NIH Clinical Center

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Patient Care and Support Initiatives: Clinical Center Profile 2000-2001

Joint Commission on Accreditation of Healthcare Organizations. The CC completed its triennial survey in November 2000. Preliminary results are positive. Surveyors noted that despite an aging facility, the physical plant is well maintained. The survey team praised staff understanding and alignment to the mission and found staff throughout the hospital to be enthusiastic about their work. One surveyor remarked, “Every employee is a leader.”

Map of Active CC Patients Map of US shows 0-99 patients in 9 states, 100-999 in 32 states, 1000-4999 in 5 states, 5000-9999 in one state.

Pain and Palliative Care Service. In response to requests from both patients and institute clinical staff, the CC created a pain and palliative care service to provide comprehensive pain and symptom management and palliative care support for CC patients. Dr. Ann Berger was recruited and hired to head this new service. This initiative serves patients with acute and chronic pain and those with acute and chronic symptoms (such as nausea, vomiting, fatigue, etc.) that result either from underlying illnesses or therapies provided to patients for their illnesses. In just 4 1/2 months, the pain clinic served 189 patients.

Medical Consult Service. The Medical Executive Committee recommended that the Clinical Center provide in-house consultative support in general internal medicine. During the past year, the CC contracted a highly respected local internist and two nurse practitioners, who provide this consultative service 8 hours a day, 5 days a week. When the Medical Executive Committee evaluated the new consult service four months after its inception, the service received very positive reviews. The MEC endorsed the continuation of the consult service and endorsed the concept of hiring (rather than contracting) the consultant, resulting in considerable cost savings.

Nursing Department Reorganization. The CC has hired Clare Hastings, Ph.D., R.N., as the Chief of Nursing and Patient Care Services. She has begun the intensive work of preparing for the move into the Clinical Research Center in 2003. The move will decrease the number of patient care units from 22 to 13. She is working with CC and institute staff to pilot a new model of unit management, and reorganizing the department to accommodate both its clinical care and research missions.

Trans-Institute Pediatric Program. The CC hired two new Clinical Center pediatricians this year, Dr. Deborah Merke and Dr. John Hurley, an expert in pediatric nephrology. Their expertise will increase the scope and quality of pediatric services offered to patients and investigators and provide support for NIH’s continuing medical education programming.

Neurosurgery Relocation. Parking garage renovations and CRC construction impact necessitated an alternative site for delicate microscopic neurosurgery. CC departments worked closely with surgeons and staff in the National Institute of Neurological Disorders and Stroke to move the surgical program to neighboring Suburban Hospital. An operating room at Suburban was outfitted to replicate the CC neurological operating suite. Patients are transferred to Suburban prior to surgery and returned to the Clinical Center surgical intensive care unit postoperatively.

Hospitality Services. As a result of input from the Patient Advisory Group, the Clinical Center launched a hospitality services program in 1999. The program staffs three strategically located hospitality desks, along with a front-door greeter. The majority of the resources for this new initiative were made available through retraining and redeployment of existing resources.

NIH Family Lodge. Currently, the CC provides lodging for families of seriously ill patients in five local hotel rooms and two rented apartments. This provides a convenient, economical lodging option for families of patients who have lengthy stays. The Clinical Center, in partnership with the Foundation for NIH, is pursuing a permanent residence close to the hospital on campus. The Foundation has committed to raising $9 million to fund the design and construction of the NIH Family Lodge. Construction is expected to be completed by mid-2003.

Patient Education. Interdisciplinary collaboration became the focal point for patient education at the Clinical Center. The patient education task force, convened by the CC Quality Assurance Committee, surveyed existing resources, developed a quality assurance process for these resources, increased use of the internet to support programs, and established an interdisciplinary mechanism to document patient education. The group oversees operation of an online database of patient education materials and a standard clinical desktop resource for health information and patient-education resources.

Starbright World. Through the Starbright Foundation, the Clinical Center’s youngest patients now have new worlds to explore. Starbright World is a private, interactive computer network designed for hospitalized children and teenagers. Steven Spielberg, Academy Award-winning filmmaker and foundation chairperson, envisioned this escape for kids, hoping to create a haven and tool to help children cope with illness. The foundation provided four computer units for the hospital. Programming includes games, videoconferencing, specialized chat rooms, and interactive multimedia programs that help explain common medical procedures.

Telemedicine. A telemedicine facility is operating in the outpatient clinic to provide remote access and home care monitoring of patients. The facility also provides teleradiology capabilities so that clinicians can send and receive images for diagnostic consultation.

Family Friend Program. The Family Friend Program was introduced to provide support for patients who need child care while participating in clinical trials. A multi-disciplinary group created the program to support patient recruitment efforts. A special cadre of volunteers was recruited and trained to provide these services. The program is located in the 14th floor playroom.

Nursing Education. The Nursing Department Competency Program for Professional Nurses includes nine major categories: clinical practice, research, education, management, leadership, ethics and the law, communication and collaboration, information technology, and diversity appreciation. This year it was expanded to include links to privileging, orientation, ongoing validation of competence, performance improvement planning, and career development. A new Competency Assessment and Performance Evaluation tool was also developed for each professional nurse position description to document the assessment and validation of competence.

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