THIS IS LAURA FORESE.
I'VE HAD THE PRIVILEGE OF
CHAIRING THIS GROUP FOR A NUMBER
OF YEARS NOW.
ACTUALLY SIX.
AND JUST WANT TO SAY I'M SO
DELIGHTED AS I'M GOING TO BE
HANDING OFF THE VIRTUE GAVEL TO
DR. VAN COOTS, WHAT A PRIVILEGE
IT IS TO BE IN PERSON WITH SOME
OF OUR NEW MEMBERS WHO COULD
MAKE IT.
THE CAMPUS LOOKS GORGEOUS TODAY.
IT'S A PALPABLE SENSE OF THE
GORGEOUS CAMPUS WHERE THINGS ARE
GOING ON.
FOR THOSE BOARD MEMBERS IN THIS
ROOM IN THE PAST, CERTAINLY RICK
AND STEPHANIE, MAYBE OTHERS, THE
ROOM WAS COMPLETELY REDONE.
IT'S JUST A TERRIFIC ROOM, IN
ADDITION TO OBVIOUSLY GREAT AV.
I WANT TO TAKE NOTE OF ALL OF
THE BOARD MEMBERS, SOME LEAVING,
NEW FOLKS JOINING.
WE HAVE SOME PENDING MEMBERS.
WE'RE GOING TO, AS PER NIH
OBLIGATIONS AND REGS HERE, TAKE
NOTE THAT THERE ARE SOME PEOPLE
STILL TO BE CONFIRMED.
SO, IN THE ROOM TODAY WE HAVE
DAVID CHEN AND CRAIG SAMMUT,
ALSO TWO PATIENT REPRESENTATIVE
NOMINEES, MR. DAVID BAMU,
MS. ANTOINETTE ROYSTER.
WE DON'T SEE DR. CUNNINGHAM ON
ON BUT SHE WILL BE JOINING FROM
UNIVERSITY OF PENNSYLVANIA, AND
DR. DEVAKSAR GETTING UP EARLY
FROM UCLA AND JOINING US SO
EARLY.
I MENTIONED STEPHANIE REEL, DR.
COOTS, CURRENT MEMBERS JOINING
US ON ZOOM DR. JULIE AND RICHARD
SHANNON, STEVE GOLDSTEIN, RUTH
BRINKLEY WILLIAMS IS GOING TO
JOINING US, SHE'S SPEAKING AT A
CONFERENCE IN CHICAGO WHERE
SHE'S BEING HONORED, HER LAST
MEETING AS WELL AS MINE.
IN TERMS OF COLLEAGUES IN THE
ROOM, OF COURSE, DR. TABAK IS
HERE, DR. GILMAN, DR. SCHWETZ.
WE'RE HAPPY TO HAVE ALL OF THEM.
DR. GALLIN IS ON ZOOM, SUBBING
FOR DR. GOTTESMAN TODAY IS DR.
RICHARD WYATT, WHO I SEE, YES,
THERE YOU ARE, GREAT.
THANK YOU FOR BEING WITH US.
DR. DOUG LOWY WHO GETS SPECIAL
RECOGNITION BECAUSE HE'S
REJOINING US ONCE AGAIN, THANK
YOU, DOUG, FOR BEING WITH US I
THINK WE'VE GOT OTHER TEAM
MEMBERS.
YES, I SEE SEVERAL OTHER PEOPLE
FROM THE NIH TEAM.
THANK YOU ALL FOR BEING WITH US.
JUST A COUPLE OTHER THINGS
BEFORE I TURN IT OVER TO DR.
TABAK.
OUR CHARTER WAS FINALIZED A
MONTH AGO, AND WILL GO THROUGH
2024.
IF YOU'LL PERMIT ME, I'LL MAKE
COMMENTS AT THE END AS I HAND
OFF THE CHAIR.
WITH THAT, LARRY, LET ME TURN IT
OVER TO YOU.
>> GREAT.
THANK YOU.
GOOD MORNING, EVERYBODY.
GOOD TO SEE SOME OF YOU HERE IN
PERSON.
THE REMAINDER VIA ZOOM, THANKS
FOR JOINING US.
REALLY THIS PART OF THE PROGRAM
IS SHORT BUT IMPORTANT IN TERMS
OF SIGNIFICANCE, BECAUSE IT
REALLY DOES MARK THE OCCASION OF
LAURA STEPPING DOWN AS THE CHAIR
OF THIS GROUP.
IT WAS NOT MEANT TO BE A LIFE
SENTENCE BUT I'M SURE IT FELT
THAT WAY, AT TIMES.
HOPEFULLY NOT THE ENTIRE TIME.
BUT REALLY WHEN YOU WORK FOR
GOVERNMENT BOARDS, MOSTLY WHAT
WE CAN GIVE YOU IS THANKS AND
NOT MUCH ELSE.
PROBABLY NOT QUITE THE SAME WHEN
YOU'RE, YOU KNOW, ON CORPORATE
BOARDS, BUT NEVERTHELESS THE
SENTIMENT IS THERE.
SO, WE REALLY JUST WANTED TO BE
ABLE TO MARK THIS OCCASION WITH
A SHORT PRESENTATION.
JIM, DO YOU WANT TO SAY ANY
WORDS?
>> AFTER.
>> AFTER?
OKAY.
>> WE'VE GOT SOMETHING -- AFTER
YOU, BECAUSE WE HAVE SOME THINGS
WE'D LIKE TO GIVE LAURA.
>> OKAY.
SO DID YOU WANT ME TO GO THROUGH
MY DIRECTOR'S PRESENTATION AND
THEN WE'LL DO THIS AT THE BACK
END?
I JUST DO WHAT'S ON THE LIST,
AND IT DIDN'T SAY THAT.
OKAY.
IF WE COULD BRING UP MY SLIDES
PLEASE, I HOPE.
IS THAT POSSIBLE?
YEAH, THAT'S -- DO YOU HAVE
THEM?
OR AM I SHARING MY SCREEN?
I HOPE NOT.
OKAY.
[OFF MICROPHONE]
OKAY.
OR I WILL -- [OFF MICROPHONE]
NO, I'LL JUST STAY RIGHT HERE IF
THAT'S OKAY WITH YOU.
IS THAT NOT POSSIBLE?
OKAY.
AND IF YOU WOULD BE SO KIND AS
TO ADVANCE THEM, THAT WOULD BE
FANTASTIC.
OKAY, GREAT.
THANK YOU.
OKAY, SO THIS IS THE 25th
MEETING OF THIS BOARD,
REMARKABLY, AND IN SUCH A SHORT
SPACE OF TIME.
AS YOU'LL HEAR IN PART THIS SORT
OF SHORT RETROSPECTIVE, THIS
BOARD HAS BEEN EXTRAORDINARY IN
THE IMPACT THAT IT'S HAD IN
HELPING NIH WITH THE CLINICAL
CENTER.
IF I COULD HAVE THE NEXT SLIDE
PLEASE.
SO, I'M GOING TO TALK A LITTLE
BIT ABOUT SOME OF THE DEPARTURES
AND THE HISTORY BEHIND THE
BOARD.
MOSTLY FOR THE NEWER MEMBERS.
TALK ABOUT SOME ARRIVALS AT NIH,
THERE'S A COUPLE UPDATES WE
WANTED TO SHARE WITH YOU.
NEXT PLEASE.
LET'S START WITH THE DEPARTURES.
AS DR. FORESE SAID, RUTH
WILLIAMS BRINKLY WILL BE LEAVING
THE BOARD AFTER THIS MEETING.
AND SHE WILL CERTAINLY BE
MISSED.
SHE'S BEING HONORED AS WE SPEAK,
AND SO WE HOPE THAT YOU WILL BE
JOINING US MOMENTARILY.
IF WE HAVE THE NEXT SLIDE
PLEASE.
AND WE'RE GOING TO MAKE YOU
UNCOMFORTABLE THROUGHOUT THIS
ENTIRE MEETING.
YOU'LL HAVE TO GET USED TO THIS.
AND OBVIOUSLY, DR. FORESE WILL
BE LEAVING THE BOARD AS WELL AT
THE CONCLUSION OF THE MEETING.
AND TO SAY THAT YOUR
CONTRIBUTIONS HAVE BEEN PROFOUND
IS A GROSS UNDERSTATEMENT.
YOU HAVE PRESIDED OVER THIS
BOARD EXACTLY SIX YEARS AGO
TODAY, JULY 15, 2016.
AND PRIOR TO THAT, SHOWING NO
GOOD DEED GOES UNPUNISHED DR.
FORESE WAS A MEMBER OF A TEAM
THAT ACTUALLY LED TO THE
CREATION OF WHAT WE NOW CALL THE
CLINICAL CENTER RESEARCH
HOSPITAL BOARD.
SO, THANK YOU.
THANK YOU AND THANK YOU.
NEXT SLIDE PLEASE.
SO, THIS IS THE ORIGINAL BOARD.
I TEND TO BE CAMERA SHY SO YOU
WILL NOT SEE ME IN ANY OF THESE
PICTURES EVER.
I WAS SUCCESSFUL IN NAVIGATING
THAT.
AND I THINK IT'S PROBABLY WORTH
REVISITING HOW THIS INITIAL
GROUP CAME TOGETHER.
SO COULD I HAVE THE NEXT SLIDE
PLEASE.
SO, AS SOME OF YOU KNOW, WE HAD
A REAL SOUL-SEARCHING PERIOD
HERE AT NIH.
THE SPRING OF 2015, AFTER IT
BECAME KNOWN THROUGH A
WHISTLEBLOWER COMPLAINT THAT
THERE WERE UNSAFE PROCEDURES IN
THE CLINICAL CENTER PHARMACY,
RELATED TO THE USE OF STERILE
INJECTABLES.
AS THE -- YOU KNOW, WHEN I WAKE
UP EVERY MORNING, THE FIRST
THING I DO IS LOOK ABOVE THE
FOLD AND NIH ISN'T THERE I
FIGURE IT'S GOING TO BE A GOOD
DAY.
IF WE'RE NOT BELOW THE FOLD THEN
I KNOW IT'S GOING TO BE A GOOD
DAY.
THIS ONE WAS ABOVE THE FOLD ON
THE FRONT PAGE.
AND FOR GOOD REASON, OF COURSE,
BECAUSE THIS WAS VERY
SIGNIFICANT.
NEXT SLIDE PLEASE.
SO, AFTER WE HAD A FORMAL
INSPECTION BY THE FOOD AND DRUG
ADMINISTRATION, WHO CONFIRMED
THE PROBLEMS IN THE PHARMACY, WE
TOOK STEPS TO SUSPEND ALL
PROBLEMATIC OPERATIONS.
AN INTERNAL TASK FORCE CAME
TOGETHER TO REVIEW THE SITUATION
AND THEN A FEW MONTHS LATER THE
ADVISORY COMMITTEE TO THE NIH
DIRECTOR ESTABLISHED A WORKING
GROUP, KNOWN AS THE RED TEAM.
AND THIS WAS A
MULTI-DISCIPLINARY GROUP OF
OUTSIDE EXPERTS, AND THEN
DIRECTOR FRANCIS COLLINS ASKED
THEM TO REVIEW HOW THE ENTIRE
CLINICAL CENTER OPERATED, AND I
HAVE TO SAY THE RED TEAM TOOK
THEIR CHARGE VERY SERIOUSLY.
THEY SUGARCOATED NOTHING.
AND ON APRIL 21, THEY SUBMITTED
THEIR REPORT TO THE ADVISORY
COMMITTEE TO THE DIRECTOR.
AMONG THE RECOMMENDATIONS THAT
THEY CAME OUT WITH WAS TO
ESTABLISH AN EXTERNAL BOARD
ACTING LIKE THE BOARD OF ANY
LOCAL HOSPITAL TO OVERSEE THE
HOSPITAL'S MANAGEMENT IN TERMS
OF ITS SAFETY AND QUALITY AND SO
FORTH.
AND SO, THIS BOARD, CCRHB, IS
THE DIRECT RESULT OF THAT
RECOMMENDATION.
AND AS YOU CAN SEE FROM THE
TIMELINE THAT IS DISPLAYED, THE
FIRST OF THESE MEETINGS OCCURRED
LITERALLY SIX YEARS AGO ON THE
SAME DAY.
SO, IF I COULD HAVE THE NEXT
SLIDE PLEASE.
SO, THE THEMES IN THE REPORT,
AND THESE WILL PROBABLY COME AS
NO SURPRISE TO ANY OF YOU, BUT
THE TEAMS IN THE REPORT WAS THE
NEED TO FORTIFY A CULTURE AND
PRACTICE OF SAFETY AND QUALITY.
MAINLY BY STRENGTHENING THE
AUTHORITY OF THE LEADERSHIP.
SO NIH IS A DECENTRALIZED
ORGANIZATION.
OUR INSTITUTES AND CENTERS
RECEIVE THEIR OWN DIRECT
APPROPRIATIONS FROM THE CONGRESS
OF THE UNITED STATES.
AND SO WE REALLY ARE A FEDERATED
SYSTEM, BUT, YOU KNOW, A
HOSPITAL IS A HOSPITAL.
AND SO REGARDLESS OF SOME OF THE
CHALLENGES THAT OUR FEDERATED
ORGANIZATION PRESENTS, IT WAS
THOUGHT THAT WE REALLY NEEDED TO
STRENGTHEN THE OVERSIGHT.
THE TEAM'S FINDINGS DETAILED A
CULTURE OF OVERWORK IN THE
PHARMACY.
THE STAFF REALLY HAD STRUGGLED
TO PLEASE INTRAMURAL
RESEARCHERS, AND UNFORTUNATELY
NONE REPORTED TO THEIR
LEADERSHIP THEY WERE BEING
PUSHED BEYOND WHAT WAS A
REASONABLE SET OF EXPECTATIONS.
THOSE COMPLAINTS, THOSE
CONCERNS, JUST NEVER REACHED THE
HIGHER LEVELS OF MANAGEMENT IN
THE HOSPITAL.
AND SO THE ACB UNANIMOUSLY
ACCEPTED THE RED TEAM'S 11
RECOMMENDATIONS, AND THE NEXT
MORNING FRANCIS, THEN NIH
DIRECTOR, THE CLINICAL CENTER
DIRECTOR, JOHN GALLIN, AND I
PRESENTED THE TEAM'S FINDING TO
A TOWN HALL OF THE INTRAMURAL
COMMUNITY.
IF I CAN HAVE THE NEXT SLIDE
PLEASE.
SO, THE FIRST MEETING WAS
CONVENED, AND FRANCIS APPOINTED
DR. FORESE, WHO AT THE TIME HAD
A LOT OF SPARE TIME ON YOUR
HANDS, AT THE TIME SHE WAS
ALREADY OVERSEEING SIX MAJOR
HOSPITALS IN THE NEW YORK CITY
AREA.
AND I KNOW THOSE HOSPITALS.
SHE COMMITTED TO LEAD THE BOARD
AT QUARTERLY MEETINGS FOR TWO
YEARS.
THE RED TEAM IN 2016 AND ANY
BOARD IN THE YEARS SINCE HAVE
REALLY BEEN POPULATED WITH
INDIVIDUALS WHO ARE ACCUSTOMED
TO THINKING ABOUT CONTINUOUS
IMPROVEMENT IN HOSPITAL
OPERATIONS.
AND I HAVE TO SAY, THE FIRST
YEAR OR SO WHEN THE BOARD WAS
CREATED, WE DID RECEIVE QUITE A
BIT OF CRITICISM FROM SOME
MEMBERS, NOT ALL, OF THE NIH
COMMUNITY.
BUT REGARDLESS OF THAT, IT WAS
UNAMBIGUOUS TO EVERYBODY THAT
THE OUTSIDE EXPERTS WERE ABLE TO
PINPOINT REAL STRUCTURAL
PROBLEMS IN OUR GOVERNANCE AND
IN OUR FUNDING MODEL, THAT
NEEDED TO BE ADDRESSED.
NOW, IN ADDITION TO CHAIRING THE
BOARD IN 2016, DR. FORESE LED
THE EFFORT TO FILL A NEW
POSITION, CLINICAL CENTER CEO.
SO, IF I CAN HAVE THE NEXT SLIDE
PLEASE.
WELL, NOW, SOMEHOW FRANCIS
CONVINCED YOU THAT TWO YEARS WAS
JUST A STARTING POINT OF YOUR
RELATIONSHIP WITH NIH, AND OF
COURSE WE HAVE BENEFITED
ENORMOUSLY.
AND DR. FORESE HAS SKILLFULLY
LED THIS BOARD UP TILL PRESENT
DAY, AND HERE WE ARE AT A
RIBBON-CUTTING CEREMONY FOR THE
BRAND NEW STATE-OF-THE-ART
RENOVATED PHARMACY.
AND THIS REALLY WAS A WATERSHED
MOMENT.
THE PEOPLE AT KNOW I HATE DOING
CEREMONIAL THINGS LIKE THIS.
I AVOID THEM ALWAYS.
BUT THIS ONE I WANTED TO BE PART
OF.
SO THAT'S WHY I'M SORT OF DEAD
CENTER THERE.
THIS IS IMPORTANT.
AND SO, YOU KNOW, AGAIN, LAURA,
THANK YOU ON BEHALF OF ALL OF
NIH FOR YOUR DEDICATION TO THIS
PLACE, AND FOR EVERYTHING THAT
YOU BROUGHT.
ALSO, I'D LIKE TO THANK RUTH
WILLIAMS-BRINKLEY AGAIN, WHO
ALSO SERVED FOR SIX YEARS.
BOTH OF YOU WERE THERE FROM THE
BEGINNING.
SO THANK YOU.
OKAY.
NOW, LET'S GO ON TO THE NEXT
SLIDE PLEASE.
SO, OF COURSE, EVEN THOUGH WE
HAVE TO SAY GOOD-BYE OF SOME
FOUNDING MEMBERS IT'S GREAT TO
PERSONALLY WELCOME NEW ARRIVALS.
NEXT SLIDE PLEASE.
DR. VAN COOTS WILL BE ASSUMING
THE CHAIR OF THE BOARD.
AS YOU SEE, HE'S THE PRESIDENT
AND CEO OF HOLY CROSS HEALTH.
HE HAS ATTENDED MEETINGS AS AN
AD HOC MEMBER.
THIS IS HIS FIRST OFFICIAL
MEETING.
WE'RE DELIGHTED YOU ARE HERE AND
LOOK FORWARD TO YOUR WISDOM,
GUIDANCE, AND WORKING TOGETHER.
SO WELCOME.
NEXT, I DON'T KNOW IF DR.
CUNNINGHAM IS ON THE ZOOM CALL
OR NOT.
SHE IS THE CEO OF THE HOSPITAL
OF THE UNIVERSITY OF
PENNSYLVANIA, HIGHLY EXPERIENCED
HEALTH CARE EXECUTIVE AND AS YOU
SEE WITH A NURSING BACKGROUND.
NEXT, DR. SHERIN DEVASKAR,
CORRECT CORRECT ME IF I MANGLED
THE PRONUNCIATION, EXECUTIVE
CHAIR OF THE DEPARTMENT OF
PEDIATRICS AT UCLA, PHYSICIAN IN
CHIEF MATTEL HOSPITAL, ASSISTANT
VICE CHANCELLOR UCLA HEALTH.
DR. DEVASKAR'S PARTICIPATION ON
THIS BOARD IS PARTICULARLY
TIMELY, BECAUSE WE ARE IN THE
MIDST OF EXPLORING WHETHER WE
WISH TO CONDUCT MORE RESEARCH
WITH YOUNGER PEDIATRIC PATIENTS.
SO WE WILL NEED HER EXPERTISE
CERTAINLY TO HELP INFORM THAT
CONVERSATION.
OKAY.
NEXT PLEASE.
SO, THIS IS WHERE I WAS SUPPOSED
TO INTRODUCE TO YOU THE NEXT NIH
DIRECTOR, BUT THAT DIDN'T
HAPPEN.
SO YOU STILL HAVE ME AS ACTING
DIRECTOR.
AND SO THE PROCESS FOR THOSE WHO
ARE UNFAMILIAR, THE PRESIDENT
NOMINATES AN INDIVIDUAL.
IN A HAS NOT YET OCCURRED.
ONCE NOMINATED, THE SENATE HAS
TO CONFIRM THE APPOINTMENT OF
THE INDIVIDUAL.
AND THAT IS A PROCESS INVOLVING
INTERVIEWS AND HEARINGS AND
ULTIMATELY VOTES.
AND SO WE LOOK FORWARD TO
HEARING ABOUT THE NOMINEE IN THE
NEW TOO DISTANT FUTURE AND HOPE
FOR A TIMELY CONFIRMATION
PROCESS WITHIN THE U.S. SENATE.
IN TERMS OF BUDGET, INSTITUTE
DIRECTORS AND I TESTIFIED AT THE
CONGRESSIONAL APPROPRIATIONS
HEARING IN MAY, BOTH HOUSE AND
SENATE.
AND WE ARE HOPEFUL WE WILL SEE A
MODEST INCREASE IN BUDGET IN 23,
AS WE HAVE ENJOYED IN THIS
FISCAL YEAR, 2022.
IF I COULD HAVE THE NEXT SLIDE
PLEASE.
NOW, I DO HAVE ONE ARRIVAL AND
DEPARTURE TO NOTE THAT'S VERY
IMPORTANT FOR NIH, WHICH
ACTUALLY WAS ANNOUNCED
YESTERDAY.
AND THAT WAS THE APPOINTMENT OF
DR. NINA SCHOR TO SERVE AS NIH
ACTING DEPUTY DIRECTOR FOR
INTRAMURAL RESEARCH, AND SHE
WILL BE TAKING OVER THE REINS
FROM DR. MICHAEL GOTTESMAN WHO
SERVED AS THE DEPUTY DIRECTOR
FOR INTRAMURAL RESEARCH FOR 29
YEARS.
AND HE ANNOUNCED HIS PLANS LAST
YEAR TO STEP DOWN.
HE WILL BE RETURNING FULL TIME
TO HIS LABORATORY IN THE CENTER
FOR CANCER RESEARCH AT THE NCI
WHERE HE HAS BEEN THE CHIEF OF
THE LABORATORY OF CELL BIOLOGY
SINCE JOINING NIH.
DR. SCHOR IS A PEDIATRIC
NEUROLOGIST, AND SHE WILL BEGIN
HER NEW ROLE ON AUGUST 1.
AND SO NEEDLESS TO SAY WE'RE
GRATEFUL FOR ALL MICHAEL HAS
GIVEN IN HIS ROLE AND LOOK
FORWARD GREATLY TO WORKING WITH
DR. SCHOR GOING FORWARD.
OKAY.
NEXT PLEASE.
SO, REMAINING FEW MOMENTS, I
JUST WANT TO FOCUS ON NIH-WIDE
DIVERSITY, EQUITY, INCLUSION,
AND ACCESSIBILITY STRATEGIC
PLANNING.
THIS IS VERY, VERY IMPORTANT FOR
US, AND I WANTED THIS BOARD TO
BE AWARE OF WHAT WE'RE DOING
SORT OF AT HIGH LEVEL,
OVERARCING LEVEL.
RESPONDS TO TWO MANDATES, WE
RECEIVED LANGUAGE IN THE 2021
BUDGET REQUIRING US TO DEVELOP A
STRATEGIC PLAN IN WHICH WE'RE TO
INCLUDE BOTH SHORT- AND
LONG-TERM GOALS TO ADDRESS
RACIAL, ETHNIC, GENDER
DISPARITIES AT NIH, TO IDENTIFY
AND ADDRESS BARRIERS AND ACCESS
TO NIH FUNDING BY INVESTIGATORS
WHO ARE RESEARCHING HEALTH
DISPARITIES.
AND THEN EXECUTIVE ORDER 14 035
ALSO PROVIDED US WITH
RESPONSIBILITY TO DEVELOP THIS
PLAN.
NEXT SLIDE PLEASE.
SO, WHO IS DEVELOPING THIS PLAN?
BECAUSE THIS AFFECTS EVERYTHING
AT NIH.
EVERYTHING THAT WE DO.
INTERNALLY, EXTERNALLY.
AND SO WE HAVE A WORKING GROUP
OF ROUGHLY 100 INDIVIDUALS FROM
ALL 27 INSTITUTES AND CENTERS
AND MANY OF THE OFFICES WITHIN
THE OFFICE OF THE DIRECTOR.
THE EFFORT IS BEING LED BY CHIEF
OFFICER FOR SCIENTIFIC WORKFORCE
DIVERSITY, DR. MARIE BERNARD.
ACTING DIRECTOR AT THE TIME, DR.
SHELMA LITTLE, AND THE DIRECTOR
OF THE OFFICE OF HUMAN RESOURCES
JULIE BERKO.
THE DPCPSI, OUR DIVISION THAT
MANAGES NIH ACTIVITIES IS
MANAGING THE OVERALL PROCESS,
AND IN PARTICULAR MARINA VOLKOV
AND HER STAFF IS TAKING THE
LEADERSHIP ROLE.
SO, THIS BEARS A STEERING
COMMITTEE OF THE GROUP, THEY ARE
RESPONSIBLE FOR LAYING OUT AND
DEVELOPING BOTH THE PLAN AND ANY
IMPLEMENTATION ACTION ITEMS.
AND ALL OF NIH LEADERSHIP IS
ENGAGED IN THIS.
THIS HAS BEEN DISCUSSED WITH THE
INSTITUTE CENTERS, INSTITUTE
CENTER DIRECTOR, WITH SCIENTIFIC
DIRECTOR, WITH THE EXECUTIVE
OFFICERS, HEAD ADMINISTRATOR IN
ALL OF THE ORGANIZATIONS.
SO, THIS IS -- EVERYBODY IS
ENGAGED IN THIS.
IF I COULD HAVE THE NEXT SLIDE
PLEASE.
SO, WE BEGAN IN THE SUMMER OF
2021.
THE WORKING GROUP DEVELOPED A
HIGH LEVEL FRAMEWORK WHICH WAS
PRESENTED TO THE INSTITUTE AND
CENTER DIRECTORS IN JANUARY,
APPROVED BY THEM.
WE THEN SOUGHT PUBLIC COMMENT
BOTH EXTERNAL PUBLIC COMMENT BUT
ALSO INTERNAL TO NIH, AND I'M
SURE THIS WILL SURPRISE NONE OF
YOU, OUR STAFF ARE NOT BASHFUL,
AND THEY, YOU KNOW, CERTAINLY
EXPRESSED THEIR VIEWS.
AND THAT WAS VERY HELPFUL.
WE'RE CURRENTLY AT PHASE 4 OF
THIS.
WE'RE REFINING THE FRAMEWORK
INFORMED BY THE INPUT THAT WE
RECEIVED DURING PHASE 3.
AND THE WORKING GROUP IS NOW
DRAFTING A PLAN.
AND OUR GOAL IS TO HAVE THIS
DONE BY THE END OF THE SUMMER.
AND I THINK WE'RE ON TRACK AND
WE SHOULD BE ABLE TO MAKE THAT.
IF I COULD GO IN THE NEXT SLIDE
PLEASE.
JUST TO GIVE, AGAIN, A HIGH
LEVEL SCOPE OF THE PLAN, IT
REALLY WILL DELVE INTO THE STEPS
THAT THE AGENCY CAN TAKE TO
EMBRACE, TO INTEGRATE, AND TO
STRENGTHEN DIVERSITY, EQUITY,
INCLUSION, AND ACCESSIBILITY
ACROSS ALL OF OUR ACTIVITIES IN
SERVICE OF THE NIH MISSION.
WE WANT NIH TO BE A
PEOPLE-CENTERED ORGANIZATION.
WE WANT NIH TO BE REPRESENTATIVE
OF THE NATION'S DIVERSITY.
WE WANT NIH TO BE A PLACE WHERE
EVERYBODY HAS A SENSE OF
BELONGING.
AND SO, THE PLAN WILL CAPTURE
THE MANY ACTIVITIES THAT WE HAVE
ALREADY BEGUN AND WILL CONTINUE
TO UNDERTAKE TO MAKE THE
OVERARCING VISION OF THE PLAN,
AND WE'VE HARMONIZED THIS
FRAMEWORK WITH PRIORS ORGANIZED
AROUND ACCOMPLISHMENTS, NEEDS,
OPPORTUNITIES, AND CHALLENGES.
IF I COULD HAVE THE NEXT SLIDE.
SO, THE OBJECTIVES ARE
ARTICULATED HERE, TO GROW AND
SUSTAIN THESE EFFORTS TO
STRUCTURAL AND CULTURAL CHANGE.
IF THERE ARE STRUCTURAL
BARRIERS, HARD WIRED, THAT GET
IN THE WAY, YOU HAVE TO ADDRESS
THOSE AS WELL.
OBJECTIVE 2 TO IMPLEMENT
ORGANIZATIONAL PRACTICES TO
REALLY CENTER AND PRIORITIZE
THIS IN THE WORKFORCE.
IT CAN'T BE AN AFTERTHOUGHT,
CAN'T BE THE THING YOU ADD ON.
IT REALLY NEEDS TO BE INTEGRATED
IN THE CORE OF EVERYTHING THAT
WE DO.
AND THEN FINALLY, WE'RE A
RESEARCH ORGANIZATION.
AND WE HAVE TO ADVANCE
DIVERSITY, EQUITY, INCLUSION,
AND ACCESSIBILITY THROUGH
RESEARCH, BOTH THROUGH WORKFORCE
RESEARCH AND HEALTH RESEARCH.
AND WE FEEL THAT WE HAVE MADE A
REASONABLE START ON THIS, AND WE
WORK THROUGH HERE LOCALLY AT NIH
BUT ALSO UP THROUGH THE
DEPARTMENT AND UP UNTIL, YOU
KNOW, THROUGH THE WHITE HOUSE.
SO, THIS IS
ACROSS-THE-GOVERNMENT ACTIVITY,
AND WE'RE CERTAINLY WANTING TO
DO MORE THAN OUR PART IN THIS
EFFORT.
LAST SLIDE PLEASE.
I WANT TO THANK YOU.
I APPRECIATE THE OPPORTUNITY FOR
BRIEF OPPORTUNITIES.
NOW I WILL TURN IT OVER TO DR.
GILMAN.
>> I WAS FORTUNATE
ENOUGH TO BE SELECTED
TO BE THE FIRST CEO OF THE NIH
CLINICAL CENTER. I'VE
BEEN VERY PRIVILEGED TO HAVE THE
CHANCE TO WORK WITH LAURA AND
THIS ENTIRE BOARD, AND BY THE
WAY, VAN HEARD THAT YOU TOOK THE
JOB FOR TWO AND HAVE BEEN HERE
FOR SIX AND HE'S RETHINKING
RIGHT NOW.
[LAUGHTER]
YOU DON'T WANT US TO DO THAT
AGAIN.
WE HAVE A LETTER SIGNED BY DR.
TABAK AND DR. SCHWETZ.
AND I'M SURE YOU HAVE PLENTY OF
OTHER CERTIFICATES.
THERE'S ONE.
AND YOU MIGHT HAVE NOTICED THERE
WAS SOMETHING MISSING AT YOUR
SEAT WHEN YOU --
>> THIS MUST BE MY GAVEL!
>> THERE YOU GO.
>> THIS IS ALWAYS SO FUNNY, WHEN
THE GAVEL WOULD BE HERE.
IT FELT IMPORTANT TO BANG IT.
AWESOME!
THERE WE GO.
THERE IT IS.
IT'S GOT MY NAME ON IT.
CONGRATULATIONS.
SO THANK YOU.
[APPLAUSE]
WELCOME TO ALL OF THE NEW
MEMBERS, AND MANY THANKS TO
LAURA AND WE GET RICK SHANNON
FOR ONE MORE, AND RUTH
WILLIAMS-BRINKLEY FOR THEIR LONG
PERIOD OF SERVICE TO THE BOARD,
AND WELCOME TO DR. CUNNINGHAM
AND TO DR. DEVASKAR FOR THEIR
ARGUES AT THIS MEETING.
AND SO I'LL HAVE A SHORT
PRESENTATION, SHORTER THAN I
USUALLY HAVE, BUT I'LL BE BACK
TO GIVE FIVE-YEAR RUNNING
SUMMARY OF THE THINGS WE'VE
GOTTEN ACCOMPLISHED SINCE 2017.
WELCOME TO THE BOARD MEMBERS.
DAVID CHEN WANTED TO KNOW WHY HE
WAS STILL PENDING.
THINGS ARE HAPPENING.
IT'S GOING ACCORDING TO THE WAY
THINGS GO, IT'S JUST THE WAY IT
IS.
WE'RE VERY GLAD YOU'RE HERE.
AND YOU KNOW THAT LAURA AND
RUTH, THIS IS THEIR LAST
MEETING.
AND I'VE KNOWN VAN COOTS FOR
ABOUT 20 YEARS AND HAVE A
TREMENDOUS AMOUNT OF
APPRECIATION FOR HIS WILLINGNESS
TO STEP IN AND FILL I THINK A
POSITION THAT'S ACTUALLY PRETTY
DIFFICULT TO FILL.
BUT I'VE KNOWN VAN NOT TO SHY
AWAY FROM A CHALLENGE, AND HE
IS -- HAS WILLINGLY ACCEPTED
ANOTHER ONE.
AND PAT ACTUALLY RESEARCH THE
SOME OF THESE QUOTES FROM VAN
ONLINE AND I'LL LET YOU READ
THEM AT YOUR LEISURE.
AND SO THE NIH CLINICAL CENTER
DID WELL, SPRING HONOREES, KAREN
FRANK RECEIVED THE SECRETARY'S
AWARD FOR MERITORIOUS SERVICE,
THIS WAS FOR SETTING UP AN
ENTIRE SERIES OF ASSAYS TO DO
COVID-19 BEFORE THOSE ASSAYS
WERE WIDELY AVAILABLE, EVEN
BEFORE THE CDC HAD DISTRIBUTED
DISTRIBUTED WE WERE ABLE TO DO
COVID-19 DIAGNOSTICS HERE.
L EIGHTON CHAN RECEIVED THE HHS
AWARD FOR EXCELLENCE IN
MANAGEMENT.
LEIGHTON IS THE NIH KING AT THE
WORKING IN THE INTERAGENCY
WORLD, DOES WORK WITH THE SOCIAL
SECURITY ADMINISTRATION, AS WELL
AS MOST RECENTLY WITH A NUMBER
OF SECURITY AGENCIES, AND THEN
LAST BUT NOT LEAST BOB
DECHRISTOFORO RETIRED.
WE HAD A NICE ONLINE RETIREMENT
SOIREE FOR BOB, HONORED FOR 50
YEARS OF GOVERNMENT SERVICE.
SOME TEAM AWARDS, THE RADx
DIAGNOSTICS INITIATIVE THAT LED
TO FILLING MANY DRUG STORE AND
PHARMACY SHELVES WITH HOME TESTS
FOR COVID-19, AND THERE ARE A
COUPLE OF FOLKS FROM NURSING WHO
ARE PART OF THAT EFFORT.
AND THEN THE DIVISION OF
CLINICAL RESEARCH COVID-19
RESPONSE TEAM ALEX ARCHER ALSO
FROM CLINICAL CENTER NURSING
DEPARTMENT.
AND THEN HUBERT H HUMPHREY AWARD
FOR SERVICE TO AMERICA WENT TO
OFFICE OF REFUGEE AND
RESETTLEMENT TEAM, AND
ADMINISTRATION FOR CHILDREN AND
FAMILIES.
AND THERE ARE NUMEROUS CLINICAL
CENTER VOLUNTEERS, A NUMBER OF
WHOM WERE PART OF PUBLIC HEALTH
SERVICE AND A NUMBER OF
CIVILIANS WHO PARTICIPATED IN
THAT ROLE, NOT JUST CLINICAL
CENTER STAFF BUT ACROSS THE NIH.
EVEN AT AN INSTITUTE DIRECTOR,
JOSH GORDON FROM NATIONAL
INSTITUTE OF MENTAL HEALTH, WENT
TO TEXAS TO BE PART OF THAT
EFFORT.
IN TERMS OF KEY STAFF UPDATES,
THIS IS SOMETHING THAT OCCUPIES
A LOT OF OUR TIME.
I WILL NOT GO INTO DETAIL HERE
ABOUT THE PROCEDURES AND
POLICIES AT THE NIH, JUST SORT
OF YOU CAN EXTRAPOLATE FROM THE
FACT OF HOW LONG IT TAKES TO GET
YOU APPOINTED TO BE A MEMBER OF
THIS GROUPO HOW IT TAKES
TO FILL KEY POSITIONS OF THE
NIH.
WHEN I WAS HIRED AFTER REALLY A
FIVE OR SIX-MONTH EFFORT I WAS
TOLD THAT WAS WARP SPEED FOR THE
NIH.
I DIDN'T BELIEVE IT AT THE TIME.
I DO NOW.
AND SO WE'RE IN THE PROCESS, WE
HAVE A VERY GOOD ACTING CHIEF
NURSE OFFICER BUT WE'RE STILL IN
THE PROCESS OF FILLING THAT
POSITION PERMANENTLY.
MARIA JOYCE RETIRED AT THE END
OF 2021, SO WE'RE IN THE
BUSINESS OF FINDING THE NEXT
CHIEF FINANCIAL OFFICER,
FORTUNATELY THE CHIEF OPERATING
OFFICER OF THE CLINICAL CENTER
COMES FROM A RESOURCE MANAGEMENT
BACKGROUND IN THE MILITARY, AND
PIUS AS FILLED IN WITH SOME
YOUNGER STAFF IN THAT
DEPARTMENT.
WE'RE ABOUT HALFWAY THROUGH I
THINK, MAYBE A LITTLE OVER
HALFWAY THROUGH, FINDING THE
NEXT CHIEF OF THE PHARMACY
DEPARTMENT.
AS LARRY INDICATED, IN HIS
PRESENTATION, THE PHARMACY
DEPARTMENT WAS SORT OF WHERE IT
ALL BEGAN.
AND WE NOW HAVE A BEAUTIFUL NEW
PHARMACY FACILITY WHERE WE
ALREADY MOVED THE UNIT DOSE OR
INPATIENT PHARMACY AND
OUTPATIENT PHARMACY IN, AND IT'S
UP AND OPERATING AND WORKING
WELL.
WE HAVE NOT MOVED THE
INTRAVENOUS ADMIXTURE UNIT.
THERE'S A LOT OF COMMISSIONS AND
TRAINING WORK THAT NEEDS TO GO
ON IN THERE BEFORE THAT WILL
HAPPEN.
BUT WE ARE MAKING PROGRESS ON
THAT ALL THE TIME.
AND WE'RE ALMOST ALL BACK TO
WORK, ALTHOUGH THERE'S A LOT
MORE TELEWORK THAT GOES ON BUT
IT'S MORE PART TIME THAN BEFORE.
CENSUS HAS NOT COME BACK FROM
THE START OF THE PANDEMIC, THE
INPATIENT CENSUS HAS NOT COME
BACK SINCE THE START OF THE
PANDEMIC, AND I'M NOT SURE IF OR
WHEN THAT IS GOING TO HAPPEN,
BUT IT IS SOMETHING THAT WE
WATCH VERY CLOSELY AND SOMETHING
THAT CONCERNS US A LITTLE BIT.
I'LL GET INTO THIS MORE IN THE
NEXT PRESENTATION, BUT I THINK
OVER THE COURSE OF THE NEXT
COUPLE YEARS THERE WILL BE A
REEXAMINATION OF WHAT RESEARCH
AT THE NIH CLINICAL CENTER
REALLY IS AND IS SUPPOSED TO BE
IN THE VIRTUAL WORLD.
I DON'T THINK THAT HAS REALLY
HAPPENED.
I WOULD SAY SORT OF THE
TRADITION, THE HISTORY, THE
DOGMA IS THE RESEARCH AT THE NIH
CLINICAL CENTER SHOULD FOCUS ON
THINGS THAT CAN'T BE DONE
ANYTHING ELSE, AND WHEN YOU
START WITH TELEHEALTH AND
WORKING REMOTELY, YOU SORT OF
HAVE TAKEN YOURSELF OUT OF THAT
GAME.
SO THERE'S ALWAYS BEEN A LOT OF
WORK INVOLVED IN BEING PRESENT
AT THE CLINICAL CENTER, AND WE
INVEST SIGNIFICANTLY IN PATIENT
TRAVEL AND OTHER KINDS OF
THINGS.
I THINK THAT'S ONE OF THE
CONSTRUCTS THAT WILL NEED TO BE
EXAMINED OVER THE NEXT TWO OR
THREE YEARS.
THE GOOD NEWS IS THAT OUR CLINIC
VISITS ARE UP.
WE'RE SEEING MORE PATIENTS THAN
THE OUTPATIENT CLINIC, NEW
PATIENT NUMBERS ARE UP FROM FY
21 TO 22.
THESE ARE NOT BACK TO
PRE-PANDEMIC NUMBERS, BUT THEY
ARE AT LEAST HEADED IN THE RIGHT
DIRECTION.
AND MOST DAYS THE CLINICS ARE
PRETTY BUSY.
AND THEN YOU ADD IN THE
TELEHEALTH APPOINTMENTS.
AGAIN, BEFORE THE PANDEMIC
STARTED WE HAD NO TELEHEALTH
PRESENCE.
AND YOU CAN SEE THAT WE RELIED
ON IT EVEN MORE HEAVILY BACK IN
2021.
BUT WE HAVE A STEADY BUSINESS
AND IT SEEMS TO BE A SERVICE
THAT IS ACCEPTED AND UTILIZED
FAIRLY WELL, AND TRISH KOFFEY
AND FOLKS IN INFORMATICS AND
HEALTH INFORMATION MANAGEMENT
DIVISION ARE ALWAYS TRYING TO
CONTINUE TO IMPROVE IT.
THERE'S NOT MUCH ON THIS
SCHEDULE, ON THIS AGENDA TODAY
THAT'S ABOUT COVID-19.
WE GAVE CLIFF LANE THE DAY OFF.
AND IT'S NOT -- AND IN PART IT'S
BECAUSE WE'RE KIND OF DOING THE
SAME THINGS WE'VE BEEN DOING FOR
TWO YEARS.
WE'VE BEEN MASKED IN THE
BUILDING SINCE THE 2nd OF
APRIL, WERE MASKED OUTSIDE UNTIL
A FEW WEEKS AGO.
WE REQUIRE THE USE OF FACE
SHIELDS ON STAFF WHEN THEY ARE
IN THE PATIENT ROOMS AND WE PUT
MASKS ON PATIENTS WHEN WE GO IN
THEIR ROOM.
WE ARE STILL SOCIALLY
DISTANCING, AND TRYING TO AVOID
SOCIAL ISOLATION BUT EVERY ONCE
IN A WHILE WE COME ACROSS
SOMEBODY WHO IS STRUGGLING.
THEY HAVE SOME DIFFICULTY
BECAUSE THEY DON'T GET TO
INTERACT WITH OTHER STAFF
MEMBERS THE WAY THEY DID BEFORE
THE PANDEMIC.
ONE OF THE BIGGEST ISSUES TO
DEAL WITH IS WHAT SOMEONE CALLED
PRESENTEISM.
PEOPLE WHO FEEL A LITTLE BIT BAD
BUT NOT TERRIBLY BAD.
SOMETIMES THEY EVEN DO A HOME
ANTIGEN TEST AND TEST NEGATIVE,
SO THEY THINK THAT THEY ARE SAFE
TO GO OUT AND INTERACT WITH
OTHER PEOPLE, AND, YOU KNOW,
OFTEN WITH THE HOME ANTIGEN TEST
IT'S DAY 2 OR DAY 3 OF DISEASE
BEFORE THE TEST IS POSITIVE AND
IN THE MEANTIME THEY HAVE
INTERACTED WITH LOTS OF PEOPLE.
WE'VE CUT BACK ON CONTACT
TRACING BECAUSE IT BECAME --
BECAUSE OF THINGS I JUST TALKED
ABOUT, IT BECAME ALMOST AN
EXERCISE IN FUTILITY.
AND WE HAVE EMPHASIZED HAND
HYGIENE STARTING A YEAR AND A
HALF BEFORE THE PANDEMIC, AND WE
CONTINUE TO FOCUS ON THAT.
LARRY TALKED ABOUT DEIA AT THE
NIH LEVEL.
THESE ARE OUR EFFORTS.
WE HAVE A NEW DEIA WEBSITE WITH
ROBUST RESOURCES AND CONSTANTLY
UPGRADING ENHANCEMENT.
WE HAVE CREATED A POSITION
CALLED SCIENTIFIC DIVERSITY
ADVISER, THAT POSITION HAS BEEN
ADVERTISED.
THERE ARE A NUMBER OF
APPLICANTS.
THE GROUP THAT'S GOING TO THE
SELECTION, THE COMMITTEE, HAS
BEEN SELECTED.
THEY ARE WORKING OUT THE FINAL
DETAILS ON THE QUESTIONS THAT
CANDIDATES ARE GOING TO BE
ASKED.
AND THE QUESTIONS WILL FOCUS ON
I WOULD SAY THE FULL BREADTH OF
THE DEIA ISSUE RATHER THAN A
PARTICULAR GROUP OR ISSUE.
WE ARE INVOLVED IN A CONTINUOUS
ASSESSMENT OF CLINICAL CENTER
WORKFORCE DEMOGRAPHICS, AND WE
ARE VERY DEPENDENT ON DATA FROM
NIH OFFICE OF DIVERSITY, EQUITY,
INCLUSION, AND ACCESSIBILITY.
WE DID A CLINICAL CENTER DEIA
SURVEY, THE RESULTS ARE POSTED
ONLINE, AVAILABLE INSIDE THE
NIH.
AND WE HAVE COMPLETED AND
SUBMITTED TO DR. TABAK AND DR.
SCHWETZ AND OGC AND EDI, OUR NIH
RACIAL AND ETHNIC EQUITY MAN.
WE'VE RECEIVED FEEDBACK, HAVE
PLACES TO TIGHTEN UP WORDING BUT
BY AND LARGE THE PEOPLE WHO PUT
TOGETHER THE PLAN DID A
WONDERFUL JOB.
WE HAVE INITIATIVES THAT WE
THINK WE CAN ACTUALLY DO.
SO, THESE ARE THE SIX THAT WE'VE
PUT ON OUR PLAN.
THE FIRST ONE IS WE WILL LEARN
TO LOOK AT EVERYTHING WE DO WITH
RESPECT TO RECOGNITION,
RETENTION, DEVELOPMENT PROGRAMS
AT THE NIH CLINICAL CENTER
THROUGH WHAT WE CALL THE RACIAL
AND ETHNIC EQUITY LENS.
WHEN I TOOK THIS JOB, WE APPLIED
THE PATIENT SAFETY LENS TO
EVERYTHING WE DID.
AND THIS AND THE REEL IS SAYING
YOU HAVE ANOTHER LENS TO MAKE
SURE IT'S EQUITABLE AND FAIR.
THE CLINICAL CENTER NURSING
DEPARTMENT IS LEADING THE WAY IN
CREATING A WRITTEN POLICY FOR
HIRING AND ADVANCEMENT IN THE
CLINICAL CENTER.
THE REST OF US WILL RIFF OFF
THEIR PLAN.
AGAIN, WE STARTED WITH THEM
BECAUSE THEY ARE THE LARGEST
DEPARTMENT IN THE HOSPITAL.
AND THE REST OF US WILL ADRAFT
THEIR PLAN FOR THE OTHER AREAS.
WE ARE TRYING TO ADDRESS HIRING
GAPS IN SENIOR POSITIONS BY
CHANGING SOME OF THE SELECTION
PARAMETERS AND LANGUAGE WE USE
IN ADVERTISING THE POSITIONS AND
PRIORITIZING PARTICIPATION AND
DOCUMENTED PARTICIPATION IN
EFFORTS TO IMPROVE EQUITY,
DIVERSITY, AND INCLUSION IN THE
SELECTION CRITERIA.
WE HAVE ALWAYS HAD A PRETTY GOOD
OUTREACH TO MINORITY-SERVING
INSTITUTIONS.
HOWEVER, WE HAVEN'T ALWAYS
MEASURED HOW WE -- WHETHER THAT
WAS PRODUCTIVE OR NOT.
AND SO WE HAVE TO BE MORE
INTENTIONAL ABOUT THAT.
WE-- IT WILL TAKE A WHILE TO
WORK OUT DETAILS OF THE AWARDS
AND RECOGNITION PROGRAM.
WE'VE ALWAYS HAD AWARDS AT THE
INDIVIDUAL LEVEL.
WHAT WE NEED ARE REALLY AWARDS
AT THE DEPARTMENTAL LEVEL.
IT WOULD TAKE TOO LONG TO
DESCRIBE OUR THOUGHTS ON THAT
AND OUR CONCEPTS BUT I THINK WE
ACTUALLY HAVE A PRETTY GOOD WAY
OF LOOKING AT IT.
THEN ONE OF THE THINGS WE FOUND
FROM OUR FOCUS GROUPS AND OUR
SURVEY WAS THAT ACCESSIBILITY OR
IN TERMS OF PHYSICAL AND MEDICAL
LIMITATIONS THAT THAT WAS
PROBABLY POORLY UNDERSTOOD BY A
NUMBER OF OUR STAFF.
AND SO WE HAVE AN IMPORTANT
TRAINING AND EDUCATION EFFORT
THAT WE HAVE TO UNDERTAKE IN
ORDER TO MAKE SOME PROGRESS
THERE ON THE A PART OF THE DEIA.
WE DO HAVE HERITAGE MONTH.
YOU CAN SEE THEM OUTLINED HERE.
AND WE JUST FINISHED PRIDE
MONTH.
AND WE HAD AS YOU'LL SEE, WE HAD
DR. RACHEL LEVINE, ADMIRAL
RACHEL LEVINE, HERE.
WE HAVE -- WE CONTINUE TO USE
THIS MESSAGING THAT WE DEVELOPED
FIVE YEARS AGO CALLED 3 MAIN
THINGS AND WE FOCUS ON THOSE
THINGS WHICH ARE MOST IMPORTANT
TO US.
AND THIS IS JUST A COPY OF ONE
OF THE MESSAGES.
AND WHERE WE INFORM THE STAFF
THAT WE WERE GOING TO POST THE
RESULTS OF THE SURVEY ON OUR
INTERNET SITE, FOR ALL TO SEE,
AND YOU CAN ALSO SEE WHAT WE'VE
SAID ABOUT THE SHOOTING IN
BUFFALO.
AND THIS WAS THE VISIT OF DR.
LEVINE.
YOU CAN SEE DR. TABAK AND HER
COMING IN, YOU CAN SEE ME WITH A
GROUP AT THE MODEL WHERE A FEW
OF YOU WILL BE ABLE TO SEE
LATER.
AND SHE PROVIDED THE OPENING
REMARKS AT THE NIH-HOSTED PANEL
DISCUSSION, HOW INTERSECTING
IDENTITIES IMPACT OUR NIH WORK.
SHE HAD A BRIEF TOUR OF THE
CLINICAL CENTER, ALTHOUGH SHE
NEEDS TO COME BACK AND GET THE
REAL TOUR YOU'RE GOING TO GET
THIS AFTERNOON.
LARRY TALKED ABOUT THE PHARMACY
RIBBON-CUTTING CEREMONY, YOU SEE
DR. TABAK, RICK DECEDARFIELD,
ACTING CHIEF FOR THREE YEARS,
AND MARILYN FRENREY, CHIEF OF
PHARMACY OPERATIONS, AND ME.
AND YOU SEE ELLEN BERTY IN THE
UPPER RIGHT.
ELLEN WAS DRESSED PRETTY CALMLY
AND UNIMAGINATIVELY FOR THE DAY.
WE HAVE PROVIDED TO YOU ONLINE
THE QUARTERLY REPORT OF OUR
PATIENT SAFETY AND STAFF SAFETY
METRICS.
AND QUALITY INDICATORS, DAVID
LANG HAS PROVIDED THAT.
DAVID HAS BRIEFED THE CLINICAL
CENTER RESEARCH HOSPITAL BOARD
TWO TIMES IN THE LAST COUPLE
MEETINGS ON THOSE METRICS.
DEPENDING ON WHAT DR. COOTS AND
THE REST OF YOU WANT, WE CAN
MAKE THAT A STANDING UPDATE TO
THE CLINICAL CENTER RESEARCH
HOSPITAL BOARD, BUT FOR THE MOST
PART, WE THINK THAT THERE'S NOT
TOO MUCH THERE THAT NEEDS TO BE
PRESENTED.
IF YOU HAVE ANY QUESTIONS OR YOU
WANT TO SEE THEM EVERY QUARTER,
THEN WE'LL BE HAPPY TO CHANGE
THAT.
IN TERMS OF TODAY'S AGENDA,
YOU'VE ALREADY HEARD FROM DR.
TABAK AND ME.
SOMEONE YOU'VE NOT HEARD FROM IN
FIVE YEARS HERE IS THE PATIENT
REPRESENTATIVE.
AND THAT'S CAPTAIN TONY JONES OF
THE UNITED STATES PUBLIC HEALTH
SERVICE COMMISSIONED CORPS.
HOSPITALS I'VE BEEN IN BEFORE
THIS OFTEN WAS AN OFFICE THAT
HAD SEVERAL PEOPLE IN IT.
TONY IS IT.
WE DO HAVE THE ABILITY TO COVER
FOR HER WHEN SHE'S GONE.
I THINK YOU'LL UNDERSTAND WHY
SHE PRETTY MUCH IS ABLE TO DO
THE JOB AND ASKING OTHER PEOPLE
TO HELP HER DO THE JOB WOULD
ONLY GET IN HER WAY.
BUT I THINK YOU NEED TO SEE THAT
WE DO HAVE THE ABILITY TO
RESPOND TO ISSUES RAISED BY
PATIENTS, WHETHER IT INVOLVES
SOMETHING RELATED TO THE
CLINICAL CENTER PER SE OR
SOMETHING RELATED TO THE
RESEARCH TEAM.
TONI IS EXTRAORDINARY AT DOING
THAT.
SHE'S ALSO BEEN THE ONE
OVERSEEING OUR VISITORS' POLICY
SINCE THE START OF THE PANDEMIC
AND HAS DONE A SPECTACULAR JOB.
ONE OF THE THINGS THAT WE HAVE
STRUGGLED WITH WHEN THE JOINT
COMMISSION OR WHEN THE
ACCREDITATION COUNCIL FOR
GRADUATE MEDICAL EDUCATION HAS
COME BY IS ANY DISCUSSION ABOUT
THE SOCIAL DETERMINANTS OF
HEALTH AND THEIR REQUEST.
WE TALKED ABOUT THIS A LITTLE
BIT.
WE HAVE SOME OTHER PLANS GOING
FORWARD.
BUT GWEN WALLEN SAID I THINK YOU
CAN USE THE PATIENT SURVEY DATA,
JIM, IN ORDER TO GET AT A LITTLE
BIT OF THIS INFORMATION.
DR. HADIGAN, CHIEF MEDICAL
CENTER, WILL LEAD THAT
DISCUSSION.
WE'LL HAVE A BREAK.
THEN IT'S TIME FOR A MAGNET
JOURNEY UPDATE.
DR. JORDAN, ACTING CHIEF NURSE,
WILL TAKE THAT ON.
AND THEN I'LL BE BACK TO TALK
ABOUT I THINK THE PROGRESS WE
MADE IN A NUMBER OF AREAS OVER
THE COURSE OF THE LAST SEVERAL
YEARS.
THAT ALIGNS I THINK PRETTY WELL
WITH THE STRATEGIC PLAN WE
PUBLISHED THREE YEARS AGO.
WE'LL GIVE DR. FORESE THE LAST
WORD.
SO, THANK YOU VERY MUCH FOR THE
CHANCE FOR THE UPDATE.
THANK YOU, AGAIN, FOR BEING
HERE, EITHER IN PERSON OR
VIRTUALLY.
AND I'LL TALK TO YOU AGAIN
LATER.
SO HERE'S CAPTAIN JONES.
>> GOOD MORNING.
JUST GIVE ME A MOMENT TO PULL UP
MY PRESENTATION.
I MIGHT NEED YOUR HELP, CARLY.
LET'S SEE.
OKAY, FANTASTIC.
GOOD MORNING, EVERYONE.
BOARD MEMBERS IN THE ROOM AND
FELLOW PRESENTERS AND ALL OF YOU
THAT ARE ON THE ZOOM CALL, I'M
TONI JONES, AS DR. GILMAN
MENTIONED, CLINICAL CENTER
PATIENT REPRESENTATIVE.
AND I AM ACTUALLY DELIGHTED TO
BRAG TO YOU A LITTLE BIT TODAY
ABOUT THE PATIENT REPRESENTATIVE
ROLE AND HOW IT HELPS TO AFFECT
THE PATIENT EXPERIENCE AT THE
CLINICAL CENTER.
HOSPITAL-BASED ADVOCACY HAS BEEN
AROUND SINCE THE '70s, STARTED
WITH ROOTS IN THE PATIENT RIGHTS
MOVEMENT.
I'M SURE YOU IN THE ROOM AND
MANY ON THE ZOOM RIGHT NOW KNOW
WHAT THIS ROLE LOOKS LIKE OF
YOU'VE EITHER WORKED WITH FOLKS
WHO DO THIS JOB, PATIENT
ADVOCATE, PATIENT AND
NAVIGATOR, LOTS OF WAYS IT'S
DESCRIBED.
AND THOSE TERMS ARE OFTEN USED
INTERCHANGEABLY.
BUT DEPENDING ON THE
ORGANIZATION, COULD SLIGHTLY
VARY IN FUNCTION.
IF YOU'RE JOINT COMMISSION
ACRESTED CREDITED YOU HAVE TO
SAY THIS ROLE.
EVERY HOSPITAL DOES NOT HAVE ONE
BUT WE DO.
NO MATTER THE TITLE WE ALL HAVE
ONE THING IN COMMON.
WE WANT TO MAKE CERTAIN ANY
CONCERN RAISED BY THE PATIENT IS
MET AND THE PATIENT HAS THE BEST
EXPERIENCE POSSIBLE.
THAT'S OUR GOAL.
I'M TRYING TO ADVANCE.
THERE WE GO.
THANK YOU.
SIMILARLY THE CLINICAL CENTER IS
THE PATIENT REPRESENTATIVE IS A
LINK BETWEEN THE PATIENT AND THE
HOSPITAL ORGANIZATION.
WHAT'S DIFFERENT ABOUT OUR
CENTER IS THE PATIENT, YOU KNOW,
THE PATIENT REPRESENTATIVE IS
THE LING BUT THERE'S THE
CLINICAL CENTER AND ALL THE
I.C.s SEEING PATIENTS IN OUR
HOSPITAL.
SO THE PATIENT ONLY SEES ONE
ORGANIZATION.
BUT IN FACT, THE REPRESENTATIVE
IS NAVIGATING 18 ORGANIZATIONS
BEHIND THE SCENES BECAUSE EVERY
I.C. HAS THEIR OWN WAY OF DOING
THINGS AND ALL OF THEM HAVE
PATIENTS -- 18 HAVE PATIENTS ON
STUDIES IN CLINICAL CENTER.
THE OTHER PIECE THAT'S UNIQUE IS
HOW THE CLINICAL CENTER
OPERATES.
IT'S NOT A REGULAR HOSPITAL.
YOU'VE HEARD THAT MANY TIMES.
PATIENTS COME HERE THOUGH WITH
EXPECTATIONS AROUND WHAT A
HOSPITAL CAN AND CANNOT OFFER.
SOMETIMES THEY ARE SURPRISED
WITH LIMITATIONS OR CONSTRAINTS
WE MIGHT HAVE THAT THEY DON'T
SEE IN A COMMUNITY HOSPITAL OR
ACADEMIC MEDICAL CENTER THEY
MIGHT HAVE EXPERIENCE WITH.
SO MY ROLE IS TO HELP THEM
UNDERSTAND THOSE DIFFERENCES AND
HOW WE OPERATE.
IT CAN BE CHALLENGING FOR THEM
TO UNDERSTAND THAT.
EVEN PATIENT RIGHTS LOOK
DIFFERENT IN A PLACE LIKE OURS.
FOR EXAMPLE, THE RIGHT TO REFUSE
CARE, THAT CAN HAVE SIGNIFICANT
IMPACT ON ABILITY TO BE ENROLLED
ON A STUDY SO IT'S NOT AS SIMPLE
AS IT IS IN A LOCAL HOSPITAL IF
THEY DECIDE THEY DON'T WANT TO
DO SOMETHING.
SOMETIMES THE WAY THAT SHOWS UP
IS A PATIENT WILL SAY TO ME,
SEEMS LIKE THE RESEARCH IS MORE
IMPORTANT THAN PATIENT NEEDS OR
DESIRES.
SO IT'S DIFFERENT IN OUR
SETTING, A DELICATE BALANCE I
HAVE TO STRIKE.
I THINK IT'S IMPORTANT TO
MENTION THAT PARTICIPATING ON A
CLINICAL TRIAL IS NOT EASY.
WE ASK A LOT OF OUR PATIENTS.
THERE ARE TIMES THOUGH THEY WANT
THE TREATMENT THAT WE HAVE TO
OFFER.
SOME REQUIREMENTS ARE
FRUSTRATING FOR THEM OR THEY
DON'T AGREE ALL THE TIME.
SO IT'S HARD TO MEET THOSE
REQUIREMENTS AND IMPOSES ON
THEIR LIVES.
WE RECOGNIZE THAT IT'S
CHALLENGING.
HOW DO PATIENTS LEARN ABOUT ME?
WHEN THEY ARE ADMITTED FOR THE
FIRST TIME, REGISTER FOR THE
FIRST OUTPATIENT OR INPATIENT
STAY, THEY GET A BRIEF
DESCRIPTION ABOUT THE ROLE OF
THE PATIENT REPRESENTATIVE.
THEY LEARN MORE ABOUT ME ON THE
UNIT.
I TRY TO GO TO INPATIENT UNITS
NOT ON THE FIRST DAY THEY ARE
ADMITTED BECAUSE ON YOUR FIRST
SOMEDAY YOU -- DAY YOU DON'T
KNOW WHAT'S HAPPENING BUT AFTER
A FEW DAYS TO REMIND THEM OF
RESOURCE, PATIENTS AND FAMILIES
TALK TO PATIENTS AND FAMILIES
AND LEARN ABOUT THE PATIENT
REPRESENTATIVE ROLE THAT WAY.
YOU NOTICE HERE THERE'S A POSTER
AND BROCHURE HOLDER.
THIS IS LOCATED IN 45 PLACES IN
THE CLINICAL CENTER IN AREAS
WHERE PATIENTS FREQUENT.
WHETHER CAFETERIA, INPATIENT
UNITS, CLINICS, DAY HOSPITALS,
ET CETERA.
IT'S ENGLISH AND SPANISH,
ANOTHER OPPORTUNITY FOR A
PATIENT TO GRAB A BROCHURE AND
REACH OUT TO ME WITH A QUESTION
OR CONCERN.
MY OFFICE, IMPORTANT TO NOTE, IS
ON THE FIRST FLOOR NEAR THE
OUTPATIENT PHARMACY, NEAR THE
TRAVEL OFFICE FOR PATIENTS,
ACROSS FROM ADMISSIONS OFFICE.
SMARTLY LOCATED SO PATIENTS CAN
FIND ME PRETTY EASILY.
I TRY TO A LITTLE BIT DURING THE
DAY HAVE MY DOOR OPEN AS AN
INVITATION TO COME IN IF YOU
NEED TO TALK WITH ME.
NOW, AS DR. GILMAN MENTIONED,
THERE'S ONLY ONE PHOTOGRAPH IN
THAT BROCHURE BECAUSE I'M THE
ONLY PATIENT REPRESENTATIVE.
THE ONLY ONE IN THE ROLE.
I SERVICE EVERY INPATIENT OR
OUTPATIENT WHETHER ON CLINICAL
TRIAL, NATURAL HISTORY STUDY,
HEALTHY VOLUNTEER, EVEN A BLOOD
DONOR.
IF YOU'VE GOT A MEDICAL RECORD
NUMBER AND ARE RECEIVING
CLINICAL CARE, I'M A RESOURCE
FOR YOU.
ADDITIONALLY CONTACT INFORMATION
FOR PATIENT REPRESENTATIVE IS ON
EVERY PROTOCOL CONSENT FORM.
ALL OF OUR CONSENT FORMS ARE
ONLINE.
I THINK THERE'S ABOUT 1600
ACTIVE STUDIES, I MAY BE OFF A
LITTLE BIT.
THE GENERAL PUBLIC ALSO REACHES
OUT TO ME.
IT'S DIFFERENT THAN WHAT YOU
FIND IN ANOTHER MEDICAL CENTER
BECAUSE THEY SEE OUR NUMBER
LISTED AND SO THEY REACH OUT.
NO MAN IS AN ISLAND, I DO HAVE
COVERAGE, MY POSITION IS UNDER
THE OFFICE OF PATIENT SAFETY AND
CLINICAL EQUAL AND THAT STAFF
COVERS FOR ME WHEN I HAVE TO
TAKE A DAY OF LEAVE.
THAT DIDN'T GO THE RIGHT WAY.
LET'S TRY THIS.
OKAY.
I DO BELIEVE THAT THOSE OF US IN
HEALTH CARE WHO HAVE THE
PRIVILEGE, DISTINCT PRIVILEGE
AND OPPORTUNITY TO WORK DIRECTLY
WITH PATIENTS, WE ALL DO
ADVOCACY ON SOME LEVEL.
THERE ARE LIKELY A NUMBER OF
POSITIONS THAT COULD DO THIS
WELL ACROSS THE PROFESSIONS BUT
I PUT THIS QUOTE IN THIS
PRESENTATION TO POINT OUT MY
BIAS.
I'LL ADMIT, AN ADVANTAGE TO
HAVING A NURSE IN THIS ROLE.
IF YOU'LL ALLOW ME, I'LL SHOW MY
OWN PROFESSIONAL JOURNEY AND
STORY TO PROVIDE CONTEXT FOR MY
BIAS.
I CAME TO THE CLINICAL CENTER AS
A NEW GRADUATE NURSE IN 1987.
I WAS A CANCER NURSE TRAINEE AT
THE TIME.
FOR 13 OR 14 YEARS, I WAS
DIRECTLY INVOLVED WITH CANCER
PATIENTS, GIVING CHEMOTHERAPY,
SUPPORTIVE CARE, WORKING WITH
THEM.
I WORKED IN THE INPATIENT SIDE,
OUTPATIENT SIDE, BEFORE THERE
WAS A DAY HOSPITAL I WAS IN THE
DAY HOSPITAL, BACK IN THOSE
DAYS.
I'VE BEEN A RESEARCH NURSE FOR
NCI.
SO I'VE BEEN A MANAGER, SEVEN OR
EIGHT YEARS WAS IN THE NURSING
DEPARTMENT AS NURSE LEADER SO I
UNDERSTAND THE PATIENT
EXPERIENCE FROM EVERY ASPECT
FROM ENROLLMENT TO CONSENT TO
TREATMENT TO DISCHARGE, TO
FOLLOW-UP.
I UNDERSTAND IT.
AND I'VE BEEN IN MANY COMMITTEES
AND WORKED IN THE CLINICAL
CENTER, ACROSS THE NIH, I'VE
ESTABLISHED LOTS OF
RELATIONSHIPS ACROSS NOT ONLY
THE HOSPITAL BUT IN THE OTHER
I.C.s.
MY GRADUATE WORK IS IN
ORGANIZATION DEVELOPMENT.
THOSE FAMILIAR, THAT'S ALL ABOUT
HUMANS IN THE ORGANIZATION,
MANAGING CHANGE, HOW THEY WORK
BETTER AS A TEAM, MANAGE
CONFLICT, ALL THOSE SORTS OF
THINGS.
SO I HAD ABOUT SEVEN YEARS IN
THE OFFICE OF WORKFORCE
MANAGEMENT USING THAT TRAINING
ACROSS DEPARTMENTS AND ACROSS
I.C.s.
SO, THAT HELPED TREMENDOUSLY.
I CAME TO THE ROLE OF THE
PATIENT REPRESENTATIVE IN JUNE
OF 2015.
THE PRIOR INCUMBENT HAD BEEN IN
THE ROLE FOR 16 YEARS, SHE
UNFORTUNATELY HAD TO LEAVE THE
ORGANIZATION IMMEDIATELY SO
THERE WAS NO OVERLAP TIME.
NO ORIENTATION.
THERE WASN'T EVEN AN OPERATIONS
MANUAL.
AND FOR PERSONAL REASONS, THERE
SIMPLY WASN'T ENOUGH TIME.
WITHIN THE FIRST FEW WEEKS, IT
BECAME CLEAR TO ME THAT MY
TRAINING, MY BACKGROUND, MY
EXPERIENCE SAVED ME IN THAT
ROLE.
I CAN ONLY IMAGINE THE
FRUSTRATION AND DISAPPOINTMENT
PATIENTS WOULD HAVE FELT BECAUSE
I WOULD HAVE BEEN SCRAMBLING
WITHOUT ANY ORIENTATION IF I
DIDN'T HAVE THE EXPERIENCE AND
THE TIME IN THE ORGANIZATION
THAT I HAD.
IT WAS A SIGH OF RELIEF FOR ME.
I WAS REALLY HAPPY TO BE ABLE TO
QUICKLY, WITH WHAT I HAD
EXPERIENCED IN THE ORGANIZATION,
STEP IN, UNDERSTAND THE NEEDS,
AND RESPOND.
SO I REALLY APPRECIATE THAT.
IT WAS QUITE A RELIEF.
ANOTHER IMPORTANT PIECE OF WHAT
I THINK HAS ENHANCED MY ABILITY
TO DO THIS ROLE IS IN 2020
UNFORTUNATELY FOR ME, I ACTUALLY
HAD MY OWN HEALTH CARE PROBLEM,
SITUATION, AND BECAME A PATIENT
IN A CLINICAL CENTER BED,
NOTHING LIKE WALKING IN THE
SHOES OF THE POPULATION YOU
SERVE TO GIVE A DEEPER
UNDERSTANDING OF FEARS,
CONCERNS, QUESTIONS THAT CAN
EMERGE WHEN YOU'RE ON THAT SIDE
OF THINGS.
THAT'S ALSO HELPED.
HOW DO I DO MY WORK?
HERE IS MY MISSION.
YOU'LL NOTICE I WROTE TIMELY AND
EFFECTIVE RESPONSE.
I PUT THAT IN BOLD SPECIFICALLY
BECAUSE THAT IS CRITICAL TO SHOW
RESPECT AND HONOR TO INDIVIDUALS
WHEN THEY BRING A CONCERN AND
THAT IT'S RESPONDED TO.
NOT JUST TIMELY BUT EFFECTIVE.
I HAVE HAD PATIENTS SAY TO ME
OVER AND OVER AGAIN, USUALLY A
FEW TIMES A WEEK, WOW, I'M
SURPRISED SOMEONE CALLED ME
BACK.
THANK YOU FOR LISTENING AND
TAKING THIS SERIOUSLY.
IT'S BEEN CONSISTENT OVER THE
LAST SIX OR SEVEN YEARS.
IT'S IMPORTANT TO THEM.
EXCUSE ME.
HERE'S MY VISION, MY HOPE, WHAT
ASPIRE TO DO.
THIS INCIDENT START WITH MY ROLE
AS A PATIENT REPRESENTATIVE.
AT THE BEDSIDE, IT WAS MY HOPE
THAT WHEN A PATIENT LEFT ME,
THEY FELT LIKE THEY HAD THE BEST
POSSIBLE EXPERIENCE.
IT MIGHT NOT HAVE BEEN FUN BUT
THEY WALKED AWAY FEELING VALUED
AND CARED FOR EVEN IF THEY
DIDN'T GET GOOD NEWS OR IF
THINGS WERE CHALLENGING FOR
THEM.
I'D LIKE TO SHARE A STORY WHEN I
WAS PREPARING FOR THIS, I
THOUGHT ABOUT A PATIENT THAT I
HAD.
I'VE HAD THOUSANDS OF THEM.
BUT BACK IN 1997, THERE WAS A
YOUNG WOMAN, LYMPHOMA PATIENT,
GIANNA CAME TO US IN 1997.
I WAS HER PRIMARY NURSE, GAVE
HER A LOT OF CHEMOTHERAPY, SPENT
A LOT OF TIME WITH HER.
THIS YOUNG WOMAN WROTE A BOOK.
THE BOOK IS "WELCOME TO MY
HEART."
A SELECTION OF STORIES ABOUT HER
EXPERIENCE WHEN SHE WAS
DIAGNOSED, BEFORE SHE CAME TO
THE NIH, AND THEN DURING HER
TIME AT NIH.
AND ONE OF THE CHAPTERS IN THIS
BOOK IS CALLED "BRIDGES."
THE FIRST SENTENCE IN THE
CHAPTER HAD SIX WORDS.
THE WORDS, I GET EMOTIONAL WHEN
I THINK ABOUT IT.
SHE SAYS, "I MET TONI ON A
THURSDAY."
LET THAT SINK IN.
I MET TONI ON A THURSDAY.
SHE WENT ON IN THAT CHAPTER TO
TALK ABOUT HOW I WAS A BRIDGE
FOR HER FROM ILLNESS TO
WELLNESS, THE INTERACTIONS WITH
ME, HOW I TOOK CARE OF HER, HOW
SHE WATCHED ME TAKE CARE OF
OTHERS.
AND IT REMINDED ME, I TELL YOU
THE STORY NOT TO GO WOW, YOU'RE
MENTIONED IN A BOOK, WHICH IS
FANTASTIC, BUT MORE IMPORTANTLY
I'VE TREATED THOUSANDS OF
PATIENTS WITH CHEMOTHERAPY OVER
THE YEARS, SO MANY I DON'T
REMEMBER THEIR NAMES, THEIR
STORIES, ALL OF THEM.
BUT THEY REMEMBER US.
I MET TONI ON A THURSDAY.
THEY REMEMBER US.
SO HOW DO I WANT TO BE
REMEMBERED?
HOW DO I WANT THIS RESOURCE TO
BE REMEMBERED?
THAT EVERY TIME A PATIENT
ENTERS, WHEN THEY LEAVE, THEY
FEEL VALUED AND CARED FOR.
I'M NOT GREAT WITH THIS
TECHNOLOGY, FORGIVE ME.
WHO ARE KEY PARTNERS?
I.C.s, I MENTIONED ALL THE
CLINICAL CENTER DEPARTMENTS AND
INDIVIDUALS THAT WORK WITHIN
THEM.
I.C. LEADERSHIP.
NOT ONLY AT THE TOP, WHETHER
RESEARCH NURSE OR WHETHER IT'S
PATIENT CARE COORDINATOR, LOTS
OF INTERACTIONS WITH THEM.
OFFICE OF HUMAN SUBJECTS
PROTECTION, WE PARTNER OFTEN TO
SORT OUT THE NATURE OF THE
COMPLAINT AND WHERE EXACTLY IT
SHOULD BE, IF IT'S A CLINICAL
CENTER ISSUE COMES TO ME, IF
RESEARCH FOCUSED I PARTNER WITH
THEM AND HAND THAT OVER.
OFFICE OF GENERAL COUNSEL, THEY
ARE A TELEPHONE CALL AWAY
DEPENDING ON THE NATURE OF THE
ISSUE, THEY ADVISE, LISTEN,
EXTREMELY A BIG HELP.
MY BIGGEST PARTNER I MUST SAY IS
CLINICAL CENTER EXECUTIVE
LEADERSHIP, PARTICULARLY DR.
GILMAN AND PIUS.
ONE THING I LEARNED IN MY
TRAINING, YOU CAN TELL ONE OF
THE WAYS YOU TELL WHAT'S
IMPORTANT TO AN ORGANIZATION
WHERE IT SPENDS TIME AND MONEY.
AND DR. GILMAN FROM DAY ONE
CARES ABOUT THE RESEARCH MISSION
WE'RE TRYING TO UPHOLD.
HE CARES ABOUT THE PATIENT
EXPERIENCE.
I KNOW THIS BECAUSE HE SPENDS
TIME WITH ME.
EVERY MONTH, WITHOUT FAIL, WE
SIT AND TALK ABOUT ALL THE
ENCOUNTERS THAT HAVE COME MY WAY
IN THE PREVIOUS MONTH.
HE HAS A SENSE OF WHAT THE
PATIENT CONCERNS ARE THAT COME
MY WAY.
AND I APPRECIATE THAT.
EVERY MONTH.
WHEN HE HIRED PIUS MY THOUGHT
WAS I'LL START TO DO THAT FOR
PIUS.
HE'S BUSY, DOESN'T HAVE TIME TO
LISTEN TO THIS.
HE CONTINUED.
PIUS ALSO CONTINUED.
NOW I MEET WITH BOTH MONTHLY TO
TALK ABOUT THE CONCERNS OF OUR
PATIENTS.
I CAN'T SAY ENOUGH ABOUT HOW
IMPORTANT THAT IS WITH THE
MESSAGE TO ME AND PATIENTS AND
FAMILIES AT THE TOP WANTS TO
KNOW WHAT CONCERNS THEM.
MY NOW DAVID LANG AND I TALK
ABOUT PATIENT CONCERNS ALL THE
TIME.
HE GETS INVOLVED AS WELL.
OUR PATIENTS HAVE A VOICE, JUST
TO ACKNOWLEDGE THAT.
IN A PLACE LIKE OURS IT CAN BE
CHALLENGING FOR A PATIENT TO
BRING A CONCERN.
THEIR FEARS ARE SLIGHTLY
DIFFERENT THAN WHAT YOU MIGHT
SEE IN OTHER HOSPITALS.
THEY WORRY THAT IF THEY SAY
SOMETHING, THAT THE PROTOCOL
WILL BE WITHDRAWN FROM THEM.
SO, IT'S IMPORTANT TO ME IN MY
ROLE WHEN THEY DO TAKE THE TIME
AND HAVE THE COURAGE TO STEP
FORWARD THAT I THANK THEM AND
ENCOURAGE THEM TO GIVE US
FEEDBACK, THAT THAT IS HOW WE
LEARN AND GROW.
BECAUSE I KNOW IT ISN'T EASY FOR
THEM BUT IT'S IMPORTANT FOR ME
TO EMPHASIZE THAT BECAUSE ONE
PATIENT WILL TELL ANOTHER
PATIENT.
IF THEY FEEL SAFE IN MY SPACE TO
SHARE, THEY CAN TELL SOMEONE
ELSE THE CLINICAL CENTER DOES
WANT TO HEAR YOUR FEEDBACK AND
DON'T BE AFRAID TO STEP UP.
WHAT ARE THE BENEFITS?
OBVIOUSLY WHEN YOU LISTEN AND
TAKE SOMEONE'S CONCERN TO HEART,
IT'S ALL ABOUT HUMANITY AND
PRESERVING DIGNITY OF HUMAN
BEINGS, HELPS ENSURE PATIENT
SAFETY WHEN WE'RE OPEN AND
AVAILABLE TO PATIENTS, AS WELL
AS MAINTAIN INTEGRITY OF THE
PROTOCOL AND HELPING THEM
COMPLY.
OVERALL PATIENT SATISFACTION IS
PROVED, AND PUBLIC PERCEPTION,
AGAIN, PEOPLE TALK.
IT'S IMPORTANT THEY TALK ABOUT
HOW THEY FEEL RESPECTED AND
CARED FOR AND WELCOME TO THE
FEEDBACK.
WHAT WE'RE LEARNING?
I WAS SO CURIOUS WHEN I APPLIED
FOR THE POSITION WHAT TYPES OF
THINGS DID PEOPLE GO TO LAURA
ABOUT IN THE ROLE?
HERE IS THE DATA I JUST WANTED
TO SHARE.
I THINK I'M DOING OKAY ON TIME.
THIS FIRST SLIDE IS A YEAR'S
WORTH OF DATA, TOTAL NUMBER OF
ENCOUNTERS, EACH TIME I ENGAGE
WITH A PATIENT AND FAMILY I
COUNT THAT AS AN ENCOUNTER.
THIS IS HOW THEY MAKE CONTACT.
THE MAJORITY OF THE TIME, AS YOU
SEE, 89%, STARTS WITH A
TELEPHONE CALL FROM THE PATIENT.
SMALLER NUMBER, VISITS IS THE
INITIAL CONTACT.
EVEN SMALLER, THEY WRITE OR
SOMETIMES SEND LETTERS THROUGH
THE MAIL OR E-MAIL.
THE NEXT SLIDE SHOWS THE COURSE
OF THE CONTACT, WHO IS
INITIATING THE CONNECTION WITH
ME.
IT CAN BE AN OUTSIDE FACILITY
WHERE WE MIGHT SHARE A PATIENT
WITH SOMEONE, THEY ARE REACHING
OUT TO GET INFORMATION.
COULD BE THE FAMILY MEMBER THAT
REACHES OUT ON THE PATIENT'S
BEHALF.
THE MENTIONED THE GENERAL
PUBLIC, OUR INFORMATION IS ON
EVERY PROTOCOL CONSENT.
NIH EMPLOYEES MIGHT REACH OUT ON
BEHALF OF A PATIENT UP FRONT.
A POTENTIAL RESEARCH VOLUNTEER,
SOMEONE LOOKING FOR A STUDY, NOT
A PATIENT YET BUT CALLING TO ASK
QUESTIONS.
AND THEN OF COURSE THE LARGER
MAJORITY OF THE CONTACT IS
PATIENTS THEMSELVES.
THIS NEXT SLIDE SHOWS THE
REASONS CATEGORIZED WHY FOLKS
REACH OUT.
THE MAJORITY IN THIS SET OF DATA
IS PROTOCOL CLARIFICATION.
THEY MIGHT CALL WITH QUESTIONS
ABOUT ANY ASPECT OF THE STUDY.
IT'S INTERESTING, IT COULD BE
INFORMATION THE PRIMARY TEAM HAS
ALREADY SHARED WITH THE PATIENT
BUT THEY DON'T WANT TO GO BACK
AND ASK AGAIN AND MIGHT COME TO
ME BECAUSE THEY FEEL SAFER OR
DON'T WANT TO FRUSTRATE OR
IRRITATE OR ANNOY THE FOLKS THAT
ALREADY EXPLAINED SOMETHING TO
THEM.
THERE'S CLINICAL CARE, CUSTOMER
SERVICE COMMUNICATION, HOSPITAL
OPERATIONS, MEDICAL RECORDS,
THERE'S ALWAYS AN "OTHER"
CATEGORY.
RECRUITMENT AND REIMBURSEMENT
FOR THOSE STUDIES, EITHER
PAYMENT OR REIMBURSEMENT BACK.
THIS NEXT SLIDE SHOWS MONTHLY
VOLUME, AS LOW IN THIS
PARTICULAR SET OF DATA, AS LOW
AS 50+ ENCOUNTERS OVER A MONTH,
AS HIGH AS 90.
PEOPLE SAY WHAT'S YOUR BUSY DAY,
IT JUST DEPENDS.
AND THIS NEXT IS A DAILY
AVERAGE.
AGAIN, AVERAGE THREE ENCOUNTERS
A DAY, AS MANY AS FIVE, SOME
DAYS TEN, REALLY VARIES BASED ON
WHAT'S GOING ON AND WHEN
PATIENTS FEEL LIKE THEY WANT TO
STEP UP.
THIS SLIDE, I INCLUDE SIMPLY AS
A REFLECTION OF HOW I SEE ALL OF
US WHO PROVIDE CARE, THE
I.C.s, CLINICAL CENTER,
HOLDING THE NET DOING THIS FOR
PATIENTS AND FAMILIES WITH
COMPASSION AND CARE AND LOVE,
REALLY, IS HOW WE'RE ABLE TO DO
THIS WELL.
OKAY.
I STAYED WITHIN MY TIME.
THANK YOU SO MUCH FOR YOUR
ATTENTION.
I REALLY FEEL HONORED TO BE ABLE
TO DO THIS WORK.
AND I WELCOME ANY QUESTIONS YOU
MIGHT HAVE.
>> THANK YOU, CAPTAIN JONES.
TERRIFIC.
WE'LL PULL DOWN THE SLIDES, LET
ME SEE IF ANYBODY ON THE ZOOM
SCREEN WANTS TO ASK A QUESTION.
I'LL START.
FIRST OF ALL, IT'S AMAZING.
IT WAS SAID EARLIER, I CAN'T
BELIEVE THERE'S ONLY ONE OF YOU.
WHEN YOU TALKED ABOUT -- YOU
HAVE THE BROCHURE IN ENGLISH AND
SPANISH, IS SPANISH CONSIDERED
THE SECOND LANGUAGE HERE BESIDES
ENGLISH THAT WE USE FOR OTHER
INTERACTIONS WITH PATIENTS?
IS THAT A STANDARD --
>> IT'S ON OUR SIGNAGE ACROSS
THE HOSPITAL, ENGLISH AND
SPANISH.
I DON'T KNOW THE EXACT NUMBERS.
I COULD EXACT NUMBERS, I COULD
CHECK WITH THE INTERPRETERS, BUT
IT'S ON OUR SIGNS AND WANTED TO
MAKE SURE WE HAD BROCHURES
ALREADY IN THAT LANGUAGE THEY
COULD GRAB.
>> IN TERMS OF THOSE WHO DO NOT
HAVE ENGLISH AS A LANGUAGE THEY
CAN COMMUNICATE WITH, WHAT'S THE
INTERPRETATION SERVICES THAT
YOU'RE USING?
HOW DO YOU MANAGE THAT HERE?
>> WE CAN PUT IN A REQUEST.
IN MY ROLE WHAT'S INTERESTING,
SOMETIMES A PERSON WILL CALL ME
AND SPEAKING IN A DIFFERENT
LANGUAGE, THE MESSAGE IS IN A
DIFFERENT LANGUAGE.
IF I CAN FIGURE OUT WHAT THE
LANGUAGE IS, WE HAVE -- EITHER
AN INTERPRETER TO LISTEN FOR ME
OR WE HAVE A SERVICE I CAN CALL
THEM BACK WITH AN INTERPRETER.
I DO THAT.
CALL THEM BACK WITH AN
INTERPRETER.
OR AS I MENTIONED, REACH OUT TO
ONE OF MY COLLEAGUES AND THE
INTERPRETER PROGRAM, CAN YOU
LISTEN FOR ME AND TELL ME, HELP
ME WALK THROUGH THIS.
>> ONE FOLLOW-UP.
HOW MUCH DO YOU HEAR FROM PEOPLE
BEFORE THEY ARE EVEN ARRIVING?
IS THAT COMMON?
>> YEAH, IT IS COMMON ACTUALLY.
PART OF THAT PROTOCOL
CLARIFICATION CATEGORY,
RECRUITMENT CATEGORY, PROTOCOL
CLARIFICATION CATEGORY IS
SOMEONE WHO HAS AN APPOINTMENT,
THEY HAVEN'T ARRIVED YET.
THEY HAVE -- WHETHER LOGISTICAL
QUESTIONS OR CONFUSION OR
CLARITY NEEDED AROUND WHAT THEY
ARE SUPPOSED TO DO OR WHAT THE
PROTOCOL IS OFFERING.
SO THERE'S A GOOD NUMBER OF
PEOPLE WHO JUST WANT TO MAKE
SURE THEY HAVE IT STRAIGHT.
LOGISTICAL PIECE, HOSPITAL
OPERATIONS QUESTIONS, WHERE I DO
SHOW UP, I GOT THIS LETTER, I
WANT TO UNDERSTAND, CAN I BRING
MY CAR, THOSE KINDS OF SIMPLE
THINGS.
>> RICK?
>> THANK YOU VERY MUCH.
IT'S REALLY GREAT TO HEAR OF
YOUR EXPERIENCES AND ONE-ON-ONE
ENGAGEMENT.
MY QUESTION, ACTUALLY DR.
DEVASKAR ASKED, I SHOULD KNOW
THIS AFTER SIX YEARS ON THE
BOARD, DO WE DO ROUTINE SURVEYS
LIKE ACAP SCORES OR OTHER -- USE
OTHER TOOLS THAT ARE PART OF THE
WAY WE ELICIT PATIENT FEEDBACK
IN THE HEALTH CARE DELIVERY
SYSTEM?
>> IS IT OKAY IF I ANSWER, DR.
GILMAN?
OKAY, YES.
PRESS GANEY IS OUR CONTRACT
SURVEY COMPANY, I SHOULD SAY.
WE DO COLLECT PATIENT SURVEY
DATA.
THERE'S A SMALL GROUP OF US AT
THE CLINICAL CENTER WHO WEEKLY
LOOK AT PATIENT COMMENTS, NOT
JUST NUMBERS BUT COMMENTS, AND
DECIDE IF THERE'S ACTION THAT
NEEDS TO BE TAKEN RIGHT AWAY
AROUND THOSE COMMENTS.
YES, THAT'S ANOTHER SORT OF
GETTING FEEDBACK.
SOMETIMES PATIENTS SHARE WHO
THEY ARE, SOMETIMES ANONYMOUS.
>> THESE ARE THE CONVENTIONAL
HCAP QUESTIONS?
I DON'T WANT TO STEAL DR.
HADIGAN'S THUNDER, SHE'S GOING
TO TALK ABOUT THAT.
>> OKAY.
>> I THINK WE'LL HEAR FROM DR.
HADIGAN SHORTLY.
STEPHANIE?
>> YEAH, QUICK QUESTION.
SOMEWHAT RELATED TO THE PREVIOUS
ONE.
AT THE POINT WHEN A PATIENT
REGISTERS, BEFORE OR AS THEY
ARRIVE, IS THERE AN OPPORTUNITY
TO IDENTIFY A PREFERRED
LANGUAGE, TO FOLLOW UP?
>> I BELIEVE THAT'S COLLECTED IN
REGISTRATION.
>> GREAT.
>> LAURA, I DIDN'T MISS THE
PRESENTATION THAT IS INTENDED TO
ANSWER MY QUESTION, THAT'S THE
GOOD NEWS.
>> THANKS, RICK.
JIM, DO YOU WANT TO ADD?
>> YEAH, I WANT -- A COUPLE
YEARS AGO, IF YOU REMEMBER, ONE
OF THE HOT TOPICS THAT WE TALKED
ABOUT IN THE CLINICAL RESEARCH
HOSPITAL BOARD HAD TO DO WITH
THE SORT OF SEQUELAE OF THE
#MeToo MOVEMENT, HARASSMENT.
IN ADDITION TO THE PATIENT
REPRESENTATIVE ROLE, TONI ALSO
IS OUR ANTI-HARASSMENT AND
RESPONSE TEAM LEAD.
WHEN WE HAD THOSE DISCUSSIONS
HERE, SOMEBODY, IT MAY HAVE BEEN
LAURA, TALKED ABOUT ESTABLISHING
A POSITION IN AN ORGANIZATION
CALLED THE CHIEF RESPECT
OFFICER.
IT WAS A NEW TITLE, I NEVER
HEARD THAT TITLE.
AND I WOULD JUST SAY THAT YOU
JUST HEARD FROM OUR CHIEF
RESPECT OFFICER.
I THINK YOU HAVE A GOOD IDEA NOW
WHY.
THANKS.
>> THAT WAS ME, I LOVE THAT
TITLE, WE HAVE A CHIEF RESPECT
OFFICER.
I RECOMMEND THAT TO EVERYONE.
IT SOUNDS, TONI LIKE YOU'VE GOT
THAT RESPONSE, NOW WE'LL ADD
THAT TITLE TO YOUR MANY OTHERS.
>> THANK YOU.
>> ANYONE ELSE?
>> I HAVE A QUESTION.
>> CRAIG AND VAN.
>> GREAT.
SORRY, I DON'T KNOW THE
PROTOCOL.
>> THIS IS OUR PROTOCOL.
IT'S BEEN SO LONG SINCE WE'VE
BEEN IN PERSON I FORGOT WHAT THE
HECK IT WAS.
>> WONDERFUL PRESENTATION.
TWO-PART QUESTION.
CAN YOU ELABORATE A LITTLE BIT
ON SOME OF THE CONCERNS THAT
HAVE COME IN IN THE CLINICAL
CARE AND CUSTOMER SERVICE
CATEGORY IN PARTICULAR AND THE
FOLLOW-ON, INTERRELATED, HAVE
YOU FOUND ANY THEMES IN THE
COMPLAINTS THAT LED TO ANY
PROCESS CHANGE OR IMPROVEMENTS
IN THE WAY WE WORK?
>> GREAT QUESTIONS.
I'LL START WITH THE FIRST ONE.
CLINICAL CARE, DID YOU WANT THE
SPECIFIC EXAMPLES OF THOSE
CATEGORIES?
I THOUGHT ABOUT INCLUDING A FEW
EXAMPLES, BUT PROBABLY UNLIKE --
SIMILAR TO OTHER PLACES WHERE A
PATIENT PERCEIVES SOMETHING WAS
DONE INACCURATELY, A COMPETENCE
ISSUE OR WHERE A PATIENT SAW A
DIFFERENCE IN THE WAY CARE WAS
DELIVERED BY TWO DIFFERENT
PROVIDERS, AND SO SAID THIS
PERSON FORGOT TO DO X OR DIDN'T
DO Y OR EVEN SOMETHING AS SIMPLE
AS THE PERSON CAME IN MY ROOM
AND DIDN'T HAVE A MASK AND I'M
IMMUNOSUPPRESSED AND DIDN'T WANT
TO SAY ANYTHING, HOW DO WE
ADDRESS THOSE, ARE YOU CURIOUS
HOW I HANDLE THOSE OR DID YOU
WANT SPECIFICALLY TO KNOW THOSE
THINGS OF THINGS DO COME UP?
SO THAT'S -- WHEN I FIRST TOOK
THE ROLE I WONDERED IF THERE
WERE LOTS OF CLINICAL CONCERNS I
WOULD SAY.
I WAS SURPRISED OF THE LOW
NUMBER, MAYBE NOT KNOW
SURPRISED, REASSURED BECAUSE I
DO THINK THAT EVERYONE COMES TO
DO THEIR BEST WORK BUT THE NIH
PEOPLE FUNCTION AT A HIGH LEVEL.
I THINK THAT COMES ACROSS AND IT
DOES HAPPEN BUT THERE ARE TIMES
CERTAINLY WHETHER IT'S
PERCEPTION OR WHETHER SOMEONE
NEEDS TRAINING AROUND SOMETHING
THAT A PATIENT WILL RAISE AN
ISSUE AND WE QUICKLY AND KINDLY
BUT QUICKLY ADDRESS THAT CONCERN
WITH LEADERSHIP, WITH THAT
INDIVIDUAL.
CUSTOMER SERVICE IS -- EVEN
THOUGH NUMBERS AREN'T HUGE IT
HAS SUCH A HUGE IMPACT WHEN
SOMEONE FEELS DISRESPECTED OR
FEEL LIKE SOMEONE DIDN'T GIVE
THEM INFORMATION.
I REMEMBER RECENTLY A PARENT WAS
FRUSTRATED GETTING TWO PIECES OF
INFORMATION, SOMETHING IN
WRITTEN, THE PLACE SHE GOT TO
SAID SHE SHOULD HAVE DONE
SOMETHING DIFFERENT.
HER FEEDBACK, YOU GUYS NEED TO
GET IT TOGETHER, ALIGN.
HERE'S WHAT I HAVE, WHAT I WAS
TOLD, BUT I GET THERE AND THEY
TELL ME I DIDN'T DO THE RIGHT
THING, OPPORTUNITIES FOR U.S. AS
AN ORGANIZATION TO LOOK AT
COMMUNICATION BECAUSE IT REALLY
IS THE MOST SIGNIFICANT IMPACT,
HOW PEOPLE ARE WORKING TOGETHER
AND TALKING ABOUT THEIR WORK TO
ONE ANOTHER.
I THINK THAT'S ACROSS THE BOARD.
THE OTHER QUESTION, CAN YOU GIVE
ME THAT AGAIN?
>> SURE, WHETHER YOU'VE SEEN ANY
THEME THAT LED TO CHANGE IN
PROCESS OR PROTOCOL.
>> SO, FOR ME IN MY OWN SPECIFIC
ROLE, THERE'S BEEN A FEW TIMES.
COMMUNICATION IS A BIG ONE.
I REMEMBER THERE WAS A NUMBER OF
PATIENTS WHO DIDN'T KNOW EACH
OTHER, I DON'T THINK.
THEY REACHED OUT SEPARATELY
ABOUT A PARTICULAR COMMUNICATION
STYLE, A STAFF MEMBER ON THE
SAME STUDY, BUT DIDN'T KNOW EACH
OTHER, DIFFERENT TIME POINTS BUT
NAMED THE SAME PERSON.
THIS IS AN PERSON, NOT A
ONE-OFF.
I HAD A CONVERSATION WITH THE
I.C. LEADERSHIP ABOUT WHAT IS
HAPPENING THAT'S GETTING IN THE
WAY OF A PERSON'S PARTICIPATION
EASILY IN THE STUDY.
I POINT AT COLLEEN BUT WEEKLY
SURVEY NOW OF COMMENTS GIVES A
CHANCE TO LOOK AT WHAT ARE WE
SEEING ACROSS THE BOARD, NOT
ONLY IN THE COMMENTS BUT EVEN I
DO THAT LOOKING A T AT MY OWN
DATA.
I CAN SORT BY I.C., BY
DEPARTMENT, 1 NORTHWEST,
SOMETHING MIGHT BE HAPPENING,
I'M NOT PICKING ON THEM, THAT
CAME TO MY MIND.
IS THERE SOMETHING IN A UNIT, IN
A GROUP WITH A PARTICULAR STUDY
THAT MIGHT GIVE US A CHANCE TO
SAY IT'S NOT ONE PATIENT BUT
HAPPENING TO A FEW.
OVERALL NUMBERS, NUMBER OF
VISITS IN A CLINICAL CENTER,
PROBABLY QUITE SMALL.
BUT STILL, THERE'S OPPORTUNITY
TO MAKE CHANGE AND MAKE
IMPROVEMENTS.
>> THANK YOU.
COLLEEN, WE'RE GOING TO TAKE A
FEW MORE QUESTIONS IF IT'S OKAY
WITH YOU.
VAN AND MS. ROYSTER AND DAVID.
>> CAPTAIN JONES, HOO-AH ON THE
YEOMAN'S WORK YOU DO ALONE.
I APPRECIATE THE DISCUSSION,
ESPECIALLY THE LAST SET OF
QUESTIONS BECAUSE IT GOES TO
MINE.
YOU TALK ABOUT PEOPLE WITH
DIFFERENT LANGUAGES FROM ALL
OVER THE UNITED STATES, MAYBE
YOU SEE THE WORLD HERE REALLY AT
NIH, NOT KNOWING WHAT THE REGS
COVER IN DEIA HOW MUCH
UNCONSCIOUS BIAS OR IMPLICIT
BIAS OR CULTURAL COMPETENCY
TRAINING IS ACTUALLY DONE WITH
STAFF AND RESEARCHERS AS THEY
BETTER PREPARE TO INTERACT WITH
DIFFERENT CULTURES THAT COME IN,
IN THE PATIENTS THAT THEY SEE.
>> THAT'S A GREAT QUESTION,
ALTHOUGH I DON'T THINK I HAVE
THE ANSWER TO THAT IN TERMS OF
--
>> WE ALL DO UNCONSCIOUS BIAS
TRAINING ANNUALLY.
AND IT'S SHRIEK A LOT OF
TRAINING, THE FIRST IT -- IT'S
LIKE A LOT OF TRAINING, THE
FIRST ITERATION WAS KIND OF
OKAY, AND IT'S PROGRESSED, WE
NOW HAVE VERY GOOD ONLINE
TRAINING THAT REQUIRES SOME
INTERACTION.
YOU CAN'T JUST FLIP THROUGH THE
SLIDES AND THEY GO THROUGH SOME
ACTUAL SCENARIOS.
I THINK THE NIH HAS DONE A
PRETTY GOOD JOB OF MAKING THAT
INVESTMENT.
IT WAS A BIG ITEM FOR THE LAST
CHIEF OF THE OFFICE OF
SCIENTIFIC WORK FORCE DIVERSITY,
IT IS A BIG ITEM FOR THE CURRENT
CHIEF OF THE OFFICE OF
SCIENTIFIC WORKFORCE DIVERSITY.
IT'S OBVIOUSLY A BIG DEAL FOR
NIH LEADERSHIP, AS YOU HEARD
FROM DR. TABAK AND CLINICAL
CENTER LEADERSHIP.
>> THANK YOU.
MS.ROYSTER?
>> SEEING SIGNS AND BUSINESSES,
IF WE SERVE YOU WELL, TELL YOUR
FRIENDS.
IF WE DID NOT, TELL US.
THERE ARE QUITE A FEW PATIENTS
WHEN I FIRST STARTED AT NIH,
WOULD ALWAYS TELL ME THEIR
ISSUES, I WOULD POINT TO THE
WALL, THAT'S THE PATIENT
REPRESENTATIVE RIGHT THERE.
AND YOU HAVE TAKEN PATIENT
REPRESENTATION TO THE NEXT
LEVEL.
I LOVE YOU SO MUCH.
YOU ARE TRULY THE CHIEF RESPECT
OFFICER.
THANK YOU, TONI, FOR ALL YOU DO.
>> MY PLEASURE.
>> THAT WAS BEAUTIFULLY STATED.
DAVID?
>> I WOULD ADD ONE COMMENT THAT
ACTUALLY PATIENTS NOW GET
INTRODUCED TO TONI, IF THEY GO
TO THE WEBSITE, WHERE SHE'S IN
THE VIDEO ABOUT COMING TO THE
NIH CAMPUS, THINGS TO BE
PREPARED FOR, THINGS NOT TO BE
PREPARED FOR, WHICH SHE
DILIGENTLY DID WITHIN 30 DAYS OF
IT BEING RAISED AT A PATIENT
ADVISORY COMMITTEE MEETING
MAKING A DIFFERENCE TO FAMILIES
AND PATIENTS BECAUSE WHEN YOU
COME UP TO THE GATES AND SEE
DOGS AND POLICE OFFICERS, IT'S
AN OVERWHELMING FEELING.
I HAVE TWO OTHER COMMENTS.
I INTERACT WITH TONI FREQUENTLY
BECAUSE OF FREQUENT VISITS TO
CAMPUS.
THE BREADTH OF HER BACKGROUND
CONTRIBUTES IN MY OPINION VERY
SIGNIFICANTLY TO EFFECTIVENESS
OF THE JOB.
I HOPE SOME DAYS THERE ARE FUNDS
TO HAVE ADDITIONAL HELP.
BUT I HAD THE PROBLEM THAT
RELATED TO EDUCATION LEVELS OF
FELLOWS WHO WERE PROVIDING
PARTICIPATION IN RESEARCH AND
PATIENT CARE IN THE HOSPITAL, IN
THE EARLY DAYS BEFORE TONI CAME
ON BOARD.
IT TOOK ME MONTHS OF TRACKING
DOWN THE PRIMARY INVESTIGATOR
BECAUSE I COULDN'T GET TO A
PATIENT REPRESENTATIVE TO HELP
ME WITH THAT PROBLEM.
THE PROBLEM WAS RESOLVED.
IT'S SOMETHING THAT A RESEARCH
HOSPITAL HAS TO BE COGNIZANT OF
AND IT IS NOW.
AND THAT IS RESEARCHERS
FREQUENTLY DON'T UNDERSTAND HOW
TO INTERACT WITH LIVE PATIENTS.
IT'S NOT TAUGHT UNFORTUNATELY.
WHEN I USED TO TEACH AT A
UNIVERSITY AS A GRADUATE STUDENT
OR DEAN OF ENGINEERING REQUIRED
US TO COME IN FOR A SUMMER
EDUCATION ON HOW TO BE A TEACHER
BECAUSE TOO MANY GRADUATE
STUDENTS DID NOT KNOW HOW TO
TEACH.
IT'S A PROBLEM THAT I THINK NIH
IS TRYING TO ADDRESS.
I KNOW THAT PARTICULAR FELLOW
GOT IT RIGHT BECAUSE HE WENT ON
TO BE A DEPARTMENT HEAD IN THE
JOHNS HOPKINS HOSPITAL IN THE
AREA.
SO, THE WHOLE RELATIONSHIP
BETWEEN PATIENTS AND THE
RESEARCH ASPECT OF THE CLINICAL
CENTER IS SOMETHING THAT IS
CONSTANTLY IMPROVING.
AND TONI IS A SIGNIFICANT
REASON.
>> WE'RE LUCKY TO HAVE HERE
CLEARLY.
THANK YOU BOTH FOR THE COMMENTS.
YOU SEE HOW IMPORTANT IT IS TO
HEAR FROM PEOPLE WHO HAVE ON THE
GROUND EXPERIENCE WITH THAT.
DAVID CHIN?
>> YOUR PASSION COMES THROUGH.
THANK YOU VERY MUCH.
MY QUESTION IS THAT GIVEN DR.
TABAK'S COMMENTS THAT THE NIH IS
A FEDERATED MODEL, HOW MUCH
VARIATION DO YOU SEE AMONG THE
INSTITUTES IN TERMS OF HOW THEY
INTERACT WITH PATIENTS.
THERE MIGHT BE VARIATION.
>> THE PATIENT SEES ONE
ORGANIZATION.
THEY TALK TO ONE ANOTHER.
THEY WOULD SAY THAT'S NOT WHAT
MY FOLKS OFFERED ME.
OR THAT'S NOT HOW THEY DO IT
WHERE I'M BEING SEEN.
AND SO, THEY DO ALL FUNCTION
DIFFERENTLY.
I DO CERTAINLY THINK THEY TRY TO
MAKE IT AS SMOOTH AS POSSIBLE
FOR PATIENTS BUT I THINK MY
ROLE, TO UNDERSTANDING THOSE
NUANCES, HELPING THE PATIENTS
UNDERSTAND THEM, BECAUSE FAIR
DOESN'T ALWAYS MEAN EQUAL, YOU
MAY BE ON A STUDY IN ONE I.C.
THAT HANDLES THINGS IN ONE WAY,
AND HAVING TO STRUGGLE WITH WHY
IT LOOKS DIFFERENT FOR THAT
FAMILY AND UNDERSTANDING THAT
THERE'S EACH I.C., HOW THEY
OPERATE, I THINK THAT IS
SOMETHING WE ALWAYS ARE GOING TO
HAVE TO DEAL WITH AND HAVE TO
MESSAGE AND SHEPHERD FOR THAT
PATIENT AND FAMILY AND HELP THEM
UNDERSTAND.
IT JUST DEPENDS ON THE I.C. AND
WHAT THE STUDY IS AND HOW THINGS
ARE ALLOCATED AND WHAT THEY CAN
ALLOW.
THERE'S A GOOD BIT OF VARIATION
DEPENDING ON WHICH VARIATION.
>> ARE THERE LESSONS OVER THE
YEARS THAT YOU STABLE A COMMON
PROTOCOL, SO THERE HAS TO BE
VARIATION BUT THERE ARE
OPPORTUNITIES TO STANDARDIZE SO
THE PATIENT DOESN'T EXPERIENCE
THE KIND OF VARIATION YOU
MENTIONED?
>> USUALLY, THE THINGS THAT ARE
OF CONCERN THAT COME TO ME ARE
USUALLY SO UNIQUE YOU CANNOT
STANDARDIZE.
THERE ARE SOME AROUND
COMMUNICATION.
DAVID MENTIONED JUST EVEN HOW TO
GET INTO THE HOSPITAL.
SOME I.C.s DO A REALLY GREAT
JOB OF MAPPING OUT FOR THAT
PATIENT AND FAMILY WHAT THEY CAN
EXPECT.
OTHERS, THE PATIENT WILL SAY I
WAS EXPECTING TO GET A CALENDAR
AND LIST AND SOME INFORMATION
AND I'M STILL WAITING FOR IT.
SO THOSE ARE THE KINDS OF THINGS
WE CAN SAY TO I.C.s.
WE HAVE A MONTHLY SECRETARIAT
MEETING WHERE A LOT OF I.C.s
ATTEND, TAKING THE OPPORTUNITY
TO REMIND THEM TO GET THE
MESSAGE OUT.
HERE THE THINGS WE'RE HEARING
ABOUT SOMETHING AS SIMPLE AS
BRINGING MARIJUANA ON THE
CAMPUS, THINGS THAT COME UP THAT
SOME PEOPLE KNOW AND SOME PEOPLE
DON'T.
YOU THINK, HOW CAN WE MAKE THAT
BETTER SO WHEN WE CAN ENGAGE
LARGE AUDIENCES THAT HAVE I.C.
PARTNERS WE GIVE THEM REMINDERS
BUT THOSE ARE THE KINDS OF SMALL
THINGS THEY SEE BUT THEY HAVE
BIG IMPACT.
WHEN YOU COME AND YOU'RE AT THE
GATE AND CAN'T GET IN BECAUSE
SOMEONE DIDN'T DO A SMALL THING
BECAUSE SOMETHING WOULD HAVE
MADE THE EXPERIENCE BETTER.
>> WE'LL LOOK FORWARD TO SEEING
HOW THINGS GO AND THEY WILL
CLONE YOU.
DR. HADIGAN IS COMING TO THE
PODIUM.
COLLEEN, WELCOME.
DR. CUNNINGHAM JOINED US.
REGINA, THANKS FOR BEING WITH
US.
FOR THOSE ON ZOOM, SOME PEOPLE
ARE CHATTING BUT WE DO NOT HAVE
GREAT WAYS TO SEE THAT.
I HOPE YOU'LL RAISE YOUR HAND
AND PARTICIPATE AND ASK A
QUESTION.
I'LL TRY TO BE VERY MINDFUL OF
THAT.
COLLEEN, THANK YOU FOR BEING
HERE.
>> OKAY.
SO THIS IS A PERFECT OPPORTUNITY
TO KIND OF EXPAND AND CONTINUE
IN THIS TOPIC OF PATIENT
SATISFACTION, PATIENT SURVEY.
I WANT TO FIRST THANK CAPTAIN
JONES FOR HER PRESENTATION AND
SAY THAT I KNOW SHE PUT METRICS
UP THERE TO SHOW WHAT SHE DOES
BUT LET'S BE HONEST, THERE'S NO
GRAPH THAT'S GOING TO CAPTURE
THE VALUE THAT WE HAVE IN HER
FOR PATIENTS AND FOR OUR STAFF.
I'M VERY APPRECIATIVE OF HER
WEEKLY MEETINGS WITH ME
REVIEWING SURVEY DATA AND
FOLLOW-UP SHE PROVIDES TO OUR
PATIENTS.
I'M GOING TO SPEND TIMESHARING
OUR PRESS GANEY RESULTS FROM THE
YEAR 2021 AND IN ADDITION
BREAKING IT OUT BY DIFFERENT
DEMOGRAPHICS TO SEE IF WE CAN
EVALUATE IF THERE'S ANY
DISPARITY IN PATIENT EXPERIENCE
BY THESE DIFFERENT DETERMINANTS.
SO, JUST AS A SIMPLE REMINDER
ABOUT HCAPS, AND DATA, PRESS
GANEY IS A LARGE ORGANIZATION
THAT COLLECTS DATA FOR MANY
HOSPITALS ACROSS THE COUNTRY.
AND IT PROVIDES PLATFORMS NOW TO
DO e-SURVEYING WITH
STANDARDIZED QUESTIONS THAT
ADDRESS MULTIPLE ASPECTS OF THE
HEALTH CARE ENCOUNTER THAT
OCCURS INCLUDING SPECIFICS
AROUND THE NURSING EXPERIENCE,
PHYSICIAN EXPERIENCE, ACCESS TO
CARE, MEALS, THE ROOM, OTHER
PERSONAL ISSUES.
I WANT TO SHARE SOME EXAMPLES.
OUR QUESTIONS ARE DESIGNED
THROUGH -- WE WORKED HARD WITH
PRESS GANEY TO INCLUDE HCAP TYPE
QUESTIONS, OR STANDARDIZE CMS
QUESTIONS TO BENCHMARK AGAINST
THE PARTICIPATING HOSPITALS.
I'LL GO THROUGH QUICKLY.
IF YOU WERE AN INPATIENT AND
RECEIVING A SURVEY, THE SECTION
RELATED TO NURSING HAS THESE
QUESTIONS, HOW WELL DID NURSES
KEEP YOU INFORMED, WHAT WAS THE
SKILL LEVEL OF THE NURSES CARING
FOR YOU?
AND THE DATA THAT I'M GOING TO
SHOW IS OUR TOP BOX AVERAGE.
THAT'S THE AVERAGE OF HOW MANY
QUESTIONS IN EACH CATEGORY WERE
RESPONDED WITH A CHECK-OFF OF
THE TOP BOX, A STANDARD WAY IN
WHICH THESE DATA ARE SUMMARIZED.
WE WENT LIVE IN APRIL OF 2021.
BECAUSE WE HAD WANTED A FULL
YEAR'S WORTH OF DATA, WE DID A
REACHBACK AND e-SURVEYED
EVERYONE WHO HAD AN ENCOUNTER IN
THE CLINICAL CENTER THAT WAS
ELIGIBLE FOR A SURVEY BEGINNING
IN JANUARY OF 2021.
THEN FORWARD WE DID IT IN REAL
TIME SURVEYING.
PATIENTS WOULD RECEIVE
e-SURVEY IMMEDIATELY AFTER
ENCOUNTER.
WE DO COLLECT DATA BASED ON BOTH
SEX, RACE, AND LANGUAGE IN WHICH
THE SURVEY IS COMPLETED.
IN 2022, WE'RE ALSO NOW
COLLECTING INFORMATION SO WE CAN
LINK TO ETHNICITY.
WE'RE USING THIS AS AN
OPPORTUNITY TO ASSESS PATIENT
EXPERIENCE, LINKED TO THIS
DEMOGRAPHIC INFORMATION.
WHAT I'M GOING TO DO IS SHOW
FIRST OUTPATIENT DATA WHICH IS
CALLED OUR MEDICAL PRACTICE.
AND THEN WE'LL SWITCH TO
INPATIENT BECAUSE THE
EXPERIENCES CAN BE DIFFERENT IN
THOSE SETTINGS.
I'LL POINT OUT I'M NOT CURRENTLY
INCLUDING OUR BEHAVIORAL HEALTH
UNITS BECAUSE WE'RE STILL DOING
A PEN AND PAPER SURVEY THAT'S
SLIGHTLY DIFFERENT AND NOT
EXACTLY COMPARABLE.
THIS INCLUDES OUTPATIENT MEDICAL
PRACTICES, IN ADULT CLINICS, AND
THE DAY HOSPITALS.
I'LL SPEND A LITTLE TIME WALKING
THROUGH THIS BECAUSE THIS MODEL
IS GOING TO BE REPEATED
THROUGHOUT THE REMAINDER OF THE
SLIDES.
THE FIRST THING TO POINT OUT IS
THE PRESS GANEY COMPARATOR GROUP
DOES NOT ALLOW US TO BREAK IT
DOWN INTO THE INDIVIDUAL DIRECT
COMPARATORS BY SEX OR RACE
BECAUSE DIFFERENT HOSPITALS DO
THEIR CATEGORIZATIONS
DIFFERENTLY ALPO AL -- ALTHOUGH
PRESS GANEY IS ALLOWING US TO
WORK TO DO THAT.
DARK SOLID BAR IS PRESS GANEY
COMPARATOR DATA.
IF YOU LOOK AT THE OVERALL
OUTPATIENT EXPERIENCE,
EXPERIENCE WITH NURSES IN THE
OUTPATIENT SETTING, WITH YOUR
CLINICIAN PROVIDER OR ACCESS TO
APPOINTMENT, ALL CATEGORIES, NIH
SCORED HIGHER THAN THE PRESS
GANEY AVERAGE, IN TERMS OF TOP
BOX SCORING.
WHEN WE BROKE IT OUT BY FEMALE
OR MALE, YOU SEE THERE IS NO
CLEAR OR SIGNIFICANT DIFFERENCE
BETWEEN SEXES, BASED ON THE
OUTPATIENT EXPERIENCE IN THOSE
DIFFERENT CATEGORIES.
NEXT IS THE SAME ORGANIZATION OF
THE DATA PG OVERALL, PRESS
GANEY, 17+ HUNDRED HOSPITALS,
NIH AVERAGE FOR OUTPATIENT
SETTING IN 2021, BROKEN OUT BY
WHETHER THE SURVEY WAS COMPLETED
IN ENGLISH OR SPANISH.
THE OVERWHELMING MAJORITY WERE
ENGLISH, A RELATIVELY SMALL
NUMBER CHOSE SPANISH BUT PRESS
GANEY DOES, WHEN e-SURVEY IS
HAVEN'T, ALLOW PARTICIPANTS TO
CHECK THE LANGUAGE.
WE DON'T SEE A SIGNIFICANT
CHANGE OR DIFFERENCE IN THE
PATIENT'S LIKELIHOOD TO RATE AS
TOP BOX EXPERIENCE BASED ON
WHETHER OR NOT THEY HAD
COMPLETED THE SURVEY IN ENGLISH
OR SPANISH.
THE NEXT IS THE SAME INFORMATION
NOW BROKEN OUT BY RACE
IDENTIFIED BY THE SURVEY
RESPONDENT.
AND NOW JUST TO MAKE IT LESS
BUSY I TOOK THE PG ALL OFF, LEFT
THE NIH ALL IN THE HASH BARS,
REPRESENTING ASIAN,
BLACK/AFRICAN AMERICAN, MIXED
RACE AND WHITE.
YOU SEE IN GENERAL, THERE IS NO
SIGNIFICANT ANDOUT RACIAL
GROUP THAT IS SCORING MARKEDLY
DIFFERENT IN TERMS OF OVERALL
SATISFACTION.
NOW I'M GOING TO WALK THROUGH
INPATIENT EXPERIENCE DATA.
AGAIN, THIS DOES NOT INCLUDE OUR
BEHAVIORAL HEALTH UNIT.
AND I'LL POINT OUT YOU'LL SEE
THE NUMBERS ARE LOWER BECAUSE
OUR CENSUS HAS BEEN LOWER AND ON
EVERYTHING JUST TO POINT OUT WE
HAVE ROUGHLY 20 TO 22% RESPONSE
RATE TO SURVEYS.
SO, AGAIN, HERE YOU SEE NIH
OVERALL IS SCORING SIGNIFICANTLY
HIGHER IN ALMOST ALL THE
CATEGORIES, 10 TO 20 PERCENTAGE
POINTS HIGHER FOR TOP BOX RATING
COMPARED TO PG DATA OVERALL.
AND THEN WHEN YOU LOOK BY
WHETHER THE RESPONDENT WAS MALE
OR FEMALE, AGAIN, YOU SEE THAT
THERE DOESN'T APPEAR TO BE A
SIGNIFICANT DIFFERENCE.
IF YOU LOOK CAREFULLY, YOU MIGHT
HAVE NOTED THAT IN THE
OUTPATIENT SETTING, WOMEN SCORED
LOWER, RATINGS WERE LOWER FROM
WOMEN THAN FROM MEN.
YOU CAN SEE ON THE INPATIENT
SETTING IT'S REVERSED, WOMEN
TENDED TO SCORE A LITTLE HIGHER
THAN MEN.
I CAN'T WRAP MY HEAD AROUND
UNDERSTANDING THAT.
I TALKED TO OUR PRESS GANEY
COLLEAGUES WHETHER OTHER
HOSPITALS SEE SIMILAR EXPERIENCE
IN RATINGS.
THEY SAID IN GENERAL WOMEN ARE
HARDER TO PLEASE, PRESS GANEY
OVERALL SAID THEY TEND TO SEE
LOWER RATINGS FROM WOMEN.
HERE IS THE INFORMATION SPLIT BY
LANGUAGE.
AGAIN, VERY SMALL NUMBER OF
RESPONDENTS COMPLETING THIS
SURVEY IN SPANISH, 12 VERSUS 351
IN ENGLISH.
THE TOP BOX RATINGS FOR THE FEW
FILLED OUT WERE AS HIGH OR
HIGHER FOR EACH OF THE DIFFERENT
CATEGORIES OF THE INPATIENT
EXPERIENCE.
AND THEN BROKEN OUT BY RACE FOR
THE INPATIENT EXPERIENCE AGAIN
SOME GROUP NUMBERS ARE SMALL,
FEWER THAN 20 FOR ASIAN AND
MIXED RACE CATEGORIES, WHICH
COULD POTENTIALLY ACCOUNT FOR
SOME VARIABILITY MAKING IT HARD
TO SAY WHETHER THESE ARE
SIGNIFICANT DIFFERENCES BUT THAT
IN GENERAL BUT WE DON'T SEE
CLEAR PATTERN OF ONE PARTICULAR
GROUP SCORING SIGNIFICANTLY
LOWER IN TERMS OF THEIR
EXPERIENCE WITHIN THE CLINICAL
CENTER AND IN PATIENT STAY.
AND SO, YOU KNOW, THIS PATIENT
SATISFACTION SURVEY DATA JUST
OFFERS ONE METRIC TO ASSESS
PATIENT EXPERIENCE, SORTING BY
SOCIODEMOGRAPHIC INDICES.
PRELIMINARY REVIEW DEMONSTRATES
LEVELS OF SATISFACTION BROKEN
DOWN BY CATEGORIES APPEAR TO BE
SIMILAR.
THERE ARE OBVIOUSLY SMALL SAMPLE
SIZES IN SOME SUBCATEGORIES, AND
THERE'S FUTURE WORK TO BE DONE
WHERE WE'RE NOW COLLECTING THE
ETHNICITY PIECE AS ANOTHER
SOCIAL DETERMINANT WE COULD LOOK
AT IN TERMS OF YOU WHO THAT
MIGHT RELATE TO PATIENT
EXPERIENCE AROUND CAN BREAK DOWN
BY AGE CATEGORIES TO SEE IF
DIFFERENT AGE GROUP HAVE
DIFFERENT EXPERIENCE AND HAVE
NOT TAKEN PART.
WITH THAT I'LL SEE IF PEOPLE
HAVE QUESTIONS OR WHAT TO SEE IF
PEOPLE WANT TO HEAR THINGS
RELATED TO SURVEY DATA.
>> TERRIFIC.
THANK YOU.
LET ME SEE, LOOK FOR COLLEAGUES
ON ZOOM.
REGINA?
>> THANKS, LAURA, VERY MUCH.
THANKS FOR THE PRESENTATION.
YOU MENTIONED THAT THE OVERALL
RESPONSE RATE WAS BETWEEN 20 TO
22%, IF I HEARD YOU CORRECTLY.
WHAT I WAS WONDERING IS WHETHER
OR NOT YOU HAVE LOOKED AT
RESPONSE RATE BY ANY OF THE
VARIABLES, RACE, OR GENDER.
WHAT MAKES ME ASK THE QUESTION
IN MY OWN FACILITY WHEN WE BREAK
DOWN THE DATA BY RACE WE FIND A
LOWER -- SIGNIFICANTLY LOWER
RESPONSE RATE AMONG OUR AFRICAN
AMERICAN POPULATION SO I'M JUST
WONDERING IF YOU HAVE THAT
INFORMATION OR ARE SEEING THAT
AS WELL.
THANKS.
>> YEAH, SO WE HAVE LOOKED AT IT
BY RACE AND SAW THERE WAS LOWER
RESPONSE RATES IN THE MIXED RACE
AND THE BLACK/AFRICAN AMERICAN
GROUP.
BUT IT WAS STILL LIKE 18%.
SO THE RANGE AT THE TOP OF THE
RANGE WAS LIKE 22% FOR
WHITE/CAUCASIAN, SO NOT TOO
DISPARATE.
>> THAT'S REALLY HELPFUL.
WHAT WE'VE NOTICED IS A
SIGNIFICANT DIFFERENCE, SO THANK
YOU FOR THAT CLARIFICATION.
>> RICK?
>> COLLEEN, THANKS.
IF I UNDERSTAND CORRECTLY, THIS
IS A PROCESS THAT'S JUST BEGUN
IN THE LAST YEAR, BEGINNING IN
2021.
IS THAT CORRECT?
>> YES, AND BEFORE THAT THERE
WAS A DIFFERENT SURVEY MECHANISM
BEING USED.
>> AND WHEN YOU SAY PRESS GANEY
e-SURVEY, THAT IMPLIES TO ME
RESPONSES THROUGH THE INTERNET
OR SOME FORM OF
e-COMMUNICATION, IS THAT
CORRECT?
NO MAIL-OUT SURVEYS?
>> CORRECT.
THE ONLY PAPER SURVEY THAT WE'RE
USING RIGHT NOW IS FOR THE
BEHAVIORAL HEALTH UNITS, BECAUSE
THERE IS SOME LONGSTANDING
TRADITIONAL RELUCTANCE TO
e-SURVEY BEHAVIORAL HEALTH
PATIENTS BECAUSE OF THE
SENSITIVITY OF THEIR DIAGNOSES
BUT WE'RE ACTUALLY MOVING
TOWARDS USING THE ELECTRONIC
SURVEYS FOR THEM AS WELL BECAUSE
THEY AND OUR INSTITUTE PARTNERS
ALL BELIEVE THEY GET MORE
SURVEYS BACK IF WE DID IT
ELECTRONICALLY BECAUSE IT'S
EASIER FOR EVERYONE TO DO.
>> AND ONE FINAL QUICK QUESTION,
THE 3100 RESPONSES YOU HAVE FROM
THE OUTPATIENT SURVEYS WHAT
PERCENT OF TOTAL OUTPATIENT
VOLUME IS THAT?
>> WELL, LET ME CLARIFY THAT
EVERY -- THERE'S NOT A SIMPLE
ANSWER BECAUSE OUTPATIENT VOLUME
WOULD BE TOTAL NUMBER OF VISITS
BUT THERE ARE RESTRICTIONS IN
HOW FREQUENTLY A PATIENT
RECEIVES A SURVEY.
WE DID A HIERARCHICAL STRATEGY
WHEN WE BUILT SURVEYS.
WE KNEW THERE WOULD BE FUTURER
LET'S SAY AMBULATORY SURGERY OR
INPATIENT VISITS, THAT WOULD
TAKE HIERARCHY OVER OUTPATIENT
VISIT SO IN A SET QUARTER FOR
INSTANCE IF AN INDIVIDUAL HAD AN
INPATIENT STAY THAT SURVEY WOULD
TAKE PRECEDENCE OVER A FOLLOW-UP
OUTPATIENT STAY AND WE DON'T
WANT TO OVERSURVEY SO I CAN'T
TELL HOW THAT NUMBER RELATES TO
THE ACTUAL NUMBER OF VISITS.
>> THANK YOU.
>> CRAIG AND THEN DAVID BAUM?
WELL DONE.
IT MIGHT BE TOO EARLY TO ASK THE
QUESTION BUT IN MY PRIOR LIVES
WHEN WE SAW STRONG RESULTS AND
CONSISTENT RESULTS LIKE THIS OUR
DESIRE WAS TO CONSTANTLY IMPROVE
WE WENT DIGGING FOR THINGS WE
COULDN'T SEE.
SO WE LOOKED AT ACTUALLY THE
BOTTOM BOX OR BOTTOM TWO BOX
RESULTS TO SEE IF THERE WAS
ANYTHING THERE OR LOOKED AT
COMMENTS, IF THAT'S POSSIBLE.
HAVE YOU DONE ANY OF THAT, GIVEN
HOW -- THEY ARE WONDERFUL
RESULTS BUT HAVE YOU DUG A BIT
DEEPER?
>> ABSOLUTELY.
I'M GIVING YOU LIKE THE
10,000-FOOT VIEW, BUT PRESS
GANEY HAS LOTS OF TOOLS TO ALLOW
YOU TO DIG DEEP TO LOOK FOR
THOSE THINGS.
WE'RE ACTIVELY AS CAPTAIN JONES
ALLUDED TO, EVERY WEEK PATIENT
SAFETY OFFICER, HEALTH
MANAGEMENT RECORDS OFFICER,
MYSELF AND CAPTAIN JONES REVIEWS
EVERY WRITTEN COMMENT BECAUSE
AFTER EVERY QUESTION THERE'S
ROOM FOR FREE TEXT FIELD.
WE READ THEM ALL, IDENTIFY AS
YOU ASKED DO YOU IDENTIFY
PATTERNS AND ACT, AN EXAMPLE, WE
HAD A MONTH WHERE WE WERE
GETTING REPEATED COMMENTS ABOUT
WAIT TIMES IN PHLEBOTOMY.
SO TOOK THOSE AGGREGATE
COMMENTS, WENT TO THE LEADERSHIP
IN THE PHLEBOTOMY AREA, PROVIDED
THEM WITH THIS INFORMATION AND
THEY DID SOME DIGGING AND
FEEDBACK TO FIND OUT WHAT WAS
GOING.
THERE WAS TWO CRITICAL STAFF
ILLNESSES THAT RESULTED IN
SLIGHTLY LOWER STAFFING BUT IT
GAVE AN OPPORTUNITY TO LOOK AT
PROCESS AND DETERMINE IF THERE
WERE OTHER THINGS WE NEEDED TO
DO TO IMPROVE IT.
THE OTHER GROUP THAT IS USING
THESE DATA IS OUR NURSING
DEPARTMENT.
AND THAT IS A BIG PART OF THE
MAGNET JOURNEY YOU'LL HEAR ABOUT
SHORTLY IN TERMS OF HAVING
ABILITY TO LOOK AT VERY SPECIFIC
AREAS FOR IMPROVEMENT AND
TRENDING OVER TIME TO SEE WHEN
WE'RE DIPPING, WHERE WE'RE
DIPPING.
I DID NOT GET INTO SOME OF THE
DETAILED STUFF BUT WE CAN LOOK
AT EXPERIENCE WITH NUTRITION AND
MEALS, INPATIENT SIDE,
CLEANLINESS AND COMFORT OF THE
ROOM, THINGS LIKE THAT.
THERE TEND TO BE LOW-HANGING
FRUIT WHERE YOU CAN MAKE
SIGNIFICANT IMPROVEMENT IN
PATIENT EXPERIENCE.
YEAH, WE HAVE A LOT OF ABILITY
TO DO THAT.
>> THANK YOU, DR. HADIGAN.
YOUR ANSWER TO GREG'S QUESTIONS
PICKED UP ON A QUESTION THAT I
HAD IN TERMS OF THE GRANULARITY
OF THE RESULTS.
>> WHO AM I MISSING?
STEVE, DO YOU HAVE YOUR HAND UP?
>> I THINK I CAN DO THAT.
I PUT MY HAND ON PEOPLE'S FACES.
[LAUGHTER]
IT WAS AN ERRANT --
>> WE'RE STILL GETTING USED TO
THIS.
>> DR. HADIGAN, I KNOW THIS IS
ALL FAIRLY NEW.
THE e-SURVEY PROCESS.
BUT ARE YOU ALL PLANNING TO IN
THE FUTURE EXPAND IT SO THAT
THERE'S MORE THAN JUST ENGLISH
AND SPANISH LANGUAGES, AS FOLKS
COME TO THE NIH FOR SERVICES?
BECAUSE THERE ARE INTERPRETERS
THAT SOMETIMES ACCOMPANY FOLKS
AROUND.
WILL THIS BE EXPANDED TO OTHER
LANGUAGES?
>> SO, IT IS ACTUALLY AVAILABLE
IN ADDITIONAL LANGUAGES.
WE DON'T GET SIGNIFICANT NUMBERS
FOR ME TO SHOW IN AGGREGATE BUT
OUR CURRENT PLATFORM THAT IS
BEING OFFERED TO US THROUGH
PRESS GANEY REPRESENTS
AVAILABILITY FOR THEM TO DO IT
IN 60 -- NOT 60, SORRY.
20 DIFFERENT LANGUAGES AND EVEN
COMMENTS ARE TRANSLATED INTO
ENGLISH FOR US SO THAT PATIENTS
CAN WRITE COMMENTS IN ANOTHER
LANGUAGE AND THEN WE'LL GET THEM
TRANSLATED BACK SO THAT'S
ALREADY KIND OF BUILT INTO THE
SYSTEM.
WE DON'T -- BECAUSE OF THE
DESIRE FOR THE PATIENT TO BE
ABLE TO DO IT TRULY ANONYMOUS WE
DON'T ACTUALLY OBSERVE THEM
DOING THE SURVEYS OR OFFER
TRANSLATION BECAUSE THEY GET IT
AFTER THEY HAVE LEFT THE
HOSPITAL ON THEIR DEVICE OR
E-MAIL.
>> RICK?
>> COLLEEN, I KNOW YOU SHOWED
SOME OF THE DATA BENCHMARKED
AGAINST 1700 OTHER PRESS GANEY
HOSPITALS.
AND OBVIOUSLY, BENCHMARKING IS
ALWAYS A CHALLENGE FOR THE
CLINICAL CENTER.
I WOULD ENCOURAGE YOU TO PAY
LESS ATTENTION TO THAT AND MORE
ATTENTION TO YOUR PROGRESS OVER
TIME, YEAR OVER YEAR, WHAT'S
HAPPENING TO YOUR PERCENT TOP
BOX SCORES.
IF YOU WERE LOOKING FOR A
BENCHMARK, ONE I'M FAMILIAR WITH
THAT I THINK WOULD BE A
REASONABLE COMPARATOR WOULD BE
ST. JUDE'S HOSPITAL FOR CHILDREN
WHICH IS A RESEARCH HOSPITAL
OBVIOUSLY FOCUSED ON CANCER IN
KIDS, BUT HAS MANY OF THE
PHENOTYPES THAT WOULD AT LEAST
BE REFERABLE TO THE CLINICAL
CENTER, NOT A PERFECT MATCH BUT
THEY DON'T CHARGE PATIENTS, IT'S
A RESEARCH FACILITY, 75 BEDS.
OUTPATIENT VISITS, YOU KNOW,
NUMBERING PROBABLY SMALLER THAN
YOURS BUT I WOULD CAUTION
AGAINST PUTTING TOO MUCH INTO
THE HOW DO WE DO COMPARATOR
BENCHMARK.
>> I APPRECIATE THAT.
AND RECOGNIZE THAT WE CAN DRILL
DOWN A LITTLE BIT TO DIFFERENT
SUBGROUPS IN PRESS GANEY BUT
STRUGGLE TO KNOW THE CORRECT CAR
-- COMPARATOR AND I AGREE THE
MOST VALUABLE DATA IS
IDENTIFYING TRENDS IN AREAS FOR
IMPROVEMENT INTERNALLY AND
LOOKING OVER TIME.
>> GREAT.
THANK YOU.
THANK YOU FOR THE PRESENTATION
TODAY.
WE LOOK FORWARD I'M SURE, THE
BOARD WILL LOOK FORWARD TO HOW
THINGS ARE GOING IN THE FUTURE.
WE'RE GOING TO GO INTO A BREAK.
I'LL TAKE THE CHAIR'S
PREROGATIVE AND HAVE US COME
BACK NOT AT 11:10 BUT 11:15 AND
I ASSURE YOU WE'LL FINISH BEFORE
1:00.
BUT WE'LL BE BACK AT 11:15.
>>I THINK WE'RE GOING TO GET
STARTED.
THIS IS DR. BARBARA JORDAN
TALKING ABOUT THE MAGNET
JOURNEY.
THANK YOU FOR HAVING ME PRESENT.
I'M PLEASED TO SHARE THE UPDATES
ON THE MAGNET
ACCREDITATION JOURNEY.
SOME PEOPLE MAY NOT BE FAMILIAR
SO I'LL GIVE A BRIEF OVERVIEW.
IT IS A DESIGNATION THROUGH THE
AMERICAN NURSES CREDENTIALING
CENTER, RECOGNIZES ORGANIZATIONS
THAT HAVE EXCEEDED ALL STANDARDS
THEY HAVE.
THERE'S WELL OVER 100 STANDARDS
IN THE MAGNET MANUAL.
IT FOCUSES ON CLINICAL
EXCELLENCE AND IN EXCELLENT WORK
ENVIRONMENT, IN WHICH EMPLOYEES
THRIVE AND DO WELL.
IT IS AN ORGANIZATIONAL
DESIGNATION.
THERE'S A FOCUS ON NURSING, AS
YOU KNOW HOSPITAL IS A TEAM, SO
NO ONE WORKS INDEPENDENTLY TO
ACHIEVE THE MISSION OF THE
ORGANIZATION.
IT IS AN ORGANIZATIONAL
DESIGNATION.
ONLY 9% OF HOSPITALS IN THE
UNITED STATES HOLD MAGNET
DESIGNATION.
IT ALSO HELPS ATTRACT HIGHLY
QUALIFIED CANDIDATES TO COME AND
WORK IN ORGANIZATIONS, HENCE THE
TERM MAGNET, TO DRAW PEOPLE IN,
TO COME AND WORK THERE.
SO, WE'RE ON THE JOURNEY.
THERE ARE KEY ORGANIZATIONAL
DRIVERS FOR MAGNET DESIGNATION.
PATIENT SAFETY, HIGH QUALITY
CLINICAL OUTCOMES, CULTURE OF
EXCELLENCE, AND HAVING AN
EMPOWERED AND HIGHLY SKILLED
WORKFORCE.
SO, THERE IS AN INTEGRATIVE
SYSTEMATIC LITERATURE REVIEW,
AND LOOKED AT ARTICLES
THROUGHOUT HEALTHCARE LITERATURE
ON OUTCOMES RELATED TO MAGNET
ACCREDITATION.
AND THESE ARE JUST SOME OF THEM.
PATIENT OUTCOMES, HOSPITALS THAT
HAVE MAGNET ACCREDITATION TEND
TO HAVE LOWER MORTALITY RATES,
PATIENT FALLS, LOWER NOSOCOMIAL
INFECTION RATES, LOWER
HOSPITAL-ACQUIRED PRESSURE
INJURIES, LOWER CENTRAL
LINE-ASSOCIATED BLOODSTREAM
INFECTIONS.
THERE'S ALSO A LOWER OVERALL
MISSED NURSING CARE, AND THAT'S
WHERE CARE WAS NOT COMPLETED,
DURING THE SHIFT OR DURING A
DAY.
THERE'S HIGHER SUPPORT FOR
EVIDENCE-BASED PRACTICE
IMPLEMENTATION.
THERE'S ALSO HIGHER NURSE
PERCEIVED QUALITY OF CARE,
HIGHER PATIENT SATISFACTION
RATINGS, AND WE HAD OUR
PRESENTATION FROM DR. HADIGAN
PREVIOUSLY REGARDING PATIENT
SATISFACTION.
I WANT TO ADD ONE OF THE OTHER
THINGS THAT WE'RE DOING AT THE
CLINICAL CENTER IS PARTNERS WITH
PRESS GANEY.
THEY HAVE A NURSING EXCELLENCE
SOLUTION CENTER THAT WE'RE ALSO
JUST BEGINNING TO PARTICIPATE
WITH, THAT WE CAN LINK THE
PATIENT SATISFACTION DATA WITH
OUR CLINICAL QUALITY OUTCOMES,
AS WELL AS ANNUALLY WE
ADMINISTER AN R.N. SATISFACTION
SURVEY FOR OUR DIRECT CARE
NURSES.
WE'RE GOING TO BE ABLE TO LINK
THIS DATA AND LOOK AT WHERE WE
HAVE OPPORTUNITIES FOR
IMPROVEMENT.
MAGNET ORGANIZATIONS HAVE A
REDUCED INCIDENCE OF WORKPLACE
ACCIDENT RATES.
THERE ARE FINANCIAL IMPACTS
RELATED TO MAGNET DESIGNATION
SUCH AS LOWER LENGTH OF STAY,
COST SAVINGS, AND WHILE WE'RE AN
ORGANIZATION THAT DOESN'T BILL
OUR PATIENTS WE STILL CARE VERY
MUCH ABOUT OUR FISCAL
ACCOUNTABILITY AND
RESPONSIBILITIES.
IT ALSO LENDS TO A POSITIVE
WORKPLACE ENVIRONMENT.
IT HAS A PREVENTIVE EFFECT ON
BULLYING AND OTHER HOSTILE
BEHAVIORS, LOWER R.N. TURNOVER
RATE, HIGHER R.N. JOB
SATISFACTION RATE, REDUCED
BURNOUT.
SO, FOR OUR MAGNET JOURNEY, IT
IS A JOURNEY.
SOMETIMES IT MIGHT SEEM LIKE
WE'RE NOT PROGRESSING, WE ARE.
SOME OF THE KEY MILESTONES THAT
WE'RE GOING TO LOOK FOR IN A
MAGNET JOURNEY IS WE'RE PLANNING
TO SUBMIT OUR APPLICATION TO THE
AMERICAN NURSES CREDENTIALING
CENTER NEXT JANUARY.
AND WE ARE CURRENTLY -- WE HAVE
A RELATIONSHIP WITH ANCC THAT
WE'RE PRE-INTENT ORGANIZATION
MEANING WE HAVE SIGNED AN
AGREEMENT WE'RE INTENDING TO
PURSUE MAGNET DESIGNATION, THAT
ACCORDS US CERTAIN RIGHTS WE CAN
USE THE LOGO ON A JOURNEY TO
MAGNET BUT ALSO THAT WE HAVE THE
SERVICES OF A CONSULTANT FROM
ANCC TO HELP, YOU KNOW, ANSWER
QUESTIONS THAT WE MAY HAVE
REGARDING THE DIFFERENT
STANDARDS.
SOME OF THESE, WE HAVE DATES
ASSOCIATED WITH THEM, BUT IT'S
ALSO CONCURRENT.
WE'RE WORKING RIGHT NOW ON
DEVELOPING THE MAGNET DOCUMENT.
THAT IS THE BIGGEST PIECE OF
WORK ASIDE FROM ASSESSING ALL OF
THE STANDARDS MAKING SURE THAT
WE'RE MEETING EVERYTHING WITH
THE STANDARDS, WHERE WE HAVE
GAPS DEVELOPING ACTION PLANS
THAT WE MEET THOSE GAPS, AND
CLOSE THE GAPS.
ALSO WE HAVE TO WRITE OUR STORY.
APPRAISERS THROUGH THE NURSES
CREDENTIALING CENTER DON'T KNOW
US SO WE HAVE TO TELL OUR STORY
IN A FASHION THAT THEY
UNDERSTAND.
SUPPORTED WITH A LOT OF DATA AND
WITH DOCUMENTS.
SO THAT REALLY TAKES A LOT OF
TIME.
WE PLAN TO SUBMIT OUR MAGNET
DOCUMENT TO ANCC IN APRIL OF
2024, AND THAT MAY TO SOME SEEM
LIKE IT'S SO FAR AWAY, TIME
PASSES QUICKLY.
SO THIS WILL PASS QUICKLY TOO.
THEY REVIEW AND SCORE AND SAY
YOU'RE READY TO MOVE ON THE NEXT
PHASE IS A SITE VISIT.
THERE'S ALSO THEN PERIOD OF
PUBLIC COMMENT, SO THAT WE HAVE
TO POST AND INVITE PEOPLE TO
COMMENT, ANYTHING THEY CARE TO
SAY ABOUT THE CLINICAL CENTER.
THE SITE, THE APPRAISERS COME ON
SITE.
PEOPLE CAN WRITE PRETTY
DOCUMENTS BUT THEY NEED TO MAKE
SURE IT'S REAL, THAT WHAT WE
WRITE IS HAPPENING IN THE
CLINICAL CENTER, WHICH IT WILL
BE.
WE AWAIT A DECISION FROM THE
MAGNET COMMISSION.
THAT'S THE TIMELINE.
SOME OF THE PROGRESS THAT WE'VE
MADE, ON THE RIGHT HERE IS A
BANNER.
RACHEL IS OUR MAGNET PROGRAM
MANAGER.
AND SHE WORKED WITH OUR
COMMUNICATIONS OFFICE ON
DEVELOPING BANNERS.
NOW THIS BANNER IS -- WE SEE
THEM THROUGHOUT THE CLINICAL
CENTER, SPOT THEM, AND ENCOURAGE
PEOPLE TO TAKE PICTURES WITH
THEM.
ONE OF THE THINGS WE'VE DONE IS
UPDATED OUR MISSION STATEMENT
FOR THE NURSING DEPARTMENT.
PREVIOUS MISSION STATEMENT WAS
FOCUSED ON DEVELOPING THE
SPECIALTY OF CLINICAL RESEARCH
NURSING AND CLINICAL RESEARCH
NURSE MODEL OF CARE WHICH HAS
BEEN ACCOMPLISHED.
SO WE UPDATED OUR MISSION
STATEMENT.
AND WE WORKED VERY CLOSELY WITH
NIH OFFICE OF STRATEGIC
PLANNING, AS WELL AS US HAVERING
NURSING STRATEGIC PLAN WHICH
I'LL SHARE IN A MOMENT.
NEW MISSION STATEMENTS, WE
IMPROVE HUMAN HEALTH BY
SUPPORTING CUTTING EDGE CLINICAL
RESEARCH AND PROVIDING
COMPASSIONATE CARE TO DIVERSE
POPULATION OF PATIENTS AND
FAMILIES.
AS YOU HEARD PREVIOUSLY TODAY,
WE HAVE A DIVERSE PATIENT
POPULATION.
ONE OF THE QUESTIONS IN THE
CHAT, I WAS ABLE TO SEE IT ON MY
LAPTOP, WAS REGARDING
DEMOGRAPHIC INFORMATION THAT WE
COLLECT UPON ADMISSION.
PATIENTS DO PROVIDE THEIR
PREFERENCES FOR GENDER AND
LANGUAGE AND ETHNICITY, SO THAT
INFORMATION IS COLLECTED ON
MISSION, SO I JUST WANTED TO
ANSWER THAT.
SO, WE'VE FOLLOWED A PATH FOR
THE DEVELOPMENT OF THE NURSING
DEPARTMENT'S STRATEGIC PLAN.
I WANT TO QUALIFY SOMETIMES
WE'RE AMBITIOUS WITH THE GOALS
THAT WE SET, BUT WE'VE ALWAYS
DEVELOPED ANNUAL GOALS THAT WE
CREATE AND DEFINE WITH
PARTICIPATION AND INPUT.
WE THEN HAVE A NURSING STRATEGIC
PLAN, OF COURSE WE FOLLOW THE
CLINICAL CENTER STRATEGIC PLAN,
NIH STRATEGIC PLAN, HAVE A
NURSING DEPARTMENT STRATEGIC
PLAN.
SO AS I MENTIONED EARLIER, WE
WORKED, PARTNERED WITH OFFICE OF
STRATEGIC PLANNING AND THEY ARE
PHENOMENAL.
IT'S REALLY HELPFUL TO WORK WITH
PEOPLE THAT ARE OUTSIDE OF THE
DEPARTMENT TO PROVIDE AN
OBJECTIVE LENS THAT ALSO THEY
HAVE SUCH WONDERFUL SKILLS TO
HELP WITH CRAFTING OUR DOCUMENT
AND HELPING US HONE IN ON WHAT
IT IS WE WANT TO ACHIEVE.
SO WE STARTED WORKING WITH THEM
A YEAR AGO, ON REDEFINING OUR
MISSION AND VISION.
AND THEN WE LOOKED AT THE MAGNET
MANUAL BECAUSE WE HAD DONE A GAP
ANALYSIS, REGARDING ONE OF THE
THINGS WE NEED TO ACHIEVE, WHAT
DO WE NEED TO KEEP WORKING ON
AND WHAT DO WE NEED TO WORK
TOWARDS BECAUSE, AGAIN, WE CAN'T
DO EVERYTHING AT ONCE.
WE SOLICITED FEEDBACK FROM KEY
STAKEHOLDERS THROUGHOUT THE
NURSING DEPARTMENT, FROM OUR
MAGNET AMBASSADORS THAT ARE MADE
UP OF NURSING DEPARTMENT,
INSTITUTE, OTHER DEPARTMENTAL
REPRESENTATIVES JUST TO MAKE
SURE WE WEREN'T MISSING
ANYTHING.
AND THEN WE ALIGNED INITIATIVES
OVER THREE-YEAR PLAN.
SO WE CURRENTLY HAVE THE HIGH
LEVEL VERSION OF THE PLAN WHICH
I'LL SHARE NEXT.
AND THEN WE'RE COMPLETING THE
DETAILED PLAN THAT WE'LL BE
PUBLISHING.
BUT WE'VE ALREADY STARTED
COMMUNICATING THE STRATEGIC PLAN
OUT TO THE NURSING DEPARTMENT
AND SHARING WITH ALL OF YOU.
SO, IN OUR STRATEGIC PLAN WE USE
THE FOUR COMPONENTS OF THE
MAGNET MODEL JUST AS CHAPTERS OF
OUR PLAN, IF YOU WILL.
AND SO THE FIRST IS
TRANSFORMATIONAL LEADERSHIP.
THERE ARE MANY THINGS THAT FALL
UNDER HERE.
AND UNDER THE -- THESE ARE GOALS
UNDER EACH OF THESE COMPONENTS,
AND IN EACH WE HAVE FURTHER WORK
DEFINED, BUT WE DON'T HAVE -- IT
TOOK ME AN HOUR TO PRESENT THE
WHOLE PLAN.
AND I DON'T HAVE THAT TIME HERE.
BUT WE DO HAVE INITIATIVES UNDER
EACH OF THESE.
WE NEED TO PROVIDE LEARNING
EXPERIENTIAL OPPORTUNITIES FOR
LEADERSHIP DEVELOPMENT.
I MET WITH A DIRECT CARE NURSE
YESTERDAY INQUIRING ABOUT THIS
VERY THING, HE WAS PLEASED TO
HEAR THIS IS IN OUR STRATEGIC
PLAN.
WE HAVE TO PROVIDE LEARNING AND
DEVELOPMENTAL OPPORTUNITIES AT
ALL LEVELS OF THE DEPARTMENT.
IT'S ONE THING TO HAVE SOMETHING
WRITTEN ON PAPER, BUT YOU HAVE
TO LIVE IT.
WE HAVE TO DO THAT.
WE'RE EMBEDDING PRINCIPLES OF
DIVERSITY, EQUITY, AND INCLUSION
IN OUR NURSING PRACTICE AND IN
THE WORK ENVIRONMENT.
DR. GILMAN SHARED EARLIER THAT
WE HAVE THE HONOR OF WORKING ON
THE DEVELOPING OF A POLICY AND
PRACTICE GUIDELINE FOR INTERVIEW
SELECTION, HIRING, PROMOTION
PROCESSES.
VERY IMPORTANT.
WE'RE A LARGE DEPARTMENT.
AND SELECTING OFFICIALS AS WE'RE
CALLED IN HIRING, EVERYONE MAY
HAVE A LITTLE BIT DIFFERENT
PRACTICE.
WE HAVE TO MAKE SURE WE'RE
TRANSPARENT AND THAT WE'RE
EQUITABLE IN OUR HIRING AND
PROMOTING PRACTICES.
AND SO ONE OF OUR SERVICE CHIEFS
IN THE NURSING DEPARTMENT IS
LEADING THIS WORK ALONG WITH OUR
NURSING DEPARTMENT, DIVERSITY,
EQUITY, AND INCLUSION COUNCIL,
WE'RE PLEASED TO HAVE THIS
OPPORTUNITY.
WE ALSO HAVE TO PROVIDE FORUMS
FOR NURSING DEPARTMENT MEMBERS
TO SHARE IDEAS, AND WE DO THAT,
WE HAVE A ROBUST SHARED
GOVERNANCE STRUCTURE IN THE
DEPARTMENT.
WE HAVE TO OBTAIN MANAGEMENT
RESOURCES USING FISCALLY
RESPONSIBLE PRACTICES AND TO
ACHIEVE MAGNET DESIGNATION.
STRUCTURAL EMPOWERMENT IS TO
HAVE THOSE PROCESSES AND
PRACTICES IN PLACE IN ORDER TO
BE SUCCESSFUL.
WE SUPPORT OUR NURSING
DEPARTMENT MEMBERS AND THEIR
INDIVIDUAL PROFESSIONAL GROWTH
AND DEVELOPMENT.
WE HAVE THE COMPREHENSIVE
TRANSITION TO PRACTICE PROGRAM,
FOR NURSES MOVING INTO NEW
ROLES.
WE HAVE AN ACCREDITED WITH
DISTINCTION TRANSITION PRACTICE
PROGRAM FOR GRADUATE NURSES IN
OUR NURSE RESIDENCY PROGRAM AND
HAVE TO LOOK FOR NURSES MOVING
INTO OTHER ROLES IN THE
ORGANIZATION AS WELL.
I'LL NOT GO THROUGH ALL OF THESE
BUT WE ALSO WANT TO INCREASE
AWARENESS OF OUR RECOGNITION
PROGRAMS, AND ENCOURAGE
CONSISTENT UTILIZATION OF THOSE.
FIRST THING THIS MORNING AT 7:00
I WAS IN THE O.R. AS ONE OF OUR
O.R. NURSES WAS RECEIVING HOUSE
OF HOPE AWARD.
THAT'S A NURSING DEPARTMENT
AWARD AT THE UNIT LEVEL.
WHERE PEERS OR COLLEAGUES,
PHYSICIANS, PATIENTS, CAN
RECOGNIZE MEMBERS OF THE NURSING
DEPARTMENT FOR THEIR EXCELLENCE
AND IT'S SELECTED BY A COMMITTEE
OF PEERS TO RECOGNIZE.
AND THIS MIKEY ANDRES WAS THE
NURSE IN THE O.R. RECOGNIZED,
SHREWDLY -- ABSOLUTELY
WONDERFUL, WITH US TWO YEARS, IT
MAKES YOUR DAY WHEN YOU
RECOGNIZE PEOPLE FOR EXCELLENCE.
I ALREADY MENTIONED THE
STANDARDIZATION OF THE INTERVIEW
SELECTION PROCESS.
NEXT SELECTIONs IS EXEMPLARY
PROFESSIONAL PRACTICE THAT WE
PROMOTE THAT NURSES ARE
PARTICIPATING IN
INTERDISCIPLINARY TEAMS.
WE'RE TEAM FOCUSED.
AND A WORK THAT FEEDS INTO OUR
PRESS GANEY SCORES IS REGARDING
DISCHARGE PLANNING.
WE HAVE GREAT OPPORTUNITIES
THERE SINCE WE ARE DIFFERENT, WE
HAVE DIFFERENT RESOURCES OR
MIGHT NOT HAVE RESOURCES.
WE'RE LOOKING AT DURABLE MEDICAL
EQUIPMENT WHEN PATIENTS
DISCHARGE SO WE HAVE AN
INTERDISCIPLINARY GROUP BEING
LED BY JASMINE, ONE OF OUR
SUPERVISORY SOCIAL WORKERS, AND
HELEN MAYBERRY, NURSING PROGRAM
DIRECTOR FOR SAFETY AND QUALITY
LEADING A MULTI-DISCIPLINARY
GROUP ON DISCHARGE PLANNING AND
STANDARDIZING PROCESSES A CROSS
THE CLINICAL CENTER.
WE'RE FOCUSED ON WELL-BEING OF
THE STAFF.
FINALLY, NEW KNOWLEDGE
INNOVATION AND IMPROVEMENTS THAT
WE SUPPORT INNOVATIONS,
RESEARCH, PARTNER WITH DR.
WALLEN AND HER RESEARCH BRANCH,
AND WE ALSO IMPLEMENTED A
NURSING EVIDENCE-BASED PRACTICE
AND RESEARCH INNOVATIONS COUNCIL
THIS YEAR, AND THIS IS LED BY A
DIRECT CARE NURSE.
WE'RE VERY MUCH LOOKING FORWARD
TO THE WORK THIS COUNCIL IS
GOING TO BRING TO THE
DEPARTMENT.
WE UTILIZE TECHNOLOGY TO IMPROVE
WORK PRACTICES AND CLINICAL
CARE, EVERYTHING IS TECHNOLOGY
RELATED.
AND THEN WE PROVIDE AN
ENVIRONMENT WHERE
INQUISITIVENESS CAN FLOURISH.
WE'VE ALSO ALIGNED THE WORK
AROUND OUR MAGNET JOURNEY.
WE'VE CREATED CLINICAL CENTER
MAGNET STEERING COMMITTEE, IT'S
A MULTI-DISCIPLINARY COMMITTEE,
AND THE COMMITTEE MET ON JULY 6
FOR THE INAUGURAL MEETING.
AND IT WAS REALLY EXCELLENT.
THE PURPOSE OF THE STEERING
COMMITTEE IS TO PROVIDE
OVERSIGHT TO THE JOURNEY, AND TO
HOLD US ACCOUNTABLE FOR THE WORK
THAT WE'RE DOING BUT ALSO TO
MAKE SURE THAT WE'RE BEING
INCLUSIVE OF CLINICAL CENTER AND
OUR INSTITUTE PARTNERS.
IT'S ALSO -- WE WILL REPORT TO
THEM ON THE WORK THAT WE'RE
DOING, SO THAT WAS VERY -- IT
WAS A GREAT FIRST MEETING.
WE HAVE SUBGROUPS REPORTING TO
THE MAGNET STEERING COMMITTEE.
ONE IS MAGNET DOCUMENT TEAM.
THIS IS A GROUP OF PEOPLE WHO
ARE GOING TO BE -- OR WHO ARE
RESPONSIBLE FOR COLLECTING
NARRATIVES AND THE DATA TO TELL
OUR STORY.
WE HAVE OUR MAGNET AMBASSADOR
GROUP.
I MENTIONED THEM PREVIOUSLY.
IT'S A GREAT GROUP OF PEOPLE
FROM ACROSS THE CLINICAL CENTER
WHO ARE LEARNING ABOUT MAGNET,
ALSO THE ONES GOING OUT AND
SPREADING THE MESSAGE, BUT ALSO
BRINGING THE STORIES BACK.
WE HAVE MAGNET COMMUNICATIONS
BECAUSEES WE DO HAVE TO SHARE
THE INFORMATION.
WE PARTNER VERY CLOSELY WITH OUR
OFFICE OF COMMUNICATIONS AND
MEDIA RELATIONS IN THE CLINICAL
CENTER.
AND ON THE MAGNET AMBASSADOR
TEAM, STEERING COMMITTEE,
EXCELLENT PARTNERS.
WE ALSO ACQUIRED SERVICES OF
INDEPENDENT MAGNET CONSULTANT,
SHE'S BEEN INVALUABLE IN
PROVIDING GUIDANCE BECAUSE,
AGAIN, WE DON'T KNOW IT ALL.
WE DON'T PROFESS TO.
WE CAN CERTAINLY USE THE
ASSISTANCE AND GUIDANCE.
WE HELD SESSIONS WITH NURSE
LEADERS THIS PAST SPRING TO
BEGIN IDENTIFYING POTENTIAL
NARRATIVES THAT WE CAN USE FOR
OUR DOCUMENT SUBMISSION.
OUR QUALITY AND SAFETY DATA
TRACKING IS ONGOING, AND, AGAIN,
WE PARTNER WITH DR. DAVID LANG
AND THE OFFICE OF PATIENT SAFETY
AND CLINICAL QUALITY AS WELL AS
NURSING DEPARTMENT, PATIENT
SAFETY AND QUALITY OFFICE ON OUR
DATA.
BECAUSE THAT REALLY TELLS OUR
STORY.
PATIENT SATISFACTION DATA IS
PART OF THE REQUIREMENTS.
I'M PLEASED TO SAY THAT WE'RE
EXCEEDING THE TARGETS NEEDED TO
MEET MAGNET DESIGNATION SO WE
HAVE TO KEEP THAT GOING.
IT HAS TO BE CONTINUOUS.
AND THEN WE'VE -- RACHEL IS
COMPLETING AN OVERALL TIMELINE
FOR THE MAGNET DOCUMENT
COMPLETION SO WE STAY ON TRACK
BECAUSE TIME FLIES QUICKLY.
WE'VE ALSO BEGUN SOME CLINICAL
CENTER ENGAGEMENT.
WE HAVE A MAGNET INFORMATION
BOOTH AT THE NIH COMMUNITY
MARKET, SO RACHEL TAKES THE
BANNERS OUTSIDE AND HAS A TABLE
AND HAVE STARTED DOING THAT IN
THE NORTH LOBBY AND HAVE HAD
GREAT ENGAGEMENT WHEN WE'VE DONE
THAT.
PATIENTS WILL COME UP AND IT'S
LIKE, I'VE BEEN IN MAGNET
HOSPITALS, I'M SURPRISED YOU'RE
NOT MAGNET.
WELL, WE THINK WE ARE BUT NOW
WE'RE GOING TO GET THE
DESIGNATION BECAUSE WE DO A LOT
OF THINGS WELL AND WE'RE ABLE TO
ENGAGE WITH EVERYBODY THAT COMES
THROUGH IN THE NORTH ATRIUM,
WHERE WE HAVE A COFFEE SHOP
THERE.
CONCERTS ARE PLAYED THERE.
IT'S VERY BUSY AND VIBRANT
PLACE, A GREAT PLACE TO HAVE A
PRESENCE.
OUR MAGNET PROGRAM MANAGER,
RACHEL, PROVIDES UPDATES, GOES
TO CLINICAL CENTER DEPARTMENTS
AND INSTITUTE PARTNERS TO KEEP
THEM INFORMED AND ENGAGED AND
SOLICIT FEEDBACK.
AND AGAIN MAGNET AMBASSADORS ARE
A KEY COMPONENT OF CLINICAL
CENTER ENGAGEMENT.
AND THAT CONCLUDES MY
PRESENTATION.
THANK YOU.
>> THANK YOU, BARBARA.
LET ME OPEN UP FOR ANY QUESTIONS
OR COMMENTS.
DAVID?
>> TERRIFIC PRESENTATION.
CERTAINLY SUPPORT THE NIH
CLINICAL CENTER OBTAINING MAGNET
STATUS.
THAT'S WONDERFUL.
A QUESTION I HAD, IS IT A MATTER
OF REPACKAGING AND DOCUMENTING
THINGS THAT EXIST ALREADY OR IS
THERE SOME INVESTMENTS THAT ARE
REQUIRED GOING FORWARD,
STRUCTURAL CHANGES, IF YOU COULD
ELABORATE WHAT THEY MIGHT BE AND
MAGNITUDE OF INVESTMENT.
>> GREAT QUESTION.
SOME THINGS WE ALREADY HAVE IN
PLACE.
NURSING DEPARTMENTS SHARE
GOVERNANCE STRUCTURE, IT'S BEEN
IN PLACE FOR YEARS.
IT'S REALLY STRONG.
THAT'S GREAT.
WE CAN GET A LOT OF -- WE HAVE A
LOT OF EVIDENCE TO SHOW FOR
THAT.
ONE THING THAT WE DID NOT HAVE
IN PLACE IS A PEER REVIEW
PROCESS.
AND THIS IS SOMETHING THAT'S
EXPECTED, PROFESSIONALS PROVIDE
PEER REVIEW.
SO WE IMPLEMENTED THAT TWO YEARS
AGO IN THE NURSING DEPARTMENT
FOR ALL OF NURSING, DIRECT CARE
NURSES, NURSE LEADERS, SO
IMPLEMENTING.
THERE'S THINGS LIKE THAT.
ANOTHER AREA IS WE DON'T HAVE A
FORMAL MENTORSHIP PROGRAM.
WE HAVE TO LOOK AT HOW WE'RE
GOING TO MEET STANDARDS AROUND
MENTORSHIP.
IT'S BOTH IDENTIFYING WHAT WE
ALREADY DO WELL AND CAN SHOW
EVIDENCE OF, AND WHAT ARE THINGS
THAT WE HAVE GAPS.
THOSE ARE JUST A COUPLE GAPS
WE'VE IDENTIFIED, AND THEN
LOOKED TO SEE IF WE NEED
RESOURCE, SOMETHING WE HAVE TO
PLAN WITHIN OUR BUDGET, SOME
THINGS WE CAN DO OURSELVES, BUT
OTHERS WE NEED TO ACQUIRE THE
SERVICES OR PARTNER WITH OTHERS
TO SEE THAT IT'S DONE.
SO IT'S BOTH.
THANK YOU.
>> REGINA AND THEN BACK TO DAVID
BAUM.
>> THANK YOU.
WONDERFUL PRESENTATION.
A VERY THOROUGH OUTLINING OF
WHAT NEEDS TO HAPPEN.
I ACTUALLY WAS SURPRISED AS WELL
WHEN I HEARD THAT YOU WERE NOT
MAGNET YET.
BUT VERY NICE.
I HAVE A COUPLE QUESTIONS.
THE FIRST ONE IS WITH REGARD TO
THE STRATEGIC PLANNING WHICH IS
SUCH A CRITICAL ASPECT OF THIS.
WHAT WAS THE LEVEL OF
INVOLVEMENT OF STAFF NURSES IN
THE DEVELOPMENT OF THE STRATEGIC
PLAN.
YOU MENTION THE MAGNET CHAMPIONS
BUT I WAS WONDERING IF THEY WERE
INVOLVED IN THE DEVELOPMENT, IF
NOT, IN THE VETTING PROCESS.
LIKE HOW IS THEIR VOICE BEING
HEARD WITHIN THAT CONTEXT?
>> SO, IT WAS BOTH.
SO, WE HAD SEVERAL DIRECT CARE
NURSES ON THE WORK GROUP
DEVELOPING THIS STRATEGIC PLAN.
THEN ONCE WE HAD A DRAFT FORM,
WE SENT IT OUT TO THE MAGNET
AMBASSADORS TO OUR SHARE
GOVERNANCE SHARES, TO THE REST
OF NURSING LEADERSHIP AND
INVITED FEEDBACK.
AND THEN SINCE -- IN MAY I
PRESENTED IT AT OUR NURSE
PRACTICE COUNCIL WHICH IS DIRECT
CARE NURSE LED, PART OF OUR
SHARED GOVERNANCE, AND INVITED
FEEDBACK AND MADE SOME TWEAKS
BASED ON FEEDBACK THAT I'VE
RECEIVED.
THAT WE'VE RECEIVED.
SO WE TRIED TO GET -- IT'S HARD
TO GET EVERYBODY'S INPUT.
>> YES.
>> WE TRY.
AGAIN, I'M THE FIRST TO SAY I'M
NOT PROVIDING DIRECT CARE TO THE
PATIENTS.
I'M NOT THE ONE TO SPEAK TO THE
PRACTICE AT THE BEDSIDE.
IT HAS TO BE THE PEOPLE
PERFORMING THAT WORK AND THAT
SERVICE.
SO THANK YOU.
>> IT'S GREAT.
I MEAN, I'M GLAD TO HEAR THAT
BECAUSE I FEEL LIKE THAT'S
SOMETHING MAGNET WILL WANT TO
KNOW AND THEY WILL FOCUS ON WHEN
THEY COME FOR THE SITE VISIT FOR
SURE BECAUSE THEY KNOW THAT, YOU
KNOW, THEY WANT TO REALLY TALK
WITH STAFF.
THE OTHER BRIEF COMMENT I WANTED
TO MAKE, I THINK IT'S
COMMENDABLE YOU SET UP THE
MULTI-DISCIPLINARY STEERING
COMMITTEE BECAUSE, AGAIN, THE
SAME WAY THEY WANT TO TALK WITH
STAFF NURSES, THEY ALSO WANT TO
TALK WITH THE OTHER DISCIPLINES,
WANT TO MEET WITH PHYSICIANS AND
HEAR ABOUT THE ROLE AND WORK OF
NURSES WITHIN THE ORGANIZATION.
STRUCTURING IT THAT WAY WAS
ACTUALLY -- IT'S A GREAT SORT OF
PATHWAY, A RUNWAY TO WHEN YOU'RE
ACTUALLY PREPARING FOR THE SITE
VISIT.
SO JUST REALLY NICE WORK.
THANK YOU.
>> THANK YOU VERY MUCH.
I PREVIOUSLY -- I HAD THE
PRIVILEGE TO WORK AT A HOSPITAL
ON THE MAGNET JOURNEY IN
PITTSBURGH, AND THAT WAS WHAT I
THOUGHT WAS ONE OF THE GREATEST
SUCCESSES, WAS THE INVOLVEMENT
OF ALL OF THE DIFFERENT
DEPARTMENTS WITHIN THE HOSPITAL,
AND WHEN WE RECEIVED WORD THAT
WE ACHIEVED DESIGNATION, WE HAD
A ROOM ABOUT THE SIZE I'M
STANDING IN NOW FILLED WITH
PEOPLE FROM ALL THE DEPARTMENTS
AND EVERYONE CHEERED.
EVERYONE GOT A PIN.
AND THEY REALLY -- REALLY, IT IS
A TEAM EFFORT.
WE DON'T WORK IN ISOLATION.
SO THANK YOU FOR YOUR COMMENTS.
>> DAVID.
>> JUST A COUPLE QUICK
QUESTIONS.
DR. JORDAN, THANK YOU VERY MUCH
FOR YOUR PRESENTATION.
WHAT CAN THE PATIENT FAMILY
ADVISORY COUNCIL MEMBERS DO, IN
TERMS OF PROVIDING CONSTRUCTIVE
COMMENTS DURING THE PUBLIC
PERIOD?
ARE THEY EVEN ALLOWED TO?
>> OH, YES.
YES, IT'S FOR EVERYBODY.
AND -- BUT WHAT THE PATIENT
ADVISORY GROUP CAN DO BEFORE WE
GET THERE IS WE CAN HEAR YOUR
STORIES AND YOUR EXPERIENCES,
AND WE MAY INCLUDE -- WE COULD
POSSIBLY INCLUDE THOSE IN OUR
DOCUMENT SUBMISSION.
SO, IT'S PROBABLY SOMETHING TO
LOOK AT, AT A FUTURE MEETING
AGENDA, IF YOU WILL, TO TALK
ABOUT MAGNET BECAUSE IT'S REALLY
IMPORTANT BECAUSE WE DO THIS --
I'M CONFIDENT WE'LL ACHIEVE
DESIGNATION, BUT BY ACHIEVING
DESIGNATION IT'S NOT JUST TO GET
THE PIN, IF YOU WILL.
BUT IT'S THAT WE'VE MET VERY
STRINGENT CRITERIA OF
EXCELLENCE, THAT REALLY BENEFITS
THE PATIENTS.
AND THE PATIENTS, YOU ARE ALL
OUR PARTNERS.
SO WE HAVE TO HEAR FROM YOU.
SO I THINK THERE'S A PUBLIC
COMMENT PERIOD BUT BEFORE THEN,
BEFORE WE HAVE OUR DOCUMENTS
WRITTEN.
>> SECONDLY, I UNDERSTAND THE
MAGNET ACCREDITATION AND ITS
RELATIONSHIP TO NURSES THAT ARE
INVOLVED IN DELIVERING PATIENT
CARE.
NIH HAS A LOT OF NURSES IN OTHER
ROLES.
DOES THE MAGNET PROGRAM HAVE ANY
EFFECT OR DOES THE USE OF NURSES
IN OTHER ROLES HAVE AN EFFECT ON
OUR APPLICATION?
>> ABSOLUTELY.
SO, ALL OF THE NURSES THAT WORK
IN THE CLINICAL CENTER ARE --
THEY GO THROUGH A PRIVILEGING
PROCESS, AND SO THEY ARE
PRIVILEGED TO WORK IN THE
CLINICAL CENTER THROUGH THE
OFFICE OF THE CHIEF NURSE BUT WE
WORK CLOSELY WITH NURSES IN
OTHER DEPARTMENTS WITHIN THE
CLINICAL CENTER, BUT ALSO WITH
OUR INSTITUTE RESEARCH NURSES.
THEY COME TO OUR NURSE PRACTICE
COUNCIL MEETING.
THEY ARE ACTIVE PARTICIPANTS.
AND, AGAIN, THIS IS AN
ORGANIZATIONAL DESIGNATION.
THERE'S A FOCUS ON NURSING, IT
IS FOR THE ORGANIZATION.
BUT ABSOLUTELY, I THINK EVERYONE
WILL BE PROUD ONCE WE ACHIEVE
THIS DESIGNATION.
>> FINALLY, THE BEAUTIFUL CHART
THAT YOU SHOWED, THE TIMELINE OF
WHAT'S GOING ON, AND FURTHER TO
DR. CHEN'S QUESTION ABOUT WERE
WE MAKING CHANGES OR MERELY
DOCUMENTING EXISTING PROCESSES,
WHAT ARE ARE THE ONGOING
COMMITMENTS ONCE THE MAGNET
CERTIFICATION IS ACHIEVED IN
TERMS OF ONGOING RENEWALS AND
OTHER RESOURCE-ORIENTED.
>> I SEE SMILES FROM PEOPLE WHO
HAVE MAGNET EXPERIENCE.
IT GETS ACTUALLY A LITTLE
HARDER, ONCE YOU ACHIEVE, AND
"LITTLE" IS NOT THE CORRECT
DESCRIPTION.
YOU HAVE TO ACHIEVE IT, BUT YOU
HAVE TO MAINTAIN IT.
IT'S SUSTAINABILITY, SOMETHING
WE HAVE TO LOOK IN PRACTICE,
CHANGES WE MAKE.
IT'S NOT ONE AND DONE.
YOU HAVE TO SUSTAIN EFFORTS.
AND MAGNET, THEY KEEP RAISING
THE BAR.
THE STANDARDS GET HIGHER.
SO FROM THE PREVIOUS MANUAL,
WHEN WE LOOKED AT NURSE
SATISFACTION DATA, WE WERE
GREAT, SOLID.
ON THE 2023, WE HAVE SOME
OPPORTUNITY FOR IMPROVEMENT.
SO, IT'S A CONSTANT LOOKING AT
WHAT YOU DO, AND MAKING IT
BETTER.
SO GREAT, GREAT QUESTION AND
COMMENT.
THANK YOU.
>> JULIE?
>> YEAH, IT'S MORE DIFFICULT
ACTUALLY NOW AS WE -- I'M SURE
YOU'RE SEEING SUCH STAFFING
PROBLEMS ACROSS THE COUNTRY,
USING SO -- SEEING SO MANY
TRAVELERS.
YESTERDAY I HAD A PRESENTATION
OF OUR NURSING, 66% ARE FIVE
YEARS OR LESS WITH EXPERIENCE
BECAUSE SO MANY MORE SENIOR
NURSES HAVE LEFT.
AND ABOUT 2/3 ALSO REPORTED
EITHER SOME SORT OF TRAUMA OR
ATTACK BY PATIENTS.
THESE ARE VERBALLY OR
PHYSICALLY, OVER THE LAST YEAR
AS WELL.
I DID NOTE IN YOUR PRESENTATION
THAT MAGNET SAYS THAT ACTUALLY
HELPS DIMINISH THAT IN THE
HOSPITAL.
I GUESS MY QUESTION TO YOU, I'VE
BEEN MAGNET, I'VE LOST MAGNET,
I'VE NOT BEEN MAGNET, SO I'VE
BEEN ALL OF THAT A BIT.
WHAT SPECIFICALLY IS THAT?
IS IT MORE STAFFING THAT ALLOWS
THAT TO NOT HAPPEN TO NURSES
BECAUSE MAGNET REQUIRES A
CERTAIN STAFFING RATIO?
IS IT EDUCATION?
IS IT EXPERIENCE THAT DECREASES
THAT ABUSE OF NURSE AT THE
BEDSIDE, WHICH IS JUST SO
CONCERNING TO ALL OF US.
>> SO, I WOULD HAVE TO GO BACK
AND LOOK AT THE LITERATURE FOR
STATISTICS, BUT I REALLY THINK
IT'S THE CULTURE BUT IT'S THE
ORGANIZATIONAL COMMITMENT TO
SAFETY.
AND PROVIDING A SAFE
ENVIRONMENT.
WE'RE VERY FORTUNATE AT THE
CLINICAL CENTER, I THINK DAVID
MADE THE COMMENT EARLIER
REGARDING -- DAVID BAUM,
REGARDING WHEN PATIENTS COME,
YOU KNOW, BEING GREETED BY THE
GUARDS AND DOGS AND THINGS LIKE
THAT.
SO WE DO -- WE DON'T HAVE AN
EMERGENCY DEPARTMENT.
SO-- BUT WE STILL DO HAVE PEOPLE
THAT HAVE CLINICAL CONDITIONS,
THAT CAN LEAD TO IMPULSIVE
BEHAVIOR, FRUSTRATION, BEHAVIOR
ISSUES.
WE HAVE THINGS IN PLACE.
A COUPLE YEARS AGO IMPLEMENTED
CODE BERT, BEHAVIORAL EMERGENCY
RESPONSE TEAM STAFFED BY
BEHAVIORAL HEALTH, NEURO, AND
IMH CLINICIANS.
WHILE WE DON'T HAVE A LOT OF
THESE EMERGENCIES, IT'S USUALLY
BROUGHT ON BY A CLINICAL
CONDITION ONSET.
STILL HAVING THAT RESOURCE
AVAILABLE, THAT WAS A GASP --
GAP IN THE DEPARTMENT.
AND THE COMPANY TONI JONES, OUR
CHIEF RESPECT OFFICER, I SEE A
TITLE CHANGE PERHAPS COMING, BUT
SHE ALSO LEADING THE
ANTI-HARASSMENT, THE NIH HAS
DONE A LOT OF WORK EDUCATING
STAFF ON PROPER BEHAVIOR, AND
WHEN THERE'S IMPROPER BEHAVIOR
IT'S ADDRESSED.
SO SETTING THE TONE AND CULTURE.
BUT WE ARE DIFFERENT FROM WHAT
HOSPITALS ARE SEEING IN THE
COMMUNITY WITH REGARDS TO
ESCALATING VIOLENCE AND WE JUST
SEE REPORTS EVERY DAY WHICH IS
SO, SO SAD.
BUT ALSO IF WE DO HAVE A PATIENT
OR FAMILY MEMBER WHO IS
POTENTIALLY ABUSING A STAFF
MEMBER, IT'S ADDRESSED RIGHT
AWAY, AGAIN WITH THE HELP OF
TONI JONES, WITH THE TEAM,
WHOEVER NEEDS TO BE INVOLVED TO
HELP DEESCALATE THE SITUATION
AND HAVE A RESPECTFUL PRACTICE
ENVIRONMENT, VERY IMPORTANT.
>> BARBARA, THANK YOU SO MUCH.
>> THANK YOU.
>> I SEE RUTH WILLIAMS-BRINKLEY
JOINED US.
WELCOME.
YOUR EARS WERE BURNING.
I DO WANT TO --
>> HI.
>> AND I KNOW THAT JIM IS GOING
TO MAKE A FEW COMMENTS AND THANK
YOU ON BEHALF OF THE NIH.
BUT RUTH AND RICK AND I REMEMBER
THAT THE VERY FIRST YEAR THIS
BOARD EXISTED WE TALKED ABOUT
MAGNET.
SO JEANETTE IVES ERICKSON, ONE
OF OUR ADDITIONAL FOUNDING
MEMBERS, AND WHO WAS THE CNO
EMERITA AT MGA HAS BEEN ON THE
MAGNET COMMISSION FOREVER IS
SMILING NOW.
WHEN IT GOT RAISED, IT WAS CLEAR
THERE WERE THINGS MISSING.
THERE WERE SOME THINGS THAT
WOULD HAVE TO BE THOUGHT ABOUT
DIFFERENTLY.
THERE HASN'T BEEN TIME AND
EFFORT PUT INTO THAT SO IT'S
THRILLING TO SEE PROGRESS.
DAVID BAUM, YOU'RE GOING TO HEAR
MORE ABOUT HOW STRINGENT THIS IS
GOING FORWARD TO KEEP IT.
THIS IS GOING TO BE WONDERFUL.
SO CONGRATS TO YOU AND THE WHOLE
TEAM BECAUSE IT IS, AS YOU SAID,
NOT ABOUT NURSE, THIS IS ABOUT
EVERYONE.
OKAY, JIM, BACK TO YOU.
>> CARLY'S GOT IT.
THANK YOU, CARLY.
SO, FOR RICK AND FOR LAURA, AND
FOR RUTH, THIS IS KIND OF A
RECAP OF WHAT WE'VE DONE
TOGETHER.
FOR NEW AND NEWER MEMBERS OF THE
BOARD, IT'S A BIT OF A HISTORY
LESSON ABOUT HOW WE GOT TO WHERE
WE ARE.
AND I THINK THAT IT'S -- IT WILL
BE USEFUL, IT WILL BE MAYBE
ENJOYABLE FOR THE GROUP THAT'S
ROTATING OFF THE BOARD.
I THINK IT WILL VERY USEFUL FOR
THE NEW GROUP.
AND SO WITH THAT, WITHOUT
FURTHER ADO, AND I'M REALLY GLAD
THAT RUTH WAS ABLE TO JOIN US AT
LEAST FOR A PORTION OF THE
MEETING.
SO, THIS IS A LITTLE BIT OF A
RECAP OF WHAT LARRY ALREADY
TALKED ABOUT.
FDA INSPECTS THE PHARMACY, 2016
THE REPORT, I ARRIVED IN JANUARY
OF 2017.
FOR THE FIRST COUPLE YEARS,
EFFORTS WERE FOCUSED ON RESPONSE
TO READ TEAM REPORT.
WE FOCUSED ON THE RESPONSE BUT
ALMOST NEVER MENTIONED THE RED
TEAM REPORT.
AND THAT WAS BECAUSE FOR THE
STAFF IN CLINICAL CENTER READ
TEAM REPORT WAS A VERY DIFFICULT
THING TO THINK ABOUT AND DEAL
WITH AND TALK ABOUT.
THE QUICKEST WAY TO TAKE ALL THE
AIR OUT OF THE ROOM WAS TO
MENTION THE RED TEAM REPORT.
SO WE BASICALLY WENT TO WORK ON
THE THINGS WE ALL AGREED NEED TO
BE TAKEN CARE OF.
THAT'S WHAT WE DID FOR THE FIRST
TWO YEARS.
KIND OF STARTED WRITING A
STRATEGIC PLAN, ALMOST IN THE
FIRST YEAR, AND THEN I FIGURED
OUT I REALLY DIDN'T KNOW ENOUGH
ABOUT THE NIH YET TO DO THAT.
AND SO WE CAME BACK A YEAR LATER
AFTER I HAD BEEN HERE ABOUT 16,
18 MONTHS, AND HAD A CHIEF
OPERATING OFFICER SO I COULD
ACTUALLY FOCUS ON DOING THIS
STRATEGIC PLAN.
NUMBER TWO, I KNEW MORE ABOUT
THE NIH AND I THOUGHT MAYBE WE
COULD ACTUALLY CONSTRUCT THE
PLAN.
THEN WE'VE BEEN WORKING OUT THIS
PLAN FOR THE LAST THREE YEARS.
SO, TODAY WE SORT OF LOOK BACK
AND DECIDE ABOUT HOW WE'RE
DOING.
SO, THIS IS OUR CORPORATE
RHETORIC.
WE PROVIDE HOPE THROUGH
PIONEERING CLINICAL RESEARCH TO
IMPROVE HUMAN HEALTH.
MAYBE SEVEN IS A LOT.
WE GET GUIDED A LOT.
AND MAYBE THAT'S OKAY.
I UNDERLINED THE "AND" BECAUSE I
BELIEVE THE PATIENT SAFETY AND
HIGH RELIABILITY FOCUS IS REALLY
ALL ABOUT PREVENTING AS MANY
PROBLEMS.
THE NIH HAS NO SHORTAGE OF
PROBLEM SOLVERS.
AND THEY HAVE REALLY GREAT
PROBLEM PREVENTERS TOO.
BUT IT DOES TAKE AN EXTRA EFFORT
AND PUTTING SYSTEMS AND
PROCESSES IN PLACE TO TRY TO
ANTICIPATE AND ELIMINATE AS MANY
AS YOU CAN, EVEN BEFORE YOU
START SOMETHING NEW.
STRATEGIC PLAN WHICH IS ON OUR
WEBSITE IDENTIFIES FOUR
STRATEGIC AIMS AND CONTINUING TO
LEAD THE WORLD CONDUCTING SAFE
FIRST IN HUMAN CLINICAL RESEARCH
IN RARE AND REFRACTORY DISEASE.
THAT'S ALWAYS BEEN THE PRINCIPAL
MISSION OF THE NIH CLINICAL
CENTER.
WE WOULD LIKE TO INCREASE USE OF
THE CLINICAL CENTER BY THE NIH
INTRAMURAL RESEARCH PROGRAM, THE
PANDEMIC HAS SORT OF GOTTEN IN
OUR WAY THERE.
IT'S BEEN VERY HARD TO BRING A
LOT MORE PATIENTS TO THE
CLINICAL CENTER OR EVEN TO THE
AREA.
TRAVEL HAS BEEN DIFFICULT.
ABOUT THE TIME YOU THINK YOU'RE
OVER IT, WELL, THERE'S ANOTHER
WAVE AND IT GETS DIFFICULT
AGAIN.
THE RESPECT FOR OUR PATIENTS,
PARTNERS IN THE CLINICAL
RESEARCH ENTERPRISE, YOU SEE
DEMONSTRATED IN THE PRESENTATION
BY TONI JONES AND ALSO BY
COLLEEN HADIGAN.
AND THIS LAST ONE ACTUALLY
OCCUPIES A HUGE AMOUNT OF OUR
TIME, AND THAT IS PARTNERING
WITH THE INSTITUTES, OTHER
INSTITUTES AND CENTERS TO
RECRUIT, DEVELOP, RETAIN THE
NEXT GENERATION OF NIH CLINICAL
RESEARCHERS AND CLINICAL CENTER
STAFF THAT WILL SUPPORT THEIR
EFFORTS.
SO, THE STRATEGIC PLAN REALLY
CLASSIFIES EVERYTHING INTO ONE
OF THREE AREAS, PEOPLE, PLACES,
CAPABILITIES.
AND SO WE'LL START FIRST WITH
TALKING ABOUT PEOPLE.
AND THIS IS WHAT WE TRIED TO DO
SINCE I THINK JANUARY THE 9th,
2017, PROVIDE PERSONALIZED
INCLUSIVE HEALTH CARE
LEADERSHIP.
FIRST TOWN HALL, INTRODUCTORY
TOWN HALL MEETING I HELD WITH
CLINICAL CENTER STAFF I SAID I
SPENT A LONG TIME IN THE ARMY.
I TRY NOT TO ACT LIKE A GENERAL
VERY OFTEN.
BUT THIS IS ONE OF THOSE THINGS
THAT WE'RE GOING TO BRING TO THE
NIH CLINICAL CENTER, AND THAT IS
TAKING CARE OF THOSE ON THE
FRONT LINES.
HEALTH CARE LEADERSHIP IS
PERSONALIZED BY MAKING SURE THAT
STAFF MEMBERS HAVE ACCURATE
POSITION DESCRIPTIONS.
NOT INFLATED POSITION
DESCRIPTIONS, NOT
OVEREMPHASIZING WHAT THEY DO ON
THE MOST COMPLEX DAY, BUT AN
ACCURATE POSITION DESCRIPTION
FOR THEIR POSITION.
I FOUND OUT THAT, YOU KNOW, IN
ORDER TO ENSURE TIMELINESS OF
TIME CARDS THAT PEOPLE WERE
SOMETIMES ENCOURAGED TO SUBMIT
INACCURATE TIME CARDS AND GO
BACK AND CORRECT THEM
AFTERWARDS, AND ONE OF THE
THINGS I HATE DOING IS DOING
WORK TWICE.
SO I SAID, WE SHOULD STOP DOING
THAT.
WE SHOULD SUBMIT ACCURATE TIME
CARDS THE FIRST TIME.
AGAIN, YOUR TIME CARD IS
PERSONAL.
AND WE WANTED EVERYBODY TO BE
INCLUDED AND INVOLVED.
I HEARD A LOT OF STORIES ABOUT
ANNUAL LEAVE THAT WAS BEING
DONATED TO THE LEAVE BANK, AND
PEOPLE USING ANNUAL LEAVE AND
WITH DR. COOTS HERE AS MY
WITNESS THAT HAS ALWAYS BEEN A
PROBLEM FOR ME.
I ALWAYS THOUGHT THAT IT WAS
YOUR LEAVE, NOT SOMEBODY ELSE'S,
AND YOU SHOULD HAVE THE CHANCE
TO UTILIZE IT.
AND THAT IF YOU WANTED TO DONATE
YOUR LEAVE, YOUR ANNUAL LEAVE TO
THE LEAVE BANK, THAT WAS
PERFECTLY OKAY.
BY THE WAY, I TALKED TO THE
PEOPLE WHO RUNG THE LEAVE BANK.
THEY SAID THEY WERE IN GOOD
SHAPE.
THEY DIDN'T REALLY NEED PEOPLE
DONATING LEAVE BECAUSE THEY
WEREN'T GIVEN THE OPPORTUNITY TO
USE IT.
I ASKED -- I HAD A FEW
CONVERSATIONS WITH DIRECT
REPORTS ABOUT THOSE WHO GOT UP
TO THE END OF THE YEAR AND
HADN'T USED THEIR ALLOTMENT.
AND THEY PRESENTED A LEAVE PLAN
FOR ME FOR THE FOLLOWING YEAR TO
SHOW HOW THEY WERE NOT GOING TO
LET THAT HAPPEN AGAIN.
THE LATEST CHANGE HERE IS ALMOST
EVERYBODY IN THE CLINICAL CENTER
NOW HAS AN INDIVIDUAL
DEVELOPMENT PLAN, IT REQUIRES A
CONVERSATION BETWEEN THE
SUPERVISOR AND THEM, SOMETHING
SEPARATE FROM THEIR ANNUAL
PERFORMANCE APPRAISAL OR
ANYTHING RELATED TO PERFORMANCE
EVALUATION.
THIS IS NOT ABOUT WHAT YOU WANT
TO DO THIS WEEK AND NEXT WEEK OR
EVEN SIX MONTHS FROM NOW.
THIS IS WHERE YOU WANT TO GO.
IT IS MEANT TO BE ASPIRATIONAL.
AND AT LEAST -- NOT EVERYBODY
HAS GOTTEN THIS ON THE FIRST
GO-ROUND, BUT FOR THE MOST PART
I GET PRETTY POSITIVE FEEDBACK.
IT'S GREAT TO SIT DOWN AND TALK
WITH PEOPLE ABOUT SOMETHING
OTHER THAN WHAT THEY ARE DOING
TODAY OR TOMORROW.
I'M A BIG BELIEVER IN LEADERSHIP
TRAINING.
WE'VE INSTITUTED ADDITIONAL
TRAINING OPPORTUNITIES BESIDES
THOSE OFFERED BY NIH AND WE HAVE
A WONDERFUL STAFF IN OFFICE OF
WORKFORCE MANAGEMENT AND
DEVELOPMENT THAT HELPED US
DEVELOP THOSE.
I USE THE WORD ANCILLARY STAFF
ONE TIME IN THE LAST FIVE YEARS.
BECAUSE I TOLD EVERYBODY ELSE
NOT TO USE IT, THEY CALLED ME ON
IT AND I DON'T DO IT AGAIN.
WE-- AS HAS BEEN EMPHASIZED OVER
AND OVER AND OVER AGAIN, HEALTH
CARE, ESPECIALLY IN THE CLINICAL
RESEARCH ENVIRONMENT, IS A TEAM
SPORT.
AND THERE'S NO MEMBER OF THAT
TEAM THAT REALLY CAN BE -- THAT
YOU CAN DO WITHOUT AND HAVE A
BAD DAY.
SO, I THINK THIS IS THE KIND OF
LEADERSHIP WE TRY TO PROVIDE.
THERE'S ALWAYS BEEN A LOT OF
RECOGNITION ON THIS CAMPUS FOR
SCIENTIFIC ACHIEVEMENT.
BUT MAYBE NOT ENOUGH FOR KINDS
OF THINGS WHICH ENABLE THAT
SCIENTIFIC ACHIEVEMENT.
WE BEGAN WITH SOMETHING
NON-CONTROVERSIAL.
LENGTH OF SERVICE RECOGNITION.
YOU GET A CERTIFICATE, A PIN,
EVERY FIVE YEARS.
FIRST YEAR YOU ONLY GET A
CERTIFICATE.
AFTER TEN YEARS YOU GET A
CERTIFICATE AND PIN.
AND AFTER 20 YEARS WE PUT IT IN
A GRAHAM FOR YOU.
AND THE PROBLEM WITH STARTING AN
AWARDS PROGRAM, YOU PICK THINGS
THAT ARE -- I WANT TO PICK
THINGS THAT ARE IMPORTANT BUT
NEED TO PICK THINGS IMPORTANT TO
EVERYBODY ELSE, SO STARTING WITH
SIMPLE LENGTH OF SERVICE REGULAR
OF RECOGNITION, IT WAS
NON-RECOGNITION.
YOU SHOULDN'T BE HERE 25 YEARS
BEFORE THE CEO OF THE CLINICAL
CENTER, YOU GET TO MEET THEM.
THAT'S THE WAY I THINK.
FOR THE FIRST TWO YEARS WE WOULD
DO ALL OF THESE FOR THE PEOPLE
WHO WOULD COME AT OUR QUARTERLY
TOWN HALL MEETINGS, BUT SINCE
THE PANDEMIC WE CAN'T HAVE THESE
TOWN HALL MEETINGS WITH A LOT OF
PEOPLE IN PLACE.
WE HAD TO FIGURE OUT WHAT TO DO
THERE.
SO WHAT WE DO IS SIMPLE.
THEY GET AN E-MAIL FROM ME.
NOT FROM ANYBODY ELSE.
THEY GET AN E-MAIL FROM ME, I'VE
GOT YOUR CERTIFICATE AND PIN,
I'VE GOT YOUR FRAMED
CERTIFICATE, YOUR PIN, AND I
WANT TO HAND THIS TO YOU
PERSONALLY, IF WE CAN FIND AN
APPROPRIATE DATE, TIME, AND
PLACE.
AND SOMETIMES THEY ARE SURPRISED
TO BE GETTING AN E-MAIL FROM THE
CEO, BUT BY AND LARGE THIS IS
THE WAY WE'VE DONE THIS, SINCE
THE START OF THE PANDEMIC.
I DID HAVE A VERY BAD ACCIDENT
ABOUT A YEAR AND A HALF AGO, I
WAS OUT OF ACTION FOR ONE OF THE
QUARTERS, AND THE CHIEF
OPERATING OFFICER TOOK OVER THIS
FOR ME.
AND FRANKLY, I LIKE GIVING OUT
THE AWARDS THIS WAY BETTER THAN
I LIKED DOING IT ALL IN A GROUP.
FIRST OF ALL, THERE'S GREATER
PARTICIPATION.
I GET TO MEET MORE OF THE STAFF
MEMBERS.
SECONDLY, I ACTUALLY DO GET TO
TALK TO THEM A LITTLE BIT AND
LEARN TWO OR THREE THINGS ABOUT
THEM.
IT DOESN'T TAKE A VERY LONG
PERIOD OF TIME.
WE CAN STILL DO IT WITH PEERS,
WITH A LITTLE BIT OF
PREPARATION.
I'VE DONE THESE AT 4:00 ON A
SUNDAY MORNING FOR SOMEBODY WHO
ONLY WORKS WEEKENDS AND ONLY
WORKED PART TIME AND ON
WEEKENDS.
I DON'T DO THEM OFTEN THAT WAY
BUT I HAVE DONE SOME.
AND ESPECIALLY DURING THE
PANDEMIC, WHERE THERE'S SO MUCH
ISOLATION, SO MUCH SEPARATION, I
THINK THIS HAS BEEN A REALLY
IMPORTANT THING TO DO IT.
I'M NOT SURE I WANT TO GO BACK
AND DO THEN IN THE BIG GROUP
AGAIN.
WE DID INSTITUTE A PROGRAM FOR
CLINICIANS, AND THEN ADDED
ADMINISTRATORS IN THE SECOND
YEAR.
WE GIVE OUT A STAFF CLINICIAN
AND AN AWARD TO THE ADVANCEMENT
PRACTICE PROVIDERS.
THESE ARE NOT -- THEY DON'T HAVE
TO BE CLINICAL CENTER STAFF
CLINICIAN OR P.A. OR N P.
THIS INCLUDES INSTITUTES AND
CENTERS TOO.
THERE'S SOME CASH AND THERE'S A
NICE PLAQUE AND EVERYTHING THAT
GOES WITH IT.
THE CLINICAL CENTER NURSING
DEPARTMENT HAS AN EXTENSIVE
AWARD PROGRAM OF THEIR OWN, THE
OFFICE OF PATIENT SAFETY AND
CLINICAL QUALITY PRESENTS
PATIENT SAFETY AWARDS,
SUPERSTARS AWARDS, QUARTERLY.
ANOTHER THING ALMOST BY
ACCIDENT, DR. TABAK WAS A HUGE
HELP IN THIS.
I WAS TOLD STAFF CLINICIAN, WHEN
I ARRIVED, STAFF CLINICIANS TO
BE ON SEARCH COMMITTEES BUT
WEREN'T ALLOWED TO VOTE.
I FOUND OUT THAT THIS WAS URBAN
LEGEND.
IT WAS A MYTH.
AND I E-MAILED AND SAID CAN WE
GET THIS CHANGE?
HE E-MAILED ME BACK AND SAID
IT'S NOT A RULE.
SO WE STARTED ADDING STAFF
CLINICIANS, PEOPLE WHO TAKE CARE
OF PATIENTS, TO SEARCH
COMMITTEES BECAUSE IT DIDN'T
MAKE ANY SENSE TO ME WHY WE
WOULD ASK THE STAFF CLINICIANS
WHY THEY WERE LEAVING WHAT THEY
THOUGHT OF THEIR BOSSES IF WE
DIDN'T ALSO GIVE THEM AT LEAST A
LITTLE BIT OF A VOICE IN
SELECTION.
WE ACTUALLY ARE -- THREE SENIOR
LEADERS IN THE CLINICAL CENTER
NOW CAME OUT OF THE STAFF
CLINICIAN RANKS.
THEY CAME TO THEIR POSITIONS
BECAUSE THEY HAD A VERY LONG AND
DISTINGUISHED TRACK RECORD OF
PROVIDING PATIENT CARE, THEY
HAVE GREAT CVs AS WELL.
WE DID NOT SELECT THEM FOR THEIR
POSITIONS BASED JUST ON A CV.
AS I TALKED WITH THE FIRST ONE
OF THESE, WE DID WAS FOR
RADIOLOGY, AND IMAGING SCIENCES,
AND I ACTUALLY TALKED TO FOLKS
AROUND THE COUNTRY AND TALKED
ABOUT DIFFICULTIES WITH CHIEFS
SELECTED ON THE BASIS OF GREAT
C.V.s, AND I WAS TOLD THIS
HAPPENS ALL THE TIME, FOR PEOPLE
WHO ARE SELECTED ON THE BASIS OF
THEIR RESEARCH AND PUBLICATIONS,
BUT THEY DON'T HAVE MUCH SKILL
IN TERMS OF MANAGING A BIG GROUP
OF PEOPLE.
THEY DON'T RELATE TO TECHNICIANS
AND TECHNOLOGISTS.
THEY RELATE TO SCIENTISTS AND
PHYSICIANS WELL BUT DON'T RELATE
TO EVERYBODY IN THE DEPARTMENT.
WE'VE DONE QUARTERLY TOWN HALL
MEETINGS.
WE'VE EVEN HAD AN EXTRA ONE OR
TWO UNTIL THE PANDEMIC HIT, I
WOULD DO THREE, NOW WE DO ONE
AND RECORD IT AND LET PEOPLE
WATCH IT.
BUT GETTING TO THE PEOPLE ON
NIGHTS AND WEEKENDS WAS
IMPORTANT.
WE STUMBLED ON THIS WAY OF
COMMUNICATING WITH THE CLINICAL
CENTER STAFF FIVE YEARS AGO THAT
SEEMED TO CLICK.
SO, THE E-MAILS ARE ENTITLED
THREE MAIN THINGS, TAKE ONE
MINUTE OR LESS TO READ.
THERE'S AN OPPORTUNITY FOR
HUMOR, I'LL TAKE ADVANTAGE IT.
WE STARTED SEEING STAFF AND
FOUND OUT OTHER PEOPLE IN OUR
BUILDING, BUILDING 10, INCLUDING
RESEARCH STAFF, WANTED IT.
THEY ARE WRITTEN BY ME, NOT BY
SOMEBODY FOR ME.
THEY ARE WRITTEN BY ME.
AND I DO GET A LITTLE HELP FROM
NATASHA ONCE IN A WHILE IN
REWORDING THINGS.
SHE'LL SAY ARE YOU SURE YOU WANT
TO DO THAT?
AND MOST OF THE TIME, SHE TALKS
ME OUT OF IT.
THAT'S PROBABLY GOOD.
AND THEN I ESPECIALLY DURING THE
PANDEMIC WALK THE BUILDING
FREQUENTLY AND TALK TO PEOPLE.
THIS HAS BEEN MORE OF A PROBLEM,
TAKES A HUGE AMOUNT OF TIME.
AGAIN, THIS COMES DIRECTLY OUT
OF OUR STRATEGIC PLAN,
GENERATION OF CLINICAL
RESEARCHERS WHO BROUGHT THE
CLINICAL CENTER TO PROMINENCE
ARE THE IN THE PROCESS OF
RETIREMENT OR REDUCING
ACTIVITIES.
THEY WERE SUPPORTED BY CLINICAL
CENTER STAFF WHO SPENT ENTIRE
YEARS AFTER NIH FINDING AND
DEVELOPING THE NEXT GENERATION
OF GREAT CLINICAL INVESTIGATORS
AND STAFF MEMBERS WHO WILL
SUPPORT IN THIS CLINICAL CENTER
AS A FOCAL POINT OF THIS PLAN.
SO THIS GIVES A SENSE OF WHAT WE
HAVE DONE AND WHAT WE'RE DOING.
SO WE RECRUITED CHIEF OPERATING
OFFICER, CHIEF MEDICAL CENTER,
DAVID HENDERSON, THERE WAS A
TWO-YEAR GAP, OR 18-MONTH GAP
BETWEEN DAVID LEAVING AND DR.
HADIGAN ACCEPTING THE POSITION,
A LITTLE MORE THAN 18 MONTHS.
FIRST BIG RECRUIT WAS FOR CHIEF
NURSE OFFICER.
DR. WALLEN WAS IN AN ACTING ROLE
WHEN I CAME ON BOARD AND SHE
LEFT A YEAR AGO, AND NOW WE'RE
IN THE MIDDLE OF A NATIONAL
SEARCH.
CHIEF FINANCIAL OFFICER RETIRED
AT THE END OF 2021, WE'RE
INVOLVED IN THAT SEARCH.
WE HAVE BEEN THROUGH EXECUTIVE
OFFICER, ACTING EXECUTIVE
OFFICER, AND NOW WE HAVE DAN IN
THAT ROLE DOING A WONDERFUL JOB.
CHIEF OF RADIOLOGY I'VE REFERRED
TO AS I HAVE THE CHIEF OF THE
DEPARTMENT OF LABORATORY
MEDICINE, THOSE POSITIONS ARE
BOTH WELL FILLED.
MOST RECENT IS CHIEF OF THE
DEPARTMENT OF TRANSFUSION
MEDICINE, WITH CENTER FOR
CELLULAR ENGINEERING.
HARVEY KLEIN RETIRED, BARBARA
BRYANT IS THE INCUMBENT NOW.
WE'RE INVOLVED IN A NATIONAL
SEARCH FOR THE CHIEF OF THE
DEPARTMENT OF PHARMACY, AND THIS
IS A VERY IMPORTANT SEARCH.
IT'S VERY HARD TO OVEREMPHASIZE
HOW IMPORTANT THE PHARMACY IS TO
EVERYTHING WE DO.
AND THEN LAURA AND RICK AND RUTH
WILL REMEMBER WHEN LAURA LEE
LEFT TO GO TO MEDSTAR AND DAVID
LANG HAS APPLIED FOR AND HAS
BEEN DOING A GREAT JOB OF THE
CHIEF OF OFFICE OF PATIENT
SAFETY AND CLINICAL QUALITY.
IN TERMS OF TAKING CARE, YOU
HEARD CODE BERT REFERRED TO.
FIRST OF ALL, COMPARED TO OTHER
HOSPITAL ENVIRONMENTS, IT'S
PRETTY SAFE.
AGAIN, WE HAVE THIS CAMPUS
SURROUNDED BY GATES, GUARDS,
GUNS.
THERE STILL NEEDED TO BE THE
CAPABILITY IN THE CLINICAL
CENTER WHEN A PATIENT OR FAMILY
MEMBER OR STAFF MEMBER ACTED
OUT.
IT'S UTILIZED MORE OFTEN THAN I
THOUGHT IT WOULD BE AND PROVIDE
REASSURANCE AND SOME COMFORT TO
OUR STAFF WORKING IN THE
BUILDING, ESPECIALLY AT NIGHT
AND WEEKENDS. .
WE HAVE THE ANTI-HARASSMENT
RESPONSE TEAM, NOT AS ACTIVE AS
BEHAVIORAL RESPONSE TEAM BUT
WE'VE HAD TO HAVE SOME SERIOUS
DISCUSSIONS WITH PATIENTS ABOUT
THEIR ACTIONS AND THEIR
INTERACTIONS WITH OUR STAFF.
WHEN I ARRIVED SPIRITUAL CARE
WAS PUT IN A CORNER, THERE FOR
THE PATIENTS, NOT CLINICAL
CENTER STAFF.
WE'VE VERY CAREFULLY AND VERY
GENTLY CHANGED THAT.
AND NOW I BELIEVE THAT THEY ARE
MAKING A MEANINGFUL CONTRIBUTION
TO THE WELLNESS AND WELL-BEING
OF A NUMBER OF STAFF AS WELL.
AND WHEN THE PANDEMIC HIT, WE
VERY QUICKLY ESTABLISHED OUR
PRIORITIES AS THE SAFETY OF OUR
PATIENTS, SAFETY OF THE STAFF,
AND DID EVERYTHING WE COULD TO
TRY TO ENSURE THAT THAT WOULD
TAKE PLACE.
SO, HOW DO THE STAFF THINK THAT
WE'RE DOING?
THIS IS ONE MEASURE, FEDERAL
EMPLOYEE VIEWPOINT SURVEY IS A
MEASURE OF EMPLOYEE ENGAGEMENT.
IN THE MILITARY WE PROBABLY
CALLED IT A MORALE SURVEY.
WE DIDN'T DO A SURVEY IN 2021,
WHERE OUR SURVEY'S IN PROGRESS,
WE HAVE A PRETTY GOOD RESPONSE
WAIT, AS A MATTER OF FACT WE'RE
HIGHER THAN THE NIH RESPONSE
RATE RIGHT NOW.
IT WAS 48 OR 49% THIS MORNING.
WE'VE SHOWN CONSISTENT
IMPROVEMENT EACH YEAR.
WE HAVE -- AND I'LL SHOW YOU
COMPOSITE SCORES IN JUST A
MINUTE.
HERE IS THE EMPLOYEE ENGAGEMENT
INDICATOR.
AND THE LEVEL OF SATISFACTION
INDICATOR.
THESE ARE TWO COMPOSITE SCORES
WE GET.
THE EMPLOYEE ENGAGEMENT
INDICATOR IS INCREASED 12.4% IN
FOUR YEARS, GLOBAL SATISFACTION
INCREASED BY 12% IN THE LAST
FOUR YEARS.
FOR PLACES, WE SWITCHED FROM
PEOPLE TO PLACES NOW.
THE FIRST JOB WAS TO GET THE
SURGERY WING PROJECT MOVING,
PARTNERED WITH RESEARCH
FACILITY, CHIEFS OF THE
DEPARTMENT OF LABORATORY
MEDICINE, DEPARTMENT OF
PERIOPERATIVE MEDICINE AND
DEPARTMENT OF RADIOLOGY AND
IMAGING SCIENCES TO CREATE
NARRATIVES I THINK HAVE
CONTRIBUTED TO GETTING THIS
DONE.
WE MET WITH A STUDY GROUP FROM
NATIONAL ACADEMIES, IN ORDER TO
RELAY NARRATIVES AND WE HAD A
NUMBER OF MEETINGS WITH HHS AND
CONGRESSIONAL STAFF.
THIS GROUP PROVIDED A LETTER A
COUPLE YEARS AGO TO DR. COLLINS
TO ENCOURAGE THIS WORK.
WE TALKED TO ANYBODY WHO WOULD
LISTEN.
AND THE MONEY HAS BEEN
APPROPRIATED AND WE'LL HAVE
GROUNDBREAKING THIS SUMMER,
WON'T BE FINISHED UNTIL 2018.
ALONG THE WAY WE LEARNED THE
IMPORTANCE OF STRATEGIC
COMMUNICATION.
THAT WAS -- NO MATTER WHO WE
TALKED TO TRIED TO PRESENT THE
SAME MESSAGE, NO MATTER WHO WAS
TALKING, AND NO MATTER WHEN
TRIED TO MAINTAIN THE SAME
MESSAGE OVER TIME.
WE'VE MADE THAT.
WE'VE TALKED ABOUT THE PHARMACY
ALREADY TODAY.
AND WE HAD A DETAILED
PRESENTATION AT THE LAST BOARD
MEETING.
THIS IS A HUGE INVESTMENT BY THE
NIH OF $50 MILLION OVER ABOUT
THE LAST SIX YEARS, WE HAD TO
DEVELOP AND CONSTRUCT INTERIM
AND SWING SPACES, AND MOVE ALL
THE PHARMACY STAFF IN 2019 WITH
INTERIM READERSHIP IN PLACE, NOT
THE PERMANENT LEADERSHIP, AND
OPERATE OUT OF THOSE SPACES FOR
THE LAST THREE YEARS.
AGAIN, OUTPATIENT PHARMACY AND
UNIT DOSE ARE BACK IN POSITION
AND THIS WINTER WE'LL MOVE THE
IVAU AS WELL.
WE'VE MOVED THE COMMITTEE WITH
NEW LEADERSHIP MAKING A REAL
DIFFERENCE, ACTUALLY I THINK
WE'LL HAVE AN IMPACT ON FARM SIP
COSTS AS WELL AS SOME CHANGES IN
SUPPORTIVE PATIENT SAFETY.
RADIOPHARMACY IS STILL ON THE
DRAWING BOARD.
AND ON PAGE 15 OF OUR STRATEGIC
PLANNING DOCUMENT I THINK
THERE'S AN ACCURATE STATEMENT,
HISTORY OF THE RADIOPHARMACY HAS
BEEN FRAUGHT WITH COMPLEXITY AND
SETBACKS.
WE HAVE AN APPROVED PLAN, LATEST
SETBACK WAS SET BACK A YEAR TO
MAKE CERTAIN WE HAD ENOUGH FUNDS
FOR SURGERY, RADIOLOGY AND
LABORATORY MEDICINE WING, WE'LL
GET BACK TO THAT PLAN IN FY23.
CENTER FOR CELLULAR ENGINEERING,
YOU'VE HAD A COUPLE
PRESENTATIONS OVER THE LAST FEW
YEARS BY THE CENTER FOR CELLULAR
ENGINEERING, STARTED WITH A
SUITE IN OUR 3-T WING, AND AS
DR. KLEIN WOULD LOVE TO KLEIN IT
AS THE BEST 20th CENTURY
FACILITY MONEY COULD BUY, WAS
INADEQUATE FOR THE 21ST CENTURY,
AND SO THE NEXT FACILITY, THIS
WAS ALREADY BEING DEVELOPED
BEFORE I ARRIVED, WAS THE 2-J
FACILITY, 21ST CENTURY BUT STILL
EMBEDDED IN A POOR PART OF THE
20th CENTURY BUILDING.
WE STILL DEAL WITH THOSE
SHORTCOMINGS.
WE NOW ARE IN THE PROCESS OF
TRYING TO COMMISSION A TERRACE
MODULAR BUILDING, THE FIRST 21ST
CENTURY FACILITY IN
QUALIFICATION NOW, WHEN E-WING
RENOVATION IS COMPLETE WE HAVE A
LARGE SUITE ON THE 12th FLOOR.
WHAT MAKES THOSE TWO DIFFERENT
FROM THE OTHERS, THEY ARE NOT
LOCATED WITH A BUILDING AROUND
THEM.
SO EVERYTHING THAT GOES ON IN
THE BUILDING AROUND THESE VERY,
VERY DEMANDING STRUCTURES CAN
HAVE AN INFLUENCE.
AND SO A LITTLE WATER, A LITTLE
CHANGE IN AIR PRESSURE, A LITTLE
CHANGE IN VENTILATION, A LITTLE
CHANGE IN TEMPERATURE, AND
THESE, THE TERRACE MODULAR AND
12th FLOOR E WING ARE ISOLATED
AND HOPEFULLY WILL PROVIDE GREAT
OPPORTUNITY.
NOW, THE STRATEGIC PLAN TALKS
ABOUT ENHANCED SIMULATION
CENTER.
FRANKLY, I'M NOT SURE THAT
THAT'S NECESSARY AND I'LL GET
BACK TO THAT WHEN I TALK ABOUT
CAPABILITIES.
PEOPLE, PLACES, AND
CAPABILITIES, AND I -- WHEN I
APPLIED FOR THIS JOB, THIS HAD A
LOT TO DO WITH MY APPLICATION.
AND WE HAVE WONDERFUL SAFETY
TRACKING AND REPORTING SYSTEM
CALLED STARS, REPLACED A SYSTEM,
AND I'VE NEVER REPLACED A SYSTEM
LIKE THIS WITH ANOTHER SYSTEM,
AND SAW ABSOLUTELY NO DROP-OFF
IN ITS UTILIZATION.
I MEAN, WE HAVE ABOUT -- WE HAD
ABOUT 600 REPORTS PER MONTH
BEFORE WE PUT IN THE NEW SYSTEM
AND WE HAD 600 REPORTS THE FIRST
MONTH AFTER THE NEW SYSTEM WAS
IN.
WE SPEND A LOT OF TIME DOING
FAILURE EFFECT AND MODE
ANALYSIS, THIS IS WHERE OUR
ABILITY -- WE'VE DEVELOPED I
THINK THE ABILITY TO FOCUS ON
PROBLEM PREVENTION AND NOT JUST
PROBLEM SOLVING.
WE HAVE A VERY LOW THRESHOLD FOR
COMMUNICATION WITH JOINT
COMMISSION.
WE CALL THEM REGULARLY WITH
ADVERSE OUTCOMES.
THEY TELL US THIS DOESN'T QUITE
MEET SENTINEL EVENT BUT WE'RE
ADEPT USING ROOT CAUSE ANALOGY,
WHETHER THEY CALL IT THAT OR
NOT.
WE DID HAVE SOMETHING THAT I
THINK WILL COME BACK IN THE
OCTOBER HOSPITAL BOARD.
WE INVITED INSTITUTE FOR SAFETY
MEDICATION PRACTICE TO COME SEE
US SEVERAL YEARS AGO, ACTUALLY
NOW, PROBABLY 2018.
THEY PRODUCED A WHOLE BUNCH OF
RECOMMENDATIONS, AND MEDICATION
SAFETY IS CLEARLY CRITICAL TO
PATIENT OUTCOMES.
WE HAVE IN A VERY DISCIPLINED
WAY PRIORITIZED ALL THOSE
RECOMMENDATIONS AND WE'VE BEEN
IN A VERY CONCERTED FASHION
WORKING DOWN THAT LIST SINCE OUR
VISIT.
THE DAILY PATIENT SAFETY HUDDLE
IS STILL THE HIGH POINT OF OUR
DAY.
IT'S THE MOST IMPORTANT MEETING
WE HAVE.
AND I THINK WE'VE ALSO DEVELOPED
THE ABILITY, GREATER ABILITY TO
BRING IN PEOPLE FROM THE OUTSIDE
TO LOOK AT WHAT WE DO.
WE ARE DIFFERENT.
WE ARE SPECIAL.
BUT OUTSIDE EXPERTS VERY OFTEN
HAD INSIGHTS INTO OUR UNIQUE
ORGANIZATION THAT I THINK IN THE
PATH MAYBE WE THOUGHT THEY
WOULDN'T UNDERSTAND OUR
BUSINESS, AND I THINK THEY DO.
SINCE FY 18 CAPITAL INVESTMENT
FUND, WE CAN SPEND UP TO $50
MILLION A YEAR ALTHOUGH WE DON'T
USUALLY SPENT THAT MUCH.
IN OUR FACILITIES, WE RESIZE 9
MAIN WATER SUPPLY LINE TO REDUCE
SLUDGE AND BIOFILM AND WE
REPIPED PATIENT ROOMS USED BY
IMMUNOCOMPROMISED PATIENTS AFTER
A FEW WERE INFECTED WITHAN
SPHINGOMONAS ANOTHER
PRESENTATION TO THE BOARD ABOUT
ALL OF THAT WORK BY TARA PALMORE
AND ENGINEERS.
WE'RE NOW STARTING ON INPATIENT
NURSES STATIONS.
WE'VE PUT A CT SCANNER IN THE
UCU, HAVE A NEW PET M.R.
ADDED A THIRD SCAN, TO MAKE IT
POSSIBLE TO IMPROVE PATIENT
FLOW.
THE BIGGEST USE HAS BEEN IN OUR
INFORMATION TECHNOLOGY.
WE'VE HAD EXTENSIVE INVESTMENT
IN SECURITY, NETWORK REDESIGN,
WE HAD HAD COMPLETE OUTAGE, ONE
DARK DAY, ABOUT TWO YEARS AGO,
WE'VE DONE A NETWORK REDESIGN TO
ELIMINATE SINGLE POINTS OF
FAILURE AND WE'RE NOW IN THE
PROCESS OF MOVING TO 100G FROM
10G, THE NUMBER OF DEVICES ON
THE NETWORK JUST KEEPS GOING ON
UP AND UP AND UP.
AND IN ORDER TO INCREASE -- IN
ORDER TO MAINTAIN OUR -- KEEP
LATENCY TO A LOW LEVEL, WE THINK
THAT THIS IS NECESSARY.
I'VE ALREADY MENTIONED ALL OF
THESE THINGS.
SO I'LL NOT -- CAPABILITIES AS
WELL.
WE HAD A PRESENTATION BY THERESA
ON THE TRANSPLANTATION AND
CELLULAR THERAPY, B.I.D.CPT,
IT'S BASICALLY A TRANS-NIH
CLINICAL PROGRAM, AND FOR THOSE
THAT MIGHT BE -- THAT ARE
RELATIVELY NEW TO THE NIH, YOU
WOULD THINK THAT WOULD NOT BE A
HARD THING TO DO BUT QUITE
FRANKLY IT'S ONE OF THE HARDEST
THINGS TO DO AT THE NIH, TO HAVE
ALL THE INSTITUTES THAT ARE
INVOLVED IN SOME ASPECT OF CELL
THERAPY OR HEMATOPOIETIC STEM
CELL TRANSPLANTATION WORK
TOGETHER TO TRY TO FORM A
COHESIVE TEAM.
WE'VE BEEN AT THIS FOR A WHILE
NOW.
WE HAVE ONE MEDICAL DIRECTOR.
WE HAVE ONE OPERATIONS PROGRAM
MANAGER, ONE PROGRAM MANAGER FOR
DONOR SERVICES AND QUALITY
ASSURANCE.
WE HAVE DEDICATED INFECTIOUS
DISEASE CONSULTANTS FOR THIS
TEAM.
AND IT'S WORKING WELL BUT IT'S
ALWAYS A WORK IN PROGRESS.
DR. HADIGAN AND THE FOLKS IN THE
NATIONAL INSTITUTE FOR DEAFNESS
AND COMMUNICATION DISORDER,
WHICH IS WHERE THE ENT SURGEONS
ARE, AND DEPARTMENT OF
PERIOPERATIVE MEDICINE WHERE
ANESTHESIOLOGISTS ARE IN
RESPONSE TO A COUPLE OF ISSUES
THAT HAD VERY, VERY COMPLEX
PATIENTS WHO HAD AIRWAY ISSUES,
HAVE FORMED THE DIFFICULT AIRWAY
RESPONSE TEAM.
AND THAT WAS ONE OF THE -- THAT
WAS THE RESPONSE TO ONE OF OUR
SENTINEL EVENTS.
WE ARE ADDING -- WE'VE HAD SORT
OF PEDIATRIC HOSPITALS FOR A
WHILE BUT WE'RE ADDING -- WE'VE
HAD PEDIATRIC INTENSIVISTS AS
CONSULTANTS FOR A WHILE BUT
THESE ARE ACTUALLY HAVING A
GREATER PRESENCE AND THAT WILL
BE -- AS LARRY TALKED, LARRY
TABAK TALKED, THE DISCUSSIONS
ABOUT WHETHER TO DO MORE
RESEARCH INVOLVING PEDIATRIC
PATIENTS IS -- ARE ONGOING.
AND IT'S ONE OF THE REASONS
WE'RE VERY HAPPY DR. DEVASKAR
AGREED TO JOIN OUR GROUP.
WE'VE RECENTLY REORGANIZED
RESOURCES THAT WERE FOR
PEDIATRIC CARE TO FORM AN
ORGANIZATION THAT LOOKS MORE
LIKE A DEPARTMENT OF PEDIATRICS
THAN ACADEMIC MEDICAL CENTER AND
THOUGHT THAT WAS A NECESSARY
ENABLER FOR EVEN THINKING ABOUT
DOING MORE WITH PEDIATRICS.
WE HAD NO TELEHEALTH CAPABILITY
BEFORE COVID-19.
WE REPLACED MICROSOFT TEAMS WITH
SOMETHING THAT INTEGRATES WITH
THE HEALTH RECORDS AND ARE
REQUESTING MORE CAPABILITY.
AND WE DO BELIEVE THAT CLINICAL
CENTER IS TO BE A NATIONAL
RESOURCE MUST BE A MORE ROBUST
VIRTUAL RESOURCE, ALSO WHERE WE
GET TO THE QUESTION OF THE
CLINICAL CENTER'S HISTORICAL
MISSION WHICH WAS TO DO RESEARCH
THAT COULDN'T BE DONE ANYPLACE
ELSE AND SO WHEN YOU START DOING
TELEHEALTH AND START TALKING
ABOUT MOBILE TECHNOLOGIES AND
ALL THAT, THEN CLEARLY NOT ALL
THE RESEARCH HAS GONE ON AT THE
NIH CLINICAL CENTER BUT IT STILL
SHOULD BE RESEARCH THAT IS VERY,
VERY DIFFICULT TO DO ANYPLACE
ELSE.
BUT THIS IS -- THIS WILL I THINK
BE A DISCUSSION OVER AND OVER
AND OVER AGAIN AS WE MOVE
FORWARD.
I'M COMING BACK TO SIMULATION.
FIRST OF ALL WE'VE HAD
SIMULATION PROGRAM FOR A LONG
TIME, BUT IT WAS VERY -- PRETTY
NARROWLY FOCUSED, CRITICAL CARE
USED IT QUITE A BIT, AND THERE
WAS A SEPARATE LITTLE SECTION
DOWN IN THE CONFERENCE ROOM,
TRAINING ROOM, FOR CLINICAL
CENTER NURSING DEPARTMENT.
AND THEY BOTH USED SIMULATION.
WELL, I ALWAYS THOUGHT THAT WE
NEEDED TO DO MORE, AGAIN, THE
STATEMENT DOWN AT THE BOTTOM IS
MINE, AS AN INSTITUTION FOCUSED
ON RARE ISSUES, COMMITTED TO
PREVENTING LEAMSES AND ERRORS
IMPROVING OUR SIMULATION
CAPABILITIES IS OF HIGH
IMPORTANCE.
I ROW THAT.
WE DO COMPLEX WORK, SIMULATION
IS FIT FOR THOSE ENVIRONMENTS.
ONE DAY IN AN E-MAIL I GOT THIS
C.V. ABOUT THIS DOCTOR, IT'S
MABEL GOMEZ.
SHE'S A CARDIOLOGIST, I'M A
CARDIOLOGIST.
NATURALLY I LOOKED FURTHER.
I FOUND OUT SHE JUST COMPLETED A
MEDICAL SIMULATION FELLOWSHIP IN
BOSTON.
HAD HER COME IN FOR A NUMBER OF
INTERVIEWS.
WE ALL THOUGHT THAT MIGHT WORK
OUT PRETTY WELL, AND THEN WE
HIRED HER ON CONTRACT.
AND WE ASKED HER TO PUT TOGETHER
A SIMULATION STRATEGY.
AND THE STRATEGY SHE PRODUCED
WAS NOT WHAT I THOUGHT WE
NEEDED.
IT WAS MORE USE OF SIMULATION
WHERE YOU WERE ACTUALLY GOING TO
DO THE WORK.
IT WAS NOT FOR A BIG COMPLEX
HIGH TECH SIMULATION CENTER.
AND SO THAT'S WHAT WE'VE BEEN
DOING.
WE DID INVEST IN BETTER
EQUIPMENT, ESPECIALLY FOR
SIMULATION INVOLVING CHILDREN
AND INFANTS.
AND WE ALSO HIRED A FULL-TIME
TECH.
HAD A TRAIN THE TRAINER PROGRAM.
DR. GOMEZ NEEDED HIGH COVER AND
WE PROVIDED GREAT EXECUTIVE
SPONSORSHIP BY TOM BURKLOW, AND
DR. GOMEZ AND DR. BURKLOW HAVE
COMPUTED TAILORED PROGRAMS IN
AREAS WHERE SIMULATION WAS NOT
EMPLOYED BEFORE.
THEY PUT TOGETHER A PROGRAM FOR
THE FOLKS IN RADIOLOGY AND
IMAGING SCIENCES TO BETTER
PREPARE THEM FOR THE ABILITY TO
RESPOND TO SOMEBODY HAVING A
CONTRAST REACTION.
AGAIN, YOU DON'T WANT TO DO THAT
IN THE CENTER, YOU WANT TO DO IT
IN THE CT SUITE WHERE RADIOLOGY
IS DONE.
THAT'S AN EXAMPLE OF WHAT THEY
HAVE DONE.
I'LL TALK ABOUT OUR TWO
PEDIATRIC PATIENTS SOON BUT WE
REALLY ARE JUST GETTING STARTED
BUT I'M VERY ENCOURAGED BY WHAT
WE'VE BEEN ABLE TO DO WITH DR.
GOMEZ-MEJIA ON BOARD.
WE ESTABLISHED HOSPICE SUITES,
NONE PLANNED BEFORE I ARRIVED IT
THE CLINICAL CENTER.
THE THOUGHT HAD BEEN THE NIH
CLINICAL CENTER WAS NOT A PLACE
WHERE PEOPLE COME TO DIE.
I BELIEVE THAT'S TRUE, IT'S ALSO
TRUE MANY DO DIE HERE, A NUMBER
OF THEM DO DIE HERE.
WE HAD THE CHAMPIONS ON BOARD
WITH THE PAIN AND PALLIATIVE
CARE SERVICE, ANN BERGER IS THE
RED HEAD, OR LOOKS RED OR BROWN
HAIR THERE, IN THE PICTURE ON
THE RIGHT.
SUPPORTED BY THE SPIRITUAL CARE
DIVISION, CLINICAL CENTER
NURSING DEPARTMENT, MANY OTHERS.
WE DID THE RIBBON CUTTING IN
JULY OF 2018.
THIS ACTUALLY DOES SUPPORT SOME
IMPORTANT CLINICAL RESEARCH.
THERE ARE SOME PROTOCOLS
REQUIRING RAPID AUTOPSY AND
HOSPICE SUITE IS AVAILABLE FOR
THAT.
DR. BERGER REPORTED ON THE USE
AT THE OCTOBER HOSPITAL BOARD
MEETING.
SOME TIME AGO, WE KNOW STEPHANIE
REEL WAS INTERESTED, WE COMBINED
DEPARTMENT OF CLINICAL RESEARCH
INFORM EIGHT, WITH HEALTH
INFORMATION MANAGEMENT DIVISION
HEADED BY TRISH KOFFEY, THAT'S
ONE DEPARTMENT NOW.
WE MOVED THE ANIMAL PROGRAM FROM
UNDER THE CHIEF MEDICAL CENTER
AND REALIGNED WITH CHIEF
SCIENTIFIC OFFICER.
AND THOSE OF YOU THAT HEARD THE
BRIEF FOLLOWING OUR JOINT
COMMISSION SURVEY LAST SUMMER
KNOW THAT WE REEVALUATED WHERE
THE STERILE PROCESSING SERVICE
BELONGED.
AND WE REALIGNED TO THE CLINICAL
CENTER NURSING DEPARTMENT FROM
MATERIALS MANAGEMENT AND ALL
THOSE CHANGES HAVE ALREADY BEEN
MADE.
THERE ARE A FEW OTHER -- I
ALREADY MENTIONED WHAT WE'RE
DOING IN PEDIATRICS TO MAKE IT
LOOK MORE LIKE A DEPARTMENT OF
PEDIATRICS IN AN ACADEMIC
MEDICAL CENTER.
SO, YOU DEVELOP ALL THESE
CAPABILITIES, AND THEN YOU BRING
THEM TOGETHER AND YOU SEE HOW IT
FITS TOGETHER.
YOU TRY TO SEE HOW AS MUCH OF IT
AS POSSIBLE FITS TOGETHER.
AND IN THE MILITARY WE WOULD
CALL THIS A LIVE FIRE EXERCISE
BECAUSE IT INVOLVED REAL
PATIENTS.
IN SUMMER OF 2021 WE HAD -- WE
CARED FOR TWO INFANTS BETWEEN 6
AND 12 MONTHS OF AGE WITH GM 1
GANGLIOSIDOSIS, PARTNERED WITH
CHILDREN'S NATIONAL HOSPITAL,
SPONSORED BY AN OUTSIDE COMPANY,
WE HAD RESOURCES TO DO THAT.
THE PRINCIPAL INVESTIGATOR WAS
FROM THE NATIONAL HUMAN GENOME
RESEARCH INSTITUTE.
WE SPENT SIX MONTHS GETTING
READY TO DO THIS.
CLINICAL CENTER NURSING
DEPARTMENT, CRITICAL CARE,
PEDIATRICS, NUTRITION, PHARMACY,
I'M SURE THAT LIST IS
INCOMPLETE.
WE HAD AN ANALYSIS.
IN GOING THROUGH THE FAILURE
MODES AND EFFECTS ANALYSIS ONE
OF THE PEOPLE THAT WAS
INSTRUMENT YAM WITH THAT WAS DR.
SCHOR WHO YOU HEARD MENTIONED
EARLIER TODAY, AS NEW ACTING
DEPUTY DIRECTOR FOR INTRAMURAL
RESEARCH.
THIS IS A NEURODEGENERATIVE
CONDITION.
SHE'S VERY FAMILIAR.
NUMBER TWO, SHE RAN A PEDIATRIC
SPECIALTY HOSPITAL, HAVING HER
ON THE BOARD, ON THE GROUP THAT
WAS DOING THIS EVALUATION, WAS
EXTREMELY IMPORTANT.
AND WE DID A LOT OF TRAINING, A
LOT OF CLASSROOM TRAINING,
SIMULATION TRAINING, WHEN WE
TOOK CARE OF THE TWO LITTLE
GIRLS, ONE FROM POLAND, ONE FROM
CANADA, WE EXPERIENCED ALMOST
EVERY CONTINGENCY THAT WE
THOUGHT MIGHT HAVE HAPPENED AND
MANAGED TO COVER THEM AND GET
THEM BOTH THROUGH THE PROTOCOL
PRETTY WELL.
AND WE -- I THINK IT WAS A GREAT
EXERCISE, A GREAT
ACCOMPLISHMENT, SOMETHING WE
WERE PROUD OF, SOMETHING THAT
THOSE OF US IN THE CLINICAL
CENTER FEEL LIKE WE WANT TO DO
MORE OF.
BUT WE CAN ONLY DO THAT.
AND THIS IS ALSO COVERED IN THAT
STRATEGIC PLAN, CAN ONLY DO IT
IF WE CAN DO IT SAFELY.
THE PRESENCE OF PEDIATRIC
PATIENTS IN THE CLINICAL CENTER
HAS BEEN LIMITED, IN THE PAST,
FOR THE PAST SEVERAL YEARS HAVE
ONLY TAKEN CARE OF CHILDREN
OLDER THAN 3, LARGER THAT WERE
15 KILOS.
THIS SUGGESTS WE CAN DO MORE
WITH A GOOD PARTNER BUT ONLY IF
IT'S DONE SAFELY.
IT'S BEEN STUDIED BY ONE
INTRAMURAL WORKING GROUP,
ASSESSING NEAR-TERM
REQUIREMENTS, AND IT'S BEING
FURTHER EVALUATED BY SEPARATE
INTRAMURAL WORK GROUP THAT WILL
BE LED BY DR. DIANA BIANCHI,
DIRECTOR OF THE NATIONAL
INSTITUTE OF CHILD HEALTH AND
HUMAN DEVELOPMENT.
DR. DEVASKAR AGREED TO GROUP THE
GROUP TO EVALUATE THE GROUP OF
THE INTRAMURAL GROUPS, AND DR.
DEVASKAR WILL COME BACK TO THE
CLINICAL CENTER RESEARCH
HOSPITAL BOARD WITH RESULTS OF
THAT EFFORT.
WE CANNOT THANK HER ENOUGH FOR
HER WILLINGNESS TO DO THAT.
THIS IS WORK THAT LAURA LEE DID
RIGHT BEFORE SHE LEFT, AND IT
WAS A COMPARISON OF OUR 2017
CULTURE PATIENT SAFETY DATA.
AND SHE WALKED OUT OF HERE ABOUT
SIX INCHES OFF THE GROUND AFTER
LOOKING THROUGH THIS.
THE CLINICAL CENTER IMPROVED IN
EACH OF THE 12 DOMAINS.
WE EVEN SENT IT TO THE
STATISTICIANS AND THEY COULD
TELL US HOW MANY, WHERE THE
DIFFERENCES WERE STATISTICALLY
SIGNIFICANT.
YOU CAN SEE BETWEEN 2017 AND
2020 WE'LL PROBABLY DO THE
SURVEY AGAIN IN 2023, AND AHRQ
SORT OF COMPARATORS WERE ABOUT
THE SAME, BUT WE WENT UP
SIGNIFICANTLY, AND THESE ARE
JUST IN SOME OF THE AREAS.
IN 2020, GIVE AN OVERALL GRADE
ON PATIENT SAFETY.
YOU CAN SEE MOST OF US RATED
EXCELLENT OR VERY GOOD, AND YOU
CAN SEE THAT IT WAS BETTER THAN
IN 2017.
WE STARTED WITH FOUR STRATEGIC
AIMS.
HOW DID WE DO?
WE DID PRETTY WELL ON THE FIRST
ONE, THIS IS STILL THE PLACE TO
DO FIRST-IN-HUMAN CLINICAL
RESEARCH IN RARE AND REFRACTORY
DISEASES.
INCREASING USE OF THE CLINICAL
CENTER BY THE NIH INTRAMURAL
RESEARCH PROGRAM WE DIDN'T DO
THAT WELL.
I THINK THE PANDEMIC HAD TO LOT
TO DO WITH THAT BUT THERE ARE
STILL OTHER ISSUES INVOLVED AS
WELL.
WE'VE DONE PRETTY WELL IN TERMS
OF THE DEMONSTRATING THE
PROFOUND RESPECT FOR PATIENTS,
FOR PARTNERS IN CLINICAL
RESEARCH ENTERPRISE, THAT'S
GREEN.
AND THEN I GRADED THE LAST ONE
AMBER, TRYING TO FILL THE KEY
POSITIONS THAT REMAIN IN THE
CLINICAL CENTER.
I THINK THAT'S A FAIR INTERNAL
ASSESSMENT OF WHAT WE'VE BEEN
ABOUT.
I THINK WE'VE TRIED TO FOLLOW
THE PLAN.
AND I THINK THAT'S BEEN PRETTY
CHALLENGING FOR THE LAST TWO OR
THREE YEARS.
BUT I THINK WE'VE TRIED TO STAY
THE COURSE AND TO NOT JUST
MAINTAIN BUT ALSO TO DEVELOP THE
CLINICAL CENTER FOR WHAT I THINK
WILL NEED TO TAKE PLACE OVER THE
NEXT TEN YEARS AS WELL.
AND I THINK THAT'S MY LAST
SLIDE.
>> THANK YOU, JIM.
LET'S PULL THE SLIDES DOWN.
STEPHANIE?
>> HI, JIM.
HOW DID THE INFANTS DO?
>> THE GIRL FROM CANADA HAS
DIED, A BEAUTIFUL LITTLE GIRL,
HER NAME WAS LENNON, SPELLED
LIKE JOHN LENNON.
AND SHE WAS THE FIRST ONE WE
DID, AND IT DIDN'T -- THE GENE
THERAPY DID NOT SEEM TO WORK.
THE LITTLE GIRL FROM POLAND IS
EMMA.
EMMA SEEMS TO BE DOING BETTER.
EMMA HAD -- THERE WAS ANOTHER
CHILD IN THE FAMILY WHO HAD --
EMMA IS -- WHO DIED WITH
GANGLIOSIDOSIS, AND EMMA
ACHIEVED MILESTONES HER OLDER
SISTER DID NOT.
AS YOU KNOW, IT'S HARD TO KNOW.
IF THEY HAD BOTH DONE GREAT WE
WOULD BE TALKING TO DISNEY ABOUT
THE MOVIE RIGHT NOW.
AND SO IT'S NOT -- AND I THINK
THAT WE'LL HAVE -- I THINK FOR
THE OCTOBER MEETING, WE'LL
PROBABLY HAVE A MORE DETAILED
DISCUSSION ABOUT EVERYTHING WE
DID TO GET READY TO TAKE CARE OF
THE TWO LITTLE GIRLS.
I THINK THAT OCTOBER MEETING
WILL ALSO INCLUDE MORE
DISCUSSION ABOUT RESEARCH IN THE
CLINICAL CENTER.
I'VE TALKED WITH DR. GALLIN, AND
HE'S -- SO YOU HAVE A PRETTY
GOOD IDEA NOW AFTER THIS MEETING
OF WHAT OPERATIONS IN THE
CLINICAL CENTER HAS BEEN ABOUT,
I THINK IT WOULD BE GOOD TO HAVE
THE PRESENTATION FROM THE
SCIENTIFIC DIRECTOR WHO CAN TALK
ABOUT EVERYTHING THAT'S GONE ON
HERE IN THE CLINICAL CENTER.
YOU'VE HAD SOME OF THIS IN THE
PAST.
YOU HAD MARSTON LINEHAN TALKING
ABOUT THE KIDNEY CANCER AND YOU
HAD THE NOBEL PRESENTATION BY
HARVEY ALTER, BUT THERE ARE A
NUMBER OF OTHER THINGS FIRSTS
THAT HAVE TAKEN PLACE IN THE
CLINTON CAT CENTER -- CLINICAL
CENTER.
>> DR. DEVASKAR?
>> THANK YOU, PHENOMENAL
OVERVIEW AND PRESENTATION.
I'M SURE THERE ARE LESSONS
LEARNED IN TAKING CARE OF THESE
CHILDREN, IT WOULD BE WONDERFUL
IF THEY ARE MADE AVAILABLE TO
US.
THAT'S ALL.
THAT'S MY COMMENT.
>> OKAY, YEAH.
>> DAVID BAUM AND THEN WE'LL GO
TO CRAIG.
>> I BELIEVE IN GIVING CREDIT
WHERE CREDIT IS DUE, AND DR.
GILMAN, YOU DIDN'T TAKE CREDIT
FOR THE RAPID RESPONSE TEAM IN
THE LIST OF ALL OF THE TEAMS
THAT HAVE BEEN CREATED WHICH HAD
A PROFOUND POSITIVE EFFECT ON
PATIENTS IN TERMS OF THEIR STAY.
>> THE RAPID RESPONSE TEAM
EXISTED BEFORE FIVE YEARS AGO.
THE THING THAT CHANGED WAS THAT
WE -- WAS THAT ACTUALLY FAMILY
MEMBERS CAN ACTIVATE RAPID
RESPONSE TEAM.
THAT'S WHAT CHANGED ABOUT IT.
THAT WAS FOLLOWING A DISCUSSION
WITH THIS GROUP THAT HAPPENED.
THE OTHER THING NOT ON THE SLIDE
THAT I THINK IS REALLY IMPORTANT
IS WE PROVIDE PATIENTS -- WE
HAVE OPEN NOTES NOW.
WE HAVE PATIENTS.
AND FRANKLY, I PUSHED THAT,
DAVID, AFTER I WENT DOWN TO NCQA
AND SAW THE PRESENTATION
DOWNTOWN IN THE REAGAN -- AND I
FORGET THE NAME OF THE WOMAN WHO
IS SUCH A TREMENDOUS AND
THOUGHTFUL AND ARTICULATE
ADVOCATE FOR OPEN NOTES, BUT I
MEAN IT WAS -- WE HAVE OPEN
NOTES NOW, PEOPLE CAN READ THEIR
OWN RECORDS, AND HAVE ACCESS TO
THEIR RECORDS.
AND I THINK THAT IT'S -- I THINK
THAT'S BEEN A REALLY GOOD THING
TOO, IT'S NOT INCLUDED ON THE
SLIDES BUT I'M GRATEFUL THAT WE
DID THAT.
>> CRAIG AND DAVID CHEN?
>> CAN I FINISH?
>> I'M SORRY, DAVID.
>> I DID WANT TO ADD TO THE
COMMENT THAT DR. GILMAN MADE
RELATIVE TO THE INCIDENT ON
JULY, IN 2019, TO GIVE CREDIT TO
DR. JORDAN'S STAFF TO THE --
ACTUALLY TO THE WHOLE CLINICAL
CENTER STAFF, WHEN THE NETWORK
WAS DOWN THERE WAS NO ADVERSE
PATIENT IMPACT.
ALL THE MANUAL AND BACKUP
ALTERNATIVES THAT ARE DESIGNED
AND TESTED ON A REGULAR BASIS,
WHEN I CHAIRED THE ROOT CAUSE
ANALYSIS FROM THE TECHNOLOGICAL
PERSPECTIVE, WE COULDN'T FIND
ANY EVIDENCE OF ADVERSE PATIENT
REACTION.
AND THAT'S A GOOD PLUS I THINK
FOR NOTING IN THE EFFECTIVENESS
IN MAGNET TEAM DOCUMENTATION
THAT OUR BACKUP SYSTEMS ARE
TESTED AND ARE EFFECTIVE.
AND I HAVE ONE COMMENT BASED ON
ANECDOTAL I MADE, IN USING THE
CLINICAL CENTER, PROTOCOLS
DECREASED USE OF EXTENSIVE
TESTING REQUIRING IN-PERSON
LONG-TERM STAYS WHICH AFFECTS
THE CENSUS.
IT USED TO BE A LOT MORE TESTING
WAS WORKED INTO THE PROTOCOLS.
AND TO GET THE PATIENTS IN AND
HAVE THEM STAY LIKE I DID FOR A
WEEK OR TWO WEEKS AT A TIME,
THEY DON'T DO THAT ANYMORE IN
MOST OF THE PROTOCOLS THAT I'VE
READ, AS I KEEP READING THEM.
>> IT'S NOT THAT WE DON'T DO
THAT ANYMORE.
BUT IT IS LESS.
IF ALL YOU'RE IN THE HOSPITAL
FOR IS A BUNCH OF TESTS WE DON'T
DO THAT AS MUCH.
THAT PART IS ABSOLUTELY TRUE.
>> AND THERE IS ALSO THE FACT
THAT THE -- THERE ARE PEOPLE WHO
STILL BELIEVE THEIR PROTOCOLS,
THIS ISN'T TRUE, GET CHARGED
EVERY TIME THEY MAKE USE OF A
BED IN THE HOSPITAL ON AN
INPATIENT BASIS AND I THINK
THAT'S AN EDUCATION PROBLEM.
>> JIM, IT WAS A WONDERFUL
PRESENTATION.
I GET TO HEAR A LOT OF STRATEGIC
PLANNING UPDATES.
THIS IS ONE OF THE BEST I'VE
HEARD.
SO CONGRATULATIONS.
I SENSE YOU'RE A HARD GRADER
WHERE YOU GRADED AND SCORED THE
END BUT I SUSPECT YOU'VE DONE
FAR BETTER THAN YOU'RE GRADING.
MY QUESTION IS SORT OF TO ASK
ABOUT YOUR PHILOSOPHY ON HOW TO
STRIKE THE BALANCE BETWEEN
BRINGING IN OUTSIDE EXPERTISE
VERSUS INTERNAL DEVELOPMENT OF
TALENT.
ESPECIALLY FOR THE POSITIONS
THAT YOU'RE SEEKING NOW, WE'VE
SEEN SOME VERY EXCEPTIONAL
TALENT ON YOUR TEAM TODAY.
YOU BEGIN TO WONDER WHAT'S THE
JOB AFTER THIS JOB, BECAUSE THEY
ARE VERY SKILLED.
HOW DO YOU MAKE THE DECISION
WHEN YOU SHOULD PROMOTE FROM
WITHIN VERSUS SEEK TALENT FROM
OUTSIDE?
>> YEAH, IT'S -- I DON'T KNOW
THAT -- FIRST OF ALL, THERE'S NO
OPPORTUNITY TO -- THERE'S VERY
LITTLE OPPORTUNITY TO NOT ALLOW
APPLICANTS FROM WITHIN.
THERE'S-- I CAN'T THINK OF ANY
POSITION THAT WOULD BE
ADVERTISED, THAT YOU WOULD SHUT
OFF, YOU COULD EXCLUDE INTERNAL
APPLICANTS.
THERE'S -- AND THERE IS AN
INCREDIBLE AMOUNT OF TALENT
HERE.
AND IT'S -- BUT IT'S ALSO A VERY
INSULAR COMMUNITY.
AND SO IT TAKES WORK TO --
THERE'S A VERY -- AGAIN, THIS IS
ONE OF THE REASONS WHY NATIONAL
SEARCHES AT THE NIH TAKE A LONG
TIME, IS BECAUSE THERE'S A LOT
OF BEATING THE BUSHES BEFORE THE
SEARCH ACTUALLY STARTS TO TRY TO
LET PEOPLE KNOW THAT A POSITION
IS AVAILABLE, IS GOING TO BECOME
AVAILABLE, THIS IS WHERE IT'S
GOING TO BE ANNOUNCED, AND IF
YOU NEED HELP APPLYING THROUGH
USA JOBS WE'LL TRY TO HELP,
WE'LL TRY TO DO THAT.
SO, THAT'S THE WAY -- AND THAT'S
ONE OF THE COMPONENTS TO WHY IT
TAKES QUITE A WHILE HERE.
BUT THEN WHEN YOU GET TO THE END
OF THE SEARCH PROCESS AND YOU
SORT OF ARE IN THE NEGOTIATION
PART OR, YOU KNOW, THEN SOME OF
THE QUIRKS OF THE NIH ARE
UNKNOWN TO THE PEOPLE ON THE
OUTSIDE, AND, YOU KNOW, THE
CHIEF MEDICAL CENTER THING, I
WAS ALL THE WAY DOWN TO, YOU
KNOW, HAVING SOMEBODY FOR THAT
POSITION WHEN IT FELL APART AND
WE STARTED ALL OVER AGAIN.
NOW, IT TURNED OUT GREAT.
YOU'VE SEEN DR. HADIGAN.
TURNED OUT GREAT.
BUT IT'S NOT -- WE HAVE TO
OPERATE UNDER THE RULES.
IT'S NOT OUR H.R. FOLKS' FAULT.
WE OPERATE UNDER OPM RULES, AND
YET IT'S AN INTERNAL COMMUNITY.
IT'S VERY EASY TO STAYSE
COMPLETELYT IS --
YOU HAVE TO WORK HARDER FOR
THOSE OUTSIDE.
THAT'S TRUE.
I DON'T KNOW THAT I DID A GOOD
JOB ANSWERING YOUR QUESTION,
CRAIG.
IT'S ALSO WHY I THINK IT'S
REALLY IMPORTANT TO MAKE SURE
YOU'RE DEVELOPING THE TALENT
INSIDE.
THAT'S WHY I THINK THE
ADDITIONAL LEADERSHIP TRAINING
THAT WE ARE DOING, NOT JUST THE
COURSES WE DEVELOPED, BUT WE
HAVE INVESTED PROBABLY AS
HEAVILY IN THE EXISTING NIH
COURSES WHICH ARE REALLY GOOD,
AND THEY ARE NOT JUST NIH
FOCUSED, THEY ARE COURSES, WE
HAVE ONE PERSON IN RIGHT NOW
THROUGH AMERICAN UNIVERSITY, SO
I THINK IT'S REALLY IMPORTANT.
IT'S VERY EASY TO SORT OF GET
INTO A POSITION HERE AT THE NIH
AND STAY THERE FOR A VERY, VERY
LONG PERIOD OF TIME, AND WE
ARE -- WE HAVE WORKED HARD TO
TRY TO MAKE SURE THOSE PEOPLE WE
THINK WOULD BENEFIT AND REALLY
NEED SOME ADDITIONAL TRAINING TO
GET THEM TO TAKE SOME ADVANTAGE
AND WHERE NECESSARY TO GET
OUTSIDE OF THE NIH.
>> DAVID?
>> JIM, I WANT TO ECHO CRAIG'S
COMMENT, IMPRESSIVE PRESENTATION
ABOUT YOUR STRATEGIC UPDATE.
CONGRATULATIONS TO YOUR TEAM AND
YOU.
THAT TOOK A LOT OF WORK FOR
SURE.
I HAD TWO QUESTIONS.
ONE IS I SAW IN RED YOU WANTED
TO INCREASE AMOUNT OF INSTITUTE
USE OF THE CLINICAL CENTER.
>> YES.
>> IS IT BECAUSE THERE'S A
SECULAR CHANGE IN IT THE WAY
DAVID IS TALKING ABOUT OR IS
THERE SOME SORT OF FRICTION?
>> IT IS -- THERE'S A TENSION
THAT'S VERY PALPABLE BETWEEN THE
BASIC SCIENCE AND TRANSLATIONAL
RESEARCH AND CLINICAL RESEARCH.
CLINICAL RESEARCH IS MESSY,
MESSIER.
THERE'S WAY MORE OVERSIGHT AND
REGULATION.
IT'S MORE EXPENSIVE.
SO IF YOU'RE A YOUNG SCIENTIST,
MAYBE EVEN A PHYSICIAN-SCIENTIST
AT THE NIH, AND YOU'VE GOT --
YOU'RE GETTING SUPPORTED IN YOUR
RESEARCH AND EVERYTHING ELSE.
BUT THERE'S A CLOCK TICKING.
AND YOU'RE GOING TO HAVE TO SHOW
SOME RESULTS.
AND SO THE -- YOU KNOW, IT'S
EASY TO SAY, YOU KNOW, I THINK I
CAN MAKE MY TEN-YEAR MILESTONES
IN THE LABORATORY.
AND I UNDERSTAND THAT
COMPLETELY.
AND ESPECIALLY, YOU KNOW, DURING
THE CIRCUMSTANCES LIKE A
PANDEMIC WHICH INFLUENCES, YOU
KNOW, HOW PATIENTS CAN MOVE
AROUND AND EVERYTHING ELSE.
SO, IT'S -- I MEAN, THE AMOUNT
OF MONEY FOR THE INTRAMURAL
PROGRAM IS KIND OF FIXED.
THERE'S, YOU KNOW, A LOT OF
PEOPLE WATCHING WHAT PERCENTAGE
OF THE NIH BUDGET STAYS HERE,
WHAT GOES OUT.
AND THE -- AND THEN WHAT STAYS
IN, YOU KNOW, SOME COMES FROM
THE CLINICAL CENTER, SOME OF THE
REST GOES TO THE LABORATORIES.
AND THEN IT IS HOW DO I MAKE MY
MARK, MY INDEPENDENT RESEARCH
PROGRAM, HAS TO BE MY IDEAS AND
HAS TO BE INDEPENDENT, I HAVE TO
MAKE PROGRESS AND I HAVE TO GET
INTO ENOUGH OF THE RIGHT
JOURNALS, THEN I UNDERSTAND.
IT IS A TOUGH THING.
>> JIM, THAT'S A HUGE QUESTION
THAT I THINK YOU'RE GOING TO
WANT TO PURSUE AT A FUTURE
MEETING.
DAVID, IF I COULD ASK YOU TO
HOLD THAT SECOND QUESTION.
>> OKAY.
>> BECAUSE I WANT TO GIVE RUTH A
CHANCE TO JUMP IN BEFORE WE
FINISH.
THIS IS PRECISELY THE ONGOING
CONVERSATION THAT THIS BOARD'S
BEEN HAVING WITH JIM, LARRY, AND
THE TEAM.
THAT'S GOING TO BE A REAL
OPPORTUNITY.
I'M GOING TO TAKE THAT
PRIVILEGE, JIM, TO GIVE RUTH A
CHANCE TO SAY SOMETHING.
RUTH, IT'S YOUR LAST MEETING AND
WE WANT TO THANK YOU AND I'LL
TAKE ONE MINUTE TO CLOSE.
RUTH?
>> THANK YOU, LAURA.
THANKS, EVER.
ROBUST DISCUSSION.
I MUST SAY THAT I'M A LITTLE
DISAPPOINTED I WON'T BE AROUND
TO LARRY THE SEQUELAE TO THAT.
HOWEVER, I'VE ENJOYED MY TIME ON
THE ADVISORY BOARD.
I'VE LEARNED SO MUCH.
AND I AM SO PROUD OF WHAT THIS
TEAM HAS ACCOMPLISHED OVER THESE
YEARS I'VE BEEN INVOLVED.
SO I KNOW THERE'S A BRIGHT
FUTURE.
I JUST WANT TO ENCOURAGE YOU AND
THANK YOU ALL.
THANK YOU.
IT'S BEEN A PLEASURE WORKING
WITH YOU, AND WITH THE TEAM.
>> THANK YOU, RUTH.
JIM, I'M GOING TO CLOSE NOW, IF
IT'S OKAY WITH YOU, AND LARRY.
BECAUSE I WANT TO BANG THAT
GAVEL.
SO, JUST A COUPLE OF CLOSING
COMMENTS.
I THINK RUTH JUST SAID IT.
I'M SO SAD NOT TO BE ABLE TO
HEAR THIS ONGOING CONVERSATION
BECAUSE IT HAS BEEN, SOMEBODY
ASKED ME BEFORE, WHY WAS THAT
THING CALLED THE RED TEAM?
SO IT'S A TERM I HAD NOT HEARD
OF IT BEFORE, APPARENTLY IN
INDUSTRY AND NOW I THINK OFTEN
IN SECURITY AND CYBERSECURITY,
YOU BRING OUTSIDE EXPERTS IN TO
DO SOME KIND OF ASSESSMENT.
I WANT TO GO BACK AND NOTE THAT
THERE WASN'T A SAFETY ISSUE THAT
HAD ACTUALLY HAPPENED, THAT
ORIGINAL REASON THAT FRANCIS
CALLED SOME PEOPLE FROM OUTSIDE
TOGETHER WAS NOT BECAUSE
SOMETHING BAD HAD HAPPENED.
BUT IT WAS THIS IDEA MAYBE
SOMETHING BAD COULD HAPPEN.
AND SO IT WAS A DIVERSE GROUP,
INCLUDING THE THEN-CEOS OF JOHNS
HOPKINS HEALTH SYSTEM, MAYO
CLINIC, A NUMBER OF FOLKS WHO
WORKED TO COME IN AND SEE IF WE
WERE ON SITE FOR A NUMBER OF
VISITS BUT WE WERE ON THE PHONE
SEVERAL TIMES TO COME UP WITH.
THAT WAS THE CONCLUSION.
BUT IN THE SAME WAY THAT NIH
LOOKED AT EVERYTHING THROUGH THE
LENS OF RESEARCH, IF IT WOULD
ALSO LOOK THROUGH EVERYTHING
THROUGH THE SENSE OF PATIENT
SAFETY AND QUALITY, THEN IT
WOULD BE ABLE TO PREVENT BAD
THINGS FROM HAPPENING, ALSO UP
ITS GAME.
THAT WAS AN UNBELIEVABLE TOUR DE
FORCE LAID OUT OVER THE LAST
FIVE YEARS, CLEARLY.
AND I'M GOING TO TALK ABOUT, AS
JIM SAID, WE DIDN'T TALK ABOUT
THE RED TEAM REPORT AFTER THAT
BECAUSE IT WAS DISTRESSING FOR
THE TEAM.
IN FACT ONE TIME I WAS IN THE
CAFETERIA HERE, AND I THINK I
WAS WIGGED OUT BY HOW DISTRESSED
EVERYONE WAS.
TONY FAUCI CAME UP TO ME AND
SAID DON'T WORRY, EVERYBODY WILL
GET OVER IT, BUT IT'S IMPORTANT
THAT THINGS KEEP MOVING.
ONE OF THE THINGS I HAD TO GET
MOVING WAS HIRING THE CEO.
AND NOW YOU CAN SEE, AGAIN, I DO
THINGS, DAVID, TO YOUR POINT,
THAT JIM'S BEING PRETTY MODEST
ABOUT SOME OF THIS, BUT IT'S
ALSO BEEN A GREAT TEAM.
AS I'M EXITING, A THANK YOU TO
THE BOARD MEMBERS AND EXCITED
FOR ALL OF YOU JUST JOINING AND
GOING ON TO MORE THINGS.
I DO HOPE YOU'LL BE ABLE TO COME
ON CAMPUS ON A VERY REGULAR
BASIS.
NOW THAT WE'VE GOTTEN USED TO
ZOOM, IT'S INCREDIBLY EFFICIENT,
BUT THERE'S SOMETHING ABOUT
BEING HERE, THE VIBRANCY,
MEETING THE PEOPLE.
THAT'S BEEN SO WONDERFUL TO GET
TO MEET THIS INCREDIBLY TALENTED
NIH TEAM WHICH HAS CHANGED OVER
TIME, AS JIM WAS JUST TALKING
ABOUT, AS WE'VE SEEN, BUT HAS
JUST BEEN WONDERFUL TO WORK
WITH.
SO I FEEL AFTER I COME BACK FROM
ONE OF THESE MEETINGS THAT I'VE
GOT MORE WORK TO DO IN MY DAY
JOB BUT I ALSO FEEL GREAT ABOUT
BEING SOMEONE IN SCIENCE AND
SOMEONE WHO KNOWS THAT WE'RE
LUCKY TO BE IN THE UNITED STATES
WHERE WE HAVE THIS INCREDIBLE
GEM OF AN ORGANIZATION, THE NIH.
SO SPECIAL THANKS TO YOU, LARRY,
AND FRANCIS, OF COURSE TO TARA
AND, JIM, ESPECIALLY TO YOU FOR
ALL OF THIS.
SO GOOD LUCK, EVERYONE.
AND WITH THAT, CLOSING THE
MEETING.
THANKS, EVERYONE.