NIH Clinical Center

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Strengthening clinical care
  Patient safety In 2004, the Clinical Center developed new approaches to ensuring a robust patient safety program. Features of this program include:  
An emphasis on nonpunitive, voluntary, real-time electronic reporting of actual or potential events that may affect the quality of patient care and patient safety, using an electronic occurrence reporting system.  
Analysis of the occurrence reporting system data to identify clusters or trends of similar types of events, so interventions may be designed to eliminate them. This highly successful program has been presented at national meetings of the National Quality Forum, the National Patient Safety Foundation, and the Society for Healthcare Epidemiology in America.  
Survey of nursing staff to assess their perception of the organization’s “culture of patient safety.”  
Patient education about the care patients receive and their rights and responsibilities. “Speak up for your safety,” a brochure published in 2003, stresses the patient’s vital role in ensuring safety. Printed in both English and Spanish, the booklet is given to all new patients on admission.  
A study of the feasibility of using electronic patient identification devices (biometrics) to identify patients.  
  Pain and palliative care In 2004, the Clinical Center Pain and Palliative Care Service became one of only nine palliative care fellowship training programs in the United States to be accredited by the American Board of Hospice and Palliative Medicine (ABHPM). Accreditation is giving credibility to a new and growing field — palliative care — in this country. Getting the accreditation was more than a mere formality. The requirements led many of the staff through training they’d never before received. Fellows in training care for patients in inpatient settings, community settings (including Medicare-certified hospices), and ambulatory care settings, and are exposed to consultation services, longitudinal care, and bereavement support. They learn how to provide physical, psychosocial, and spiritual treatment for a patient and family experiencing a chronic, life-threatening illness.They learn to work in interdisciplinary teams and to value the contributions of other disciplines

In its fourth year, the service saw an average 25 to 30 inpatients a day (7,500 a year) and 30 outpatients in two weekly outpatient clinics. Under the leadership of Dr. Ann Berger, the core team has grown — adding three nurses and 2.5 physicians (including a half-time anesthesiologist). The larger team, which meets weekly, includes the patient representative and members of several disciplines, including nutrition, spiritual ministry, recreation therapy, and social work.

Dr. Ann Berger, chief of Pain and Palliative Care.
Dr. Ann Berger, chief of Pain and Palliative Care.
The chapel on the 7th floor.
The chapel on the 7th floor.
Alan Karchmer©
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