April 2016

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Published monthly by the Office of Communications and Media Relations. News, article ideas, calendar events, letters, and photographs are welcome. Submissions may be edited.

Clinical Center News
National Institutes of Health
Building 10, 10 Center Drive
Room 6-2551,
Bethesda, MD 20892-1504
Tel: 301-594-5789
Fax: 301-402-0244

2016 ISSUES:
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Changes in records management, streamlined patient-doctor communication coming soon

The NIH Clinical Center Health Information Management Department celebrated Health Information Professionals (HIP) Week, April 3-9, 2016, and hosted educational sessions for staff on the benefits of e-faxing medical records, the upcoming launch of a Clinician Portal, future features to the Patient Portal and an updated way to schedule patients' appointments.

With ongoing education and cross-training as a top priority of the week, the department kicked off the conversation with the implementation of e-faxing consents and other documents that need to be placed in the electronic medical record system quickly. Spurred by the 2015 Health Information and Management Systems Society (HIMSS) Analytics Stage 7 certification award for the Clinical Center's leading electronic medical record system, the department is now using the e-fax for important documents such as transfusion consents, advance directives (end-of-life care), medication reconciliation (a list of all medications a patient is taking) and emergency response records, among other things. The documents are placed in a patient's electronic medical record (CRIS) for clinicians to easily access in as little as 10 minutes and within 24 hours of being sent.

During HIP week, the department also announced the launch of a pilot Clinician Portal. The portal will allow a patient at NIH to grant access to two of their non-NIH physicians to set up an account, log in and view the patient's NIH medical documentation, including radiology images. Currently, NIH sends paper copies of a patient's file via fax or mail.

In an effort to continuously streamline communication, sharing and storage of medical records, the department also announced that a new tool within CRIS now allows users to send messages back and forth to each other through Secure Health Messaging. These messages can then be attached to a medical record file. Eventually, Secure Health Messaging will also expand to the Patient Portal, allowing patients to easily communicate with their NIH healthcare team.

Denise Ford, head of the Department of Patient Relations and Recruitment Services, also spoke at a session about the new patient scheduling system. Through this modernization, clinicians are now required to place a medical order before scheduling a patients' appointment. The new scheduling system is integrated in CRIS, allowing the order to be linked to the appointment and, in real-time, update the CRIS Appointment Tab in the patient record. Previously, the 47 sites that schedule patient appointments used a third party scheduling system (Scheduling.com) in addition to their own scheduling systems. The new system allows for coordinated communication of patient schedules across the care team.

The department, formerly known as the Medical Record Department, has nearly 40 staff members who ensure that medical records are accurately documented in a timely manner, readily accessible and permit prompt retrieval of data.

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The personal side of experimental gene therapy

Ashanthi De Silva and her husband

Ashanthi De Silva, the first patient to receive gene therapy in the NIH Clinical Center, and her husband.

Just over twenty-five years ago experts at the Clinical Center, along with colleagues from the National Cancer Institute (NCI) and the National Heart Lung and Blood Institute (NHLBI), performed the first gene therapy in the U.S. On Sept. 14, 1990, a team of researchers, nurses and other dedicated staff administered the novel technique that uses genes to treat or prevent disease.

Gene therapy involves replacing a mutated gene that causes disease with a healthy copy of the gene; inactivating, or "knocking out," a mutated gene that is functioning improperly; or introducing a new gene into the body to help fight a disease.

While still considered an experimental therapy decades later, the Clinical Center celebrates the milestone of this accomplishment in helping advance the science, motivate others in the medical field to continue the research and save lives. And of course this advancement couldn't have happened without the incredible patients and families who participated in the clinical trial and are partners in research. At the age of just four-years-old, Ashanthi De Silva, was the first patient to receive gene therapy. Now, 25 years later, De Silva is "doing very well!" she said. "My husband and I will be celebrating our five-year anniversary in two weeks. Although I have experienced my fair share of hospitalizations and complications, it hasn't kept me from traveling the world, completing my education, and living a full life with friends and family."

De Silva has adenosine deaminase (ADA) deficiency, a genetic disease that is one form of severe combined immunodeficiency (SCID). Her weakened immune system left her defenseless against infections from bacteria, viruses and fungi. Doctors in the Clinical Center used a modified virus to deliver the correct ADA gene to De Silva's immune cells and to the cells of another nine-year old girl. Each girl was given repeated treatments over a period of two years.

When asked how she would describe gene therapy, De Silva said "Genes are codes of DNA that instruct our cells on how to survive and function. In the example of SCID-ADA patients, our DNA doesn't properly code for a gene that allows us to make a certain enzyme, which helps us rid our blood of toxins. This is called a genetic mutation. Gene therapy is a treatment that attempts to ‘knock out' or replace a genetic mutation in the cell's DNA with a properly functioning copy of that gene. In order to perform gene therapy, the code for the gene must be known, and scientists must have developed the proper vector to hold the corrected gene as it travels to the cell."

White blood cells, which help protect the body from infection, were taken from De Silva and the other patient through apheresis (a process that withdraws blood, separates the needed cells, and returns the remainder to the body). Under the direction of Clinical Center biologist Charles C. Carter, researchers then used the blood samples to isolate T lymphocytes, a type of white blood cell, and expose them in the laboratory to a retrovirus modified to carry the normal ADA gene. The normal genes for making adenosine deaminase were inserted into the cells. After given 4-day's time to multiply and grow, the corrected cells were then reinjected into the girls.

"People often ask [what I recall from that time] — whether or not I actually remember September 14, 1990, the first day of gene therapy," De Silva said. "When you are four-years-old you don't have much of a choice in what you're going to wear for the day, let alone whether or not you'd like to be the first in the world to receive groundbreaking medical treatment!"

"It took months before September 14, 1990 to collect my cells and watch them grow. On the day when the corrected cells were supposed to be infused back into my body, a room had been set up for press, and was filled with cameras and reporters. The doctors and my parents never took their eyes off me during the entire treatment. I was given stickers, balloons, toys, yet I never cracked a smile. It must have been a pleasure for all to work with me (ha!)."

While the pioneers of gene therapy, Dr. Michael Blaese, with NCI and Drs. Kenneth Culver, and Dr. W. French Anderson both with the NHLBI have since moved on from their work at NIH, another key team member still remains – 25 years later.

In 2015, Bonnie Sink, a clinical nurse specialist in the Blood Services Section of the Clinical Center Department of Transfusion Medicine, fondly reflected on September 1990 at her desk.

‘It was an exciting time,' Sink said as she quickly located a folder marked gene therapy from her files spilling over with newspaper clippings and journal articles from 1990. "I was a registered nurse working in the apheresis clinic and I did the collections of the cells that they were going to then insert the gene into."

"We did manual apheresis because [the girls] were so small we had to worry about the amount [of blood] you could take out, based on the size of the child. It was a lot different 25 years ago. It was very time consuming. Today most cellular collections use automated apheresis methods," Sink said. "At the time it was a big accomplishment to be trying gene therapy. Looking back the biggest thing is that these girls are now young adults and are doing well. People with that disorder really did not have a very good prospect then. But they survived and have a good quality of life."

The first gene therapy, as with all milestone that the Clinical Center creates for the health of Americans and those around the world, was created with a foundation of hope.

"In the end, it boils down to one word: hope. You have to have hope for your child's life, and this is what my parents did. They hoped for the best. It wasn't much of a choice – either try the new treatment, or wait until I fell ill with an infection I couldn't fight off," De Silva said. "I would say the award for bravery should be bestowed upon my incredibly strong parents. I am also incredibly thankful for the NIH, and the three doctors who pioneered gene therapy and gave me and countless others a chance to experience life. It's difficult to fathom the countless, frustrating hours and sleepless nights that went in to this research, and for every second of it I am completely grateful. The NIH is America's shining beacon, without a doubt. I have yet to receive more skilled and attentive health care anywhere."

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Dr. Anthony Fauci lectures on Zika Virus

Dr. Anthony Fauci speaking

Dr. Anthony Fauci provided background information on the Zika virus to a packed Masur Auditorium.

On March 18, Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) presented a lecture on the Zika Virus: Pandemic in Progress.

"We really have to stop meeting like this between Ebola and Zika," Fauci said lightheartedly to a full Masur Auditorium and to nearly 1,500 viewers watching live online. "This is a perpetual challenge of emerging and reemerging infectious diseases."

Fauci provided background information on the Zika virus, which is a single stranded enveloped RNA virus first being isolated in 1947.

"We have a lot of experience with [this type of virus]," he said. Zika is a flavivirus closely related to dengue, yellow fever, Japanese encephalitis and West Nile virus. It is predominately transmitted by a mosquito to a person.

"About 80 percent of people have no symptoms," he said. The incubation period is between 3-12 days. Symptoms are mild and last about a week. Tests that are readily available now often don't distinguish between Zika and the other types of viruses prevalent in those regions, like dengue and yellow fever. There are no current Zika treatments available but supportive therapy is given, including fluids, rest and acetaminophen.

As of March 2016, Fauci stated there are 37 countries/territories with active Zika virus transmission.
While "there's almost no mortality," Fauci said, there's been "an explosion of microcephaly cases in pregnant women's fetus who are infected during pregnancy."

Fauci then reviewed the current evidence for Zika Virus as a likely cause of microcephaly, which is a rare neurological condition which causes reduced life expectancy and abnormal neurocognitive development.

In the U.S., Fauci said there may be two types of cases of Zika Virus seen: imported cases – nearly 40 million people travel to involved regions a year, and local spread – people who never leave the country.
As of March 16, in the U.S. there have been 258 cases of travel-associated Zika and no locally transmitted cases. But, in the U.S. territories, U.S. Virgin Islands, American Samoa and Puerto Rico, travel-associated Zika cases only went up to 3 but locally acquired was up to 283 cases.

Earlier this year, Fauci noted that the Centers for Disease Control and Prevention (CDC) issued an interim travel guidance related to Zika Virus including over 40 countries. And, out of an abundance of caution, CDC recommends pregnant women consider postponing travel to the areas where transmission is ongoing.

He touched on the summer Olympics in Rio de Janeiro in August 2016 and said that the CDC will likely be making recommendations in real time depending on what's going on.

Fauci said that there are multiple candidates in the queue for a future Zika virus vaccine. A Phase I clinical trial will likely begin for the most viable vaccine candidate in September 2016.

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Former Clinical Research Training Program participant returns to NIH

Dr. Robert Allison and Dr. Harvey Alter

Dr. Robert Allison and Dr. Harvey Alter.

In 2004, Dr. Robert Allison arrived at the NIH Clinical Center as a Clinical Research Training Program (CRTP) student. Now, 12 years later, he has returned to a permanent position as deputy section chief of the Infectious Disease Section in the Department of Transfusion Medicine (DTM). Allison will focus on viral hepatitis and transfusion-transmitted infections research. He will be working closely under the chief of the section, Dr. Harvey Alter.

"I am thrilled to be back at the NIH and back home in the Department of Transfusion Medicine," Allison said. "After working in several academic centers, and for federal and international agencies before coming back to NIH, I can say that our institution is by far the best place to work. The fact that so many are still here after my departure about 10 years ago is a testament to that."

Over the past decade, the CRTP transitioned into the Medical Research Scholars Program (MRSP), which is a comprehensive, yearlong research enrichment program designed to attract the most creative, research-oriented medical, dental and veterinary students to the NIH.

From 2004 to 2005, Allison conducted research on hepatitis C virus (HCV) and enjoyed it so much that, after medical school, he came back to the Clinical Center for a two-year postdoctoral clinical research fellowship in Alter's section, with a focus on HCV and why some people with chronic HCV who are immunosuppressed (HIV/HCV) have more rapid progression of liver fibrosis, after organ transplantation.

"My CRTP research on hepatitis C virus with Dr. Alter is the primary reason why I've returned to the NIH."

Most recently, Allison served as medical epidemiologist and the focal point for hepatitis B control in the World Health Organization's Eastern Mediterranean Region for the Center for Disease Control and Prevention (CDC) Global Immunization Division in the Center for Global Health. He was also the Medical Management and Patient Safety Lead for the CDC-led Vesicular Stomatitis Virus-Ebola Virus vaccine.
Alter, who has reduced hours in ‘semi-retirement,' hopes that Allison will continue to thrive as a leader in DTM even after he has left. Allison has become like ‘family' to Alter and others in the section.

"The great part of this story is that Rob started as a CRTP/MRSP student which initiated his love affair with NIH and then induced him to return as a fellow," Alter said. "Now he is a full-time member of our department. It is this type of clinical research progression that was one of the original goals of these programs. Rob is perhaps the poster child for this program, and we have mutually and equally benefited from the concept of clinical research training for aspiring medical students."

Learn more about MRSP and similar training programs.

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Dental Clinic now has enhanced capacity for clinical care and research

Dr. Janice Lee,(seated), Laurie Brenchley, Dr. Bob Range, Dr. Pamela Gardner and Mercedes Garcia

Dr. Janice Lee, NIDCR clinical director (seated), discusses a 3-D x-ray with her team (left to right): Laurie Brenchley, Dr. Bob Range, Dr. Pamela Gardner and Mercedes Garcia. Range and Brenchley are among the newest members of the expanded dental clinical team.

In the NIH Dental Clinic, located on the first floor of the Clinical Center, a new cadre of specialists manage dental emergencies for study participants but also perform screenings for dental, oral health and craniofacial problems. The clinic, which has recently expanded its clinical talent, has also seen an increase in the number of patients seeking treatment. During a recent week, the clinic managed the care of more than 70 patients, which is nearly three times the weekly average in 2014.

"We have brought board-certified specialists onto the team so that we can offer an enhanced capacity for clinical care and clinical research," said Dr. Janice Lee, clinical director for the National Institute of Dental and Craniofacial Research (NIDCR).

In addition to offering hospital dentistry, pediatric dentistry and oral medicine specialists, the clinic has experts who can perform oral and maxillofacial surgery and diagnoseand treat periodontal disease. Because oral manifestations can be a component of a number of systemic inflammatory diseases, such as Sjögren's syndrome and rheumatoid arthritis, the NIDCR team includes two rheumatologists.

group photo of specialists in NIDCR's Sjögren's Syndrome Team

Specialists in NIDCR's Sjögren's Syndrome Team evaluate and develop treatments for people with salivary gland disorders. Top row, from left to right: Research nurse Lolita Bebris, physician assistant Margaret Beach, clinical investigator Dr. Ilias Alevizos, rheumatologist Dr. Alan Baer. Bottom row, from left to right: Principal investigator Dr. Jay Chiorini, dentist Dr. Margie Grisius, research nurse Eileen Pelayo.

"The clinic is humming and people are smiling despite being so busy," Lee said.

About 85 percent of patients are referred to the clinic from other Institutes, such as the NCI, NHLBI and NIAID. An investigator or research nurse will often refer a patient for an exam to see if there's an infection or other oral health problems as well as to receive a comprehensive evaluation and dental hygiene appointment.

Clinical investigators who refer their patients to the clinic are obtaining dental, oral and craniofacial treatment planning that they would otherwise not have access to. When clinic staff examine patients and prepare them to take part in clinical studies, the specialists sometimes discover unexpected dental, oral or craniofacial issues that have become topics of new research collaborations between the Institutes.

To request a dental consult, email pamela.gardner@nih.gov and bob.range@nih.gov.

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Young professionals, former staff volunteer in hospital

Janet Logan

NIH Clinical Center volunteer, Janet Logan.

Amongst the hustle of bustle of staff, patients and researchers in the NIH Clinical Center stands a strong workforce of volunteers who support a variety of tasks that help the hospital maintain the highest levels of patient care and clinical research.

In honor of Volunteer Week, April 10-16, 2016, the Clinical Center thanks the more than 200 volunteers who have given back roughly 12,500 hours over the past year. This is equivalent to more than six full-time employees.

Janet Logan, who worked in the NIH's National Institute of General Medical Sciences, has volunteered at the Clinical Center for 20 years. On the outpatient clinic on the 12th floor, she sits and talks with patients, restocks important informational brochures and chaperones female patients' pelvic exams when a male doctor performs them. As a two-time cancer survivor, she uses her own experience to help cancer patients better understand and cope with their diagnoses.

Ezii Umejiego

NIH Clinical Center volunteer, Ezii Umejiego.

"In 1991, I was diagnosed with breast cancer and was in a clinical trial at NIH that included undergoing surgery and chemotherapy," said Logan. "When I retired from NIH in 1996, I came back as a volunteer because it was pay-back time. I wanted to give something back to the program which had done so much for me. I can empathize with patients, instead of simply sympathizing with them."

Ezii Umejiego, a postbaccalaureate Intramural Research Training Award (IRTA) participant originally from Africa, volunteers as a patient ambassador in the Department of Perioperative Medicine. He picks up patients heading to surgery from their rooms and performs the critical task of a first check to make sure the patients he picks up are the correct patients with the correct identification. He also ensures the patients are prepared for surgery and have not eaten anything after midnight the previous evening and speaks to them and their families as they make their way to the operating room. Umejiego helps patients and their families relax during an often stressful time while also ensuring patient safety.

Gideon Wolf

NIH Clinical Center volunteer, Gideon Wolf.

"It is so amazing to see the teamwork that takes place at the NIH Clinical Center," said Umejiego. "I am the first person of many who ensures the safety of our patients, and we all work together to make sure that our patients are taken care of."

Gideon Wolf, a young professional hoping to attend medical school, enjoys volunteering in the hospital setting. Wolf, a postbaccalaureate IRTA, sits in the Phlebotomy waiting room and restocks the food and coffee cart for patients. Often, patients come very early and are not able to eat before their appointments. After their blood draws, hot coffee and sweet treats are available.

"It's very fulfilling helping patients and their families feel at home at the Clinical Center," said Wolf. "The food cart helps bring a little happiness into the hospital."

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Photon-counting CT scanner used in patients for the first time

A study participant receiving a scan in the new Photon-Counting CT scanner

A study participant receives a scan in the new Photon-Counting CT scanner in the NIH Clinical Center.

The Clinical Center at the National Institutes of Health is investigating the potential use of a new generation of a computerized tomography (CT) scanner, called a photon-counting detector CT scanner, in a clinical setting. The prototype technology is expected to replicate the image quality of conventional CT scanning, but may also provide health care specialists with an enhanced look inside the body through multi-energy imaging. Patients could receive a minimum amount of radiation, while the maximal amount of information needed would be delivered to health care providers.

Over the next five years, David Bluemke, M.D., Ph.D., chief of the Department of Radiology and Imaging Sciences, and his team will continue to develop scan protocols and image processing algorithms, which could improve screening, imaging, and treatment planning for health conditions like cancer and cardiovascular disease.

Photon CT scan image of a research subject at the NIH

Photon CT scan image of a research subject at the NIH. Greater amounts of iodine contrast are shown in brighter, yellow colors.

"The NIH Clinical Center has helped shape and share research advances and health care for decades. Now is an exciting time for us and for our study participants here in the Clinical Center as we help test and develop this CT technology so that it may one day help patients around the world and impact the health care they receive," said Dr. Bluemke.

As the world's largest hospital solely dedicated to research, the NIH Clinical Center sees thousands of patients every year, many of whom have rare and complicated illnesses. In the treatment and study of disease, surgery is often viewed as the last option. CT scanning is one way that doctors can examine the body's internal features in a non-surgical way. In collaboration and through a partnership known as a cooperative research and development agreement with the manufacturer, Siemens Healthcare, and researchers in the CT technology field, the Clinical Center is testing this technology to help the health care field optimize the scanner for clinical use across the U.S. and around the globe.

The Clinical Center is one of three sites in the world to use this technology and is the first hospital-based research setting of the device. More than 45 volunteers enrolled in a research protocol have benefited from this cutting edge equipment. Initial findings have been reported in Radiology [disclaimer].

By advancing this technology, researchers aim to improve the diagnosis that doctors can offer by increasing the resolution and contrasts available for analysis. Areas of research investigation with the new technology include:

  • Doctors can identify materials in the body with anatomic precision. A dye, or contrast, is often given to a patient so that researchers can see a selected area in more detail. Different materials in the body can be displayed in different colors for faster diagnosis and precision.
  • The new technology may be used to help identify and characterize tumors, plaques or vessels that are smaller than half a millimeter. For many patients, finding a tumor that size may make a difference in identifying if it is benign or could be cancerous.

The technology may help to more accurately identify soft tissues such as proteins, tendons or collagen which are hard to differentiate with current equipment.

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2016 Pi Day combines sweets and the sciences

Pi Day Celebration photo collage

The NIH held a Pi Day Celebration on 3.14, March 14, to increase awareness of the role quantitative sciences play in biomedical science. The day included poster sessions and networking, workshops and lecture, and a little something sweet from Eurest food services available for purchase and donation. View a recap of events.

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Leading From Within

Hospital Administrators Focus on Solutions to Improve the Hospital and Themselves

For five months, a set of the Clinical Center's professionals focused on sharpening their skills. However it wasn't clinicians or research fellows, the people involved were the hospital's administrative officers (HAOs).

Hospital Administrative Officers at the Clinical Center have a unique set of skills: they fill a special niche found throughout the federal government, but HAOs at the Clinical Center also fulfill the distinct needs of a hospital. HAOs are in each of the Clinical Center departments often serving as the overall business managers for their areas and helping make sure that internal and business operations run smoothly.

HAOs at the Clinical Center touch dozens of different responsibilities on a daily basis. These include budgeting, purchasing, ensuring qualified staff are available and managing travel. HAOs also serve as "go-to" administrative leaders in their departments: from helping to facilitate millions of dollars in equipment purchases to helping ensure that patients have a safe and pleasant stay while they're enrolled in research protocols at the hospital. The communication, coordination and long-term planning conducted by hospital administrative officers at the Clinical Center ensures that the hospital's medical teams have the resources and support they need to conduct research and treat patients.

Wanting to build on this critical role, the Office of Administrative Management (OAM) developed and implemented a program in conjunction with the Clinical Center's Office of Workforce Management and Development called the NIH Clinical Center Hospital Administrative Officer Professional Development and Standardization Program, the training opportunity focused on enhancing the technical and leadership skills administrative officers need to excel at the Clinical Center.

The program focused on "leading from within." Organizers were dedicated to tapping into the talented and experienced staff in the Clinical Center and NIH instead of relying on external consultants to lead the training effort.

"We wanted to build this project from the inside and use the in-house talent from within the Clinical Center and NIH," said Eric Cole, chief of the Office of Administrative Management. "OAM's focus is to removing obstacles to the efficient performance of routine administrative tasks which translate into an increase in the amount of time that Clinical Center departments have available for direct patient care, research, training, education and other clinical support services. The expertise and potential for team-building is lost when we rely solely on outside consultants," he added.

The training strategy built upon a mutual goal of OAM and the Office of Workforce Management and Development: focusing on internal leadership development to include supervisors, team leads, aspiring leaders and clinical managers in the process of finding solutions. The program aligns with and expands the existing CC leadership development model.

OAM looked at the challenges that their teams faces on a recurring basis, with a focus on finding the answers, not just for one individual, but for the whole team.

This search for solutions meant looking at and understanding issues that seemed to linger. After developing a list, the HAOs sat down with different programs that could help resolve long-standing questions. They worked with the Office of Financial Resources Management (who focus on managing the Clinical Center's budget); the hospital's Materials Management and Environmental Services Department (who manage medical and other supplies used in the hospital); the Office of Purchasing and Contracts (who manage the ordering and procurement process for the Clinical Center); the Clinical Center Office of Space and Facility Management (who manage how space is used in the hospital) and the NIH Office of Human Resources, Client Service Division, Branch E (who manage staffing issues, especially hiring talented staff).

This face-to-face communication was key to resolving issues and also laid a foundation for future collaboration.

"This was not a training program. It was a learning program to help clarify expectations and standardize structure and approaches," said Dan Lonnerdal, deputy chief of the Office of Administrative Management.

And the participants agreed. Anonymous comments about the training program emphasized the positive impact participants felt:

  • "I would love to see more of this type of training. I am so glad to see OAM investing in me and my career."
  • "Introducing ourselves to each other, and realizing we don't completely know each other [as well as we thought we did]."

One HAO, who was asked "What did you like most about this program?" replied:

  • "The ability to work through concepts out loud [and the ability to connect everyone on a level playing field."

For more information on the program or for ideas on how to apply a similar approach in your area, contact Eric Cole at eric.cole@nih.gov or Dan Lonnerdal at daniel.lonnerdal@nih.gov.

Key Lessons

In distilling five months of training, there were some key takeaways from the sessions.

Don't let new skills atrophy
-Get technical learning and apply it right away.

Support ongoing learning and process improvement
-It is hard to go from beginner to expert.
-Get the right people in the room to help improve processes so we can serve more patients.
-Need to be able to show value derived from the learning and time invested.

Learning partners
-Pair people up with someone from an unrelated background.
-Use a structure to connect with different experiences and knowledge.
-When building a learning program, what general goals can carry over to the future to help shift and sustain the desired culture.

Organization development
-Identify the issues.
-Collect data.
-Determine an appropriate intervention
-Continue improvement.

Achieving Strategic Goals
-Plans need to be realistic, sustainable and organization-wide.
-The goals and outcomes of the program need to be clearly defined and aligned with the strategic plan of the organization.

-If leadership sets the goal, follow up.
-Strategize on how to achieve a collective goal.

-Leaders need to model desired behavior, this builds trust and respect.

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NIH-Duke Master's Program in Clinical Research now accepting applications

Interested in obtaining a Master of Health Sciences in Clinical Research? The NIH-Duke Master's Program in Clinical Research is now accepting applications for 2016-2017. NIH staff clinicians, clinical fellows, and health professionals interested in a clinical research career are encouraged to apply. Classes are held at the NIH Clinical Center and are taught by faculty of the Duke University School of Medicine with the participation of NIH investigators. For more information, please visit the NIH-Duke Master's Program website or contact Nicole Garner at NIHDukeMastersProgram@mail.nih.gov. Deadline to apply: May 15, 2016.

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Clinical trials at NIH Clinical Center in need of participants

Researchers at NIDDK seek people with fatty liver disease to participate in a study. Scientists want to learn more about food metabolism in people with fatty liver disease. If you have been diagnosed with non-alcoholic fatty liver disease or steatohepatitis you may be interested in participating. Participants will stay 2 nights at the NIH Clinical Center. Compensation is provided. (Study #15-DK-0174)

Researchers at the National Institute on Aging (NIA) seek participants with mild cognitive impairment (MCI) or early stage Alzheimer's disease. Researchers are investigating a drug called "exendin-4"( Exenatide, trade name Byetta®.)  The study will see if the injection of the exendin-4 is safe and how it affects brain chemistry and memory in people with mild cognitive impairment or mild Alzheimer's disease. There is no cost for study-related tests or medications. (Study #10-AG-0423)

For more information on the studies above or others available, call the NIH Office of Patient Recruitment 1-866-444-2214, (TTY 1-866- 411-1010) or visit www.clinicaltrials.gov.

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2016 Federal Employee Viewpoint Survey – Great Science Begins with a Great Workplace

The annual Federal Employee Viewpoint Survey (FEVS) is an important tool that measures Federal Government employees' perceptions of the strengths and weaknesses of their respective agencies. Completely confidential, this is an opportunity for NIH Clinical Center employees to candidly share their perceptions about their work experiences, organizations, and leaders. The ultimate goal of the survey is to provide NIH and CC leadership with information to build on strengths and improve challenge areas. It is therefore crucial for NIH Clinical Center employees to provide their feedback to help the NIH community. 

The FEVS launched May 5 and will be open through June 16. Eligible employees will receive an email invitation from Federal Employee Viewpoint Survey-HE (evhe@opm.gov) containing a unique link to the survey. Employees who have not completed the survey will also receive weekly email reminders with their survey link throughout the survey open period. The survey is open to all full- and part-time permanent, non-seasonal employees, including Title 42 and Commissioned Corps employees, on-board on or before Oct. 31, 2015. 

For more information about FEVS, please visit https://www.fedview.opm.gov/. For any questions about the survey, please email NIHFEVS@mail.nih.gov.

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Upcoming Events

Most lectures will be streamed live and archived

Clinical Center Grand Rounds Lecture
Treating Hematologic Malignancies with Chimeric Antigen Receptor T Cells; Human Papilloma Virus (HPV)-Targeted T cell Therapy for Patients with HPV-Associated Cancers
April 27, 2016, 12 noon1:00 p.m.
Lipsett Amphitheater
Presented by James N. Kochenderfer, MD, NCI and Christian S. Hinrichs, MD, NCI

NIH Director's Wednesday Afternoon Lecture Series
Harnessing nature's gift: human monoclonal antibodies as therapeutics against viral and bacterial infections
April 27, 2016, 3:00 p.m.4:00 p.m.
Masur Auditorium
Presented by Man-Wah Tan, Ph.D., Genentech Inc.

NIH "Take Your Child to Work Day"
April 28, 2016, 9:00 a.m.4:00 p.m.
Bring your children in grades 1-12 and inspire them to explore career paths in science and public service at our nation's biomedical research agency. The Office of Research Services, Program and Employee Services is the primary sponsor of this year's event. Registration is required. For more information, visit: http://takeyourchildtowork.nih.gov

The National Center for Complementary and Integrative Health (NCCIH) Lecture
The annual Stephen E. Straus Distinguished Lecture in the Science of Complementary Health Therapies
Change Your Brain by Transforming Your Mind
May 3, 2016, 10 a.m.11:00 a.m.
Masur Auditorium
Presented by Richard J. Davidson, Ph.D., Waisman Center, University of Wisconsin-Madison

Clinical Center Grand Rounds Lecture (Nurses Week)
Deciphering the oral microbiome in severe aplastic anemia patients: Methods and results
May 4, 2016, 12 noon1:00 p.m.
Lipsett Amphitheater
Presented by Nancy Ames, RN, PhD, CC and Jennifer Barb, PhD, CC

Ethical Writing: Issues in Scientific Publication
Wednesday, May 4, 2016, 12 noon1:00 p.m.
NIH Library Training Room
This one-hour overview class in Building 10 introduces NIH authors to the major issues surrounding the topic of publication ethics. Citing references and use of copyrighted resources will be covered. Free and open to NIH. Presented by Cindy Clark, MSLS, NIH Library. Register online or contact Cindy Clark at 301-496-2186, clarkc@ors.od.nih.gov.

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