NIH Clinical Center

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Organizational Effectiveness and Efficiency Initiatives: Clinical Center Profile 2000-2001


Inpatient Perception Survey. The CC contracted the Picker Institute of Boston, MA, to conduct its first patient survey, which focused on inpatients’ perceptions. Surveys were sent to 728 Clinical Center inpatients; nearly 62 percent responded. The CC scored above the average of the academic health centers in all dimensions, and set the benchmark in physical comfort and involvement of family and friends. Ninety percent answered “yes” to the question “Would you recommend the Clinical Center to your friends and family?” The CC also received high marks in nursing care, involvement of family and friends, and courtesy of staff. The survey also identified some areas for improvement, including communication of medical information, coordination and continuity of care, and room environment. Under the leadership of the Clinical Center deputy director for clinical care, an organization-wide performance measurement group has been established to identify and implement strategies for improvement.

Activity-Based Costing. A tracking system has been implemented across the Clinical Center to align costs to protocols. CC departments determined activities and their drivers for providing support to institutes for their clinical research protocols. Departmental activities were assigned costs, and outputs for each activity were collected. These data produced unit costs per activity that were then assigned to the protocol or institute level.

Funding. At the recommendation of the CC Board of Governors, and beginning in 2000, Clinical Center funding is through a tax to each institute in proportion to the size of its intramural budget, rather than in proportion to resources used. It is hoped that this new mechanism will establish an incentive for increasing clinical research activity. In an effort to promote equitable access to resources under this new system, the CC has been actively identifying and modifying contractual arrangements that are still on a fee-for-use basis. As a result, the payment mechanism for contract laboratory tests, outside medical services, and the school for pediatric patients are now all built into the CC budget. The CC Advisory Council was key in identifying strategies to assure equitable resource management, such as development of guidelines for funding new initiatives.

Performance Measurement. The Clinical Center initiated a performance measurement initiative to provide the director and key stakeholders with reliable data about the clinical and operational performance of the organization. The Office of the Director developed an organizational framework for performance measurement in the organization, and all departments have developed mission-related measures that line up with organizational goals. Department performance measures were presented at the annual department heads retreat in March.

Diversity Management. The CC acknowledges the growing need to diversify its workforce. In response, it has initiated a plan for diversity management and appointed a diversity-program manager. In addition, the CC has developed and publicized new policies on the diversity workforce initiative and developed a targeted recruitment and outreach plan to address retention issues. The manager coordinates with DHHS to support healthcare disparity concerns and partners with NIH on agency-wide diversity initiatives.

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