our full-time staff. Other key appointments in 1998 included Dr. Fred Gill and nurse practitioner Laura Shay. This new team will provide consultation in internal medicine.

As 1998 ended, the Clinical Center held a Forum on Pain Management and Palliative Care to explore the best way to provide these services within our hospital.



Educational opportunities in clinical research grew last year thanks to two new programs. The first is collaboration in long-distance learning with the School of Medicine at Duke University leading to a Master of Health Sciences in Clinical Research degree. The first class of 13 medical students and fellows was admitted in September. They join a Duke classroom through teleconferencing. The second new program is the post-doctoral Clinical Pharmacology Research Associate Program (ClinPRAT), which has drawn about 175 students to the program's "Principles of Clinical Pharmacology." A cooperative effort with the NIGMS, ClinPRAT will help prepare scientists to conduct both basic and applied clinical pharmacology research.

The popular "Introduction to the Principles and Practice of Clinical Research" continued in 1998. More than 1,100 students have completed the course since the program began as a pilot in 1995.



In February, Dr. Harold Varmus, NIH director, extended the Board of Governors charter until April 2000. Two new members joined the Board of Governors in 1998, Dr. Michael Johns and Dr. W. Marston Linehan. Dr. Johns is Executive Vice President for Health Affairs at Emory University and Chairman of the Board and CEO of Emory Healthcare. Dr. Linehan is chief of the Urologic Oncology Branch, NCI. Dr. H. Clifford Lane, NIAID clinical director, was named to complete the term of the late Dr. Jeffrey Hoeg. Dr. Hoeg, an extraordinary scientist, physician, and friend, died on July 21, 1998.

The Board continues to tackle major challenges. One initiative is a "school-tax" approach to Clinical Center funding. Developed and recommended by the Board in 1997, it was approved during 1998 by Institute and Center directors and Dr. Varmus. The initiative will provide a more predictable Clinical Center assessment to the Institutes and encourage full use of CC services.

The Board also initiated operational reviews for CC departments, beginning with the Materials Management and the Housekeeping and Fabric Care Departments.

The Clinical Center Advisory Council, established in 1997, continues to provide a strong voice and involvement for the Institutes in Clinical Center issues affecting intramural clinical research programs. A major contribution by the Council during the past 12 months has been planning for use of the new Clinical Research Center.

In 1998, the Clinical Center's Board of Scientific Counselors conducted its first review dedicated exclusively to science. Operational aspects of departmental performance are reviewed separately by the Board of Governors.

The Medical Executive Committee has also been busy in 1998, which began with the election of Dr. Scott Whitcup, NEI clinical director, to a two-year term as committee chair. A major action was revision of the physician-referral policy to allow patient self-referral.

In January, we asked Institute directors to nominate current and former patients for membership in a group to provide advice on design of the new Clinical Research Center. The Patient Advisory Group's role quickly evolved. They now meet quarterly, providing advice on and insight into patient concerns.



In 1998, we continued our efforts to form alliances with our colleagues in health care and science. In February, we began a stroke and cardiac imaging project with Suburban Hospital, the NINDS, and NHLBI. In April, we joined with the National Rehabilitation Hospital to work with individuals with physical disability caused by illness and injury.


Communications and public outreach

We took major strides in identifying how the public views the Clinical Center and structuring new approaches to recruit patients. Working with Macro International, Inc., a professional services firm, and Porter Novelli, a public relations firm, we are developing a patient recruitment plan that includes physician mobilization, community outreach, public and professional awareness, and internal capacity building.

In July, Dr. Harold Varmus, NIH director, acted on a recommendation by the National Academy of Sciences' Institute of Medicine to make sure that the public had a strong voice in the work we do and ultimately improve the setting of research priorities. The Clinical Center joined all of NIH in designating an office for public liaison. The Patient Recruitment and Referral Center, now renamed the Office of Patient Recruitment and Public Liaison, will lead that effort.

The Clinical Center's successes are the successes of all who work here. As we begin 1999, remember that your enthusiasm, dedication, and creativity continue to be our greatest strengths.




Male volunteers over 40 years of age and females over 50 years of age are needed for a study to assess the effects of donating blood on prevention of heart disease. Participants should have donated blood no more than once in each of the last five years, and given fewer than 15 units in their lifetime. Blood studies and carotid ultrasound will be done. Two outpatient visits are required. For more information, call Xin Fu at 2-4482.




Finding "The Way to Go"

The way we'll go will change at midnight on January 9. That's when the Clinical Center's main entrance on Center Drive closes forever. The main entrance south will open for business seconds later on January 10. Watch for it: The Way to Go.



Award recipient

Dr. Dimitrios Boumpas (right), senior clinical investigator with the Arthritis and Rheumatism Branch of the National Institute of Arthritis and Musculoskeletal and Skin Diseases, received this year's Distinguished Clinical Teacher Award. Presented annually since 1985, the award recognizes excellence in clinical training involving the direct care of patients by any senior investigator at NIH. Also shown is Dr. Elif Arioglu, presenter of the award, and CC Director Dr. John Gallin.



New for 1999 Clinical Center RoundTable

January 15 marks the debut of a new series, "Clinical Center RoundTable." Broadcast live from the NIH television studio to hospitals and academic health-care centers nationwide, each one-hour program will feature a panel of NIH physician-scientists discussing the latest clinical research on each topic. Dr. John I. Gallin, Clinical Center director, will moderate, and viewers are encouraged to call in with questions and comments.

"In addition to highlighting current research, we plan to provide more clinically relevant information for our hospital-based viewers," said Dr. Gallin. "We want to reach out to a segment of the medical public that may not be familiar with what we do here, and how it affects their practice."

Programs will be simulcast in Lipsett Amphitheater at noon and everyone is welcome to attend. The January 15 program, "What's New in the Imaging Sciences?" features Dr. R. Nick Bryan, chief of Diagnostic Radiology and Associate Director for Radiologic Imaging Sciences, and his colleagues Dr. Andrew Arai, Dr. Brad Wood, and Dr. Ronald M. Summers.

Future programs will cover: ·

    • Cutting-Edge Issues in Antiretroviral Therapy
    • Hepatitis C
    • Organ Transplantation
    • Managing Depression
    • Bone Marrow Transplantation
    • Sexually Transmitted Diseases
    • Current Issues in the Management of Breast Cancer
    • Brain Attack: Acute and Ongoing Management Issues
    • Frontiers in Immunization: New and Improved Vaccines

Watch CC News for dates and speakers.




New cost-savings program to reward employees for cost-savings ideas

Cutting costs is a perennial New Year's resolution in business and government, and the Clinical Center is no exception. Just like other organizations, the CC has found it challenging to come up with creative and effective ways to do so.

But not to fret, the CC Incentives Team, under the leadership of Social Work Chief Dr. Adrienne Farrar, has devised a new way to involve all CC employees in the cost-savings effort. Quite simply, employees will receive cash awards based on a percentage of money they save.

"The Incentives Team has worked hard to create a simple mechanism for front-line employees to be rewarded for ideas about how to do their jobs with less cost or with greater efficiency," said Dr. John I. Gallin, CC director. "We are extremely excited about the potential outcomes that this mechanism can have on our employees, as well as our organization."

Employees or groups who propose ideas that are proven to save their departments money are eligible to receive a 10% "rebate" of the savings (or a minimum of $100, whichever is greater). Awards may not exceed $5,000 for individuals or $10,000 for groups. An option also exists for the employee or group to use the reward to purchase something for their department, e.g., a piece of equipment.


Here's an example:

An employee in the Nutrition Department noticed that food containers with three sections were being used to send orders to patients, even when only one food item was ordered. She suggested that using single-serving foam containers would save storage space and money and would be adequate for 75% of the food orders. Her suggestion saved the department $800 a year. This person's award would be the minimum of $100, since that is greater than 10% of the proven savings.

Now, $800 might not sound like a huge savings. But many small savings combined can mean big savings to the Clinical Center.

"We realize that most of the ideas will generate modest savings," said team leader Dr. Farrar. "We want employees to start thinking creatively about cost savings, and even small savings are valuable and can be rewarded too."

All employees below the level of deputy directors, associate directors, and department heads are eligible to receive cash payouts derived from the savings achieved from their ideas. Deputy directors, associate directors, and department heads are eligible for NIH, CC, and other monetary and nonmonetary awards to recognize their efforts to achieve and support organizational goals.

So, what do you do with that great idea you've been mulling over? Fill out a Cost-Savings Proposal Form, available from your department head, and take it to your supervisor. Supervisors and department heads are committed to considering each idea brought to them and computing the potential savings. Once the savings are verified by the Office of Financial Resources Management, an adjustment will be made to the department's budget, and the 10% reward will be issued to the individual or group that proposed the idea. Help with idea development may be available to employees or supervisors. Contact Dr. Farrar at 6-9318 for more information.

CC News plans to publish success stories that result from this initiative. Watch for them.

-by Sue Kendall

A Team Effort

The CC Incentives Team is an outgrowth of the annual department heads retreat. It is anchored in the part of the Strategic Plan that focuses on cost efficiency and cost effectiveness. Over the past year the team considered a number of plans. The strategy outlined in this article was approved last month by Dr. Gallin and the Clinical Center Executive Committee.

Team leader Dr. Adrienne Farrar was assisted by team members Barbara Beall, Alberta Bourn, Larry Eldridge, Sue Fishbein, Ray Fitzgerald, Maureen Gormley, Jean Green, Sue Kendall, Michele Lagana, Julia Matthews, Gracie Millender, Alisa Peinhardt, Carol Romano, Bill Rosano, Maria Stagnitto, Mary Vailati, and Paula Wrenn.



Holiday celebrations at the CC

Last month, many departments here gathered to celebrate the holiday season. Activities were planned for patients, guests and staff alike. They included:



It's a family affair

Visiting with Santa Claus during Rehabilitation Medicine's Holiday Open House (from left) were CC patient Frances Delahanty and her granddaughter Crystal Selmer, along with family friend Andrew Hembree, grandsons Ryan and Matt Selmer, and daughter Darlene Selmer.



 Volunteers celebrate

During a holiday luncheon for volunteers, seasoned staff were able to meet and mingle with new volunteers who will become greeters when the south entry opens. Food and fun were at the top of the list for this celebration last month.

     Jingle bell rock

The show choir from Winston Churchill High School in Potomac were also on hand during the Holiday Open House to entertain the crowd in the 14th floor gymnasium. Here they perform their rendition of "Rudolph the Red-Nosed Reindeer." Holiday songs weren't their only treat. The show choir, which has been around for more than 25 years, showed their versatility by belting out several medleys.




News briefs

Bioethics rounds continue

"Resolving Cultural Conflicts in Patient Care" is the subject of the Feb. 3 Ethics Grand Rounds presentation set for noon in Lipsett Amphitheater. Guest speaker is Dr. Bernard Lo, director of medical ethics at the University of California at San Francisco and member of the National Bioethics Advisory Commission.


Open season

The Thrift Savings Plan open season runs until Feb. 1, 1999. FERS employees who were hired before July 1, 1998, as well as CSRS employees have an opportunity to change their current election or make an initial participation election. For more information contact human resources at 6-6924.


Nursing forum announced

The Nursing Research Forum will be held Jan. 21 from 2 to 3 p.m. in the Little Theater. Sessions will include "Clinical Evaluation of Noninvasive Oxygen Saturation Monitoring in Critically Ill Patients," and "The Health Related Quality of Life of Persons with Implantable Defibrillators: A Meta-analysis." To register, call Loan Kusterbeck at 5-2263.


Celebrate a legacy

The Office of Equal Opportunity will host the "1999 NIH Celebration of the Legacy of Dr. Martin Luther King, Jr.," on Friday, Jan. 15 from 11:30 a.m. to 1:00 p.m. in Masur Auditorium. The event will include several speakers and performers from the metropolitan area. Sign language interpretation will be provided. For additional information and reasonable accommodations, call 2-3663.



Celebrating quality

CC employees were special guests at a recent event designed to "Celebrate Quality." Several department staff members spoke to attendees to thank them for their consistent efforts in promoting quality service and care to patients and investigators in the Clinical Center. Staff were also informed of efforts towards preparation for the Joint Commission on Accreditation of Healthcare Organizations in 2000, the Clinical Center's new performance measurement initiative, the upcoming patient perception surveys, and the work of the patient education task force.


Editor: LaTonya Kittles
Clinical Center News, 6100 Executive Blvd., Suite 3C01, MSC 7511, National Institutes of Health, Bethesda, Maryland 20892-7511. (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.

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