Warren Grant Magnuson Clinical Ce

Warren Grant Magnuson Clinical Ce

Mark O. Hatfield Clinical Research C

Mark O. Hatfield Clinical Research C

“There’s no other hospital like it!

“There’s no other hospital like it!

2004 Strategic Operating Pla

2004 Strategic Operating Pl

National Institutes of Health Clinica

National Institutes of Health Clinica
Message from the Clinical Center Director

2003 was a year of unprecede

nted change and e

xploration of innovative strategies that wil

reshape the NIH clinical research enterprise. The development of a reinvigorated 

infrastructure for clinical research directly impacts the mission and vision of the Clinical Center (CC). The NIH Director’s Blue Ribbon Panel on the Future of Intramural Clinical Research has made final recommendations regarding the intramural clinical researc

h

program’s evaluation of clinical s

cience, partnerships, training, and governanc

e. As we m

forward in response to these new challenges, it is my hope that the activities outline

d i

n th

Clinical Center’s 2004 Strategic O

perating Plan will provide effective steps in supporting t

NIH Intramural Clinical Research Program.In 2003 the emergence of SARS challenged us to make sure that our infrastructure remainsflexible for responding rapidly to public health crises. T

he A

dministration’s e

mphasis on 

shrinking the federal workforce through competitive o

utsourcing (OMB A-76) challenged 

to re-examine how to maintain and renew our human r

esources to ensure the highest qual

and produ

ctivity of staff and the highest return on the public’s investment in clinical resea

Our success in addressing these and other c

hallenges reinforces m

y confidence that we ha

the talent and commitment necessary to reach our goals for 2004.This will be an historic year. Moving into t

he new Clinical Research Center (CRC), implem

Research Information System (CRIS), and opening the E

dmond J. Safra

Family Lodge are k

every employee in the Clinical Center. Change is never easy, but these initiativ

es amplify 

clinical research. T

h

ese c

hanges will also affect our patients, volunteers, and visitors. Sus

focus will take every employee’s compassion and commitment. Our

unwavering attention 

will ensur

e a smooth transition. A few months ago a patient ma

d

e a statement about her 

should serve as our standard in partnering with our patients and

each other: “You all were 

and go the extra mile to be positive and helpf

ul. It made all the difference.”

John I. Gallin, MD
Clinical Center

Strategic Planning Framew

Vision Mission 

Annual

Goals

Strategic FrameworkOperating Plan

Core 

Processes Customer Input Environmental &

Regulatory Drivers

Annual Performance 

Evaluation St

Outcome

Targets

Organizational Performance

Long-Range

Goals

Performance 

Panel
Clinical Center Customers/Stakeholders

Customers/Stakeholders are internal or e

xte

directly affect us or who are affected by us.Analyzing customer/stakeholder expectatioquestions:• To whom are we accountable?• Do we understand the requirements for o• Who has an interest in what we do or in a • Who can influence us?• Are there a

ny “non-obvious" customers/s

options or change our pla

ns?

Core

Processes

Long-Range 

Goals

Annual

Goals

Outcome

Targets

Annual Performance

Evaluation

Customer Input Environmental &Regulatory Drivers

Clinical Center Strategic Pla

n

ning Frame

work

StrategicFramework

OperatingPlan

Vision Mission

Strategies

Performance

Panel

Organizational Performance

Custom

Stakehol

Clinical Center Customers/Stakeholders:Primary Customers Other Key Customers/

• Institutes • Employees

• Patients • Referring Physicians

• NIH Administration• Ext

ramural Investigat

• DHHS• C

ongress

• the Public
Clinical Center Vision Statement

Core

Processes

Long-Range 

Goals

Annual

Goals

Outcome

Targets

Annual Performance

Evaluation

Customer InputEnvironmental &

Regulatory Drivers

Clinical Center Strategic Pla

n

ning Frame

work

StrategicFramework

OperatingPlan

Vision Mission 

Strategies

Performance

Panel

Organizational Performance

A Vision Sta

• answers the question: 

strive to be?“

• is the leadership’s view 

concept of what the orgto do or become.

The NIH Clinical Center will serve as the nation’s premier research hospinpatient and outpatient clinical research. We will continue our rich hispractice of medicine by developing national standards and tools to advanwill use our valuable resources to support distinctive and innovative resdiseases, uphold the safest, most ethical practices of clinical research, resphealth crises, and train the next gen

eration of clinical researchers.
Clinical Center Mission Statement

A

Mission Sta

• answers the questio

fundamental purpos

• emphasizes the value

cherished by the orga

Core

Processes

Long-Range 

Goals

Annual

Goals

Outcome

Targets

Annual Performance

Evaluation

Clinical Center Strategic Pla

n

ning Frame

work

StrategicFramework

OperatingPlan

Vision Mission

Strategies

Performance

Panel

Organizational Performance

Customer InputEnvironmental &Regulatory Drivers

As the nation’s clinical research hospital, the NIH Clinical Center providenvironment for: 

•inpatient and outpatient clinical care;•clinical research, in particular the application of basic science to cl•clinical research training.

The CC achieves this mission thro

u

gh a culture of creativity, intellect, div

ethical standards.
Clinical Center Core Processes

Core Pr

• are linked activitie

primary products a

Clinical Center cust

Clinical Research Support:Provision of staff, services, and environment that support cli

nical re

Patient Care:Provision of the highest quality patient car

e to participants i

n cli

nic

Operational Managem

ent: 

Provision of resources such as personnel, budget, and capital equip

m

most cost effective and efficient manner

Core

Processes

Long-Range 

Goals

Annual

Goals

Outcome

Targets

Annual Performance

Evaluation

Clinical Center Strategic Pla

n

ning Frame

work

StrategicFramework

OperatingPlan

Vision Mission

Strategies

Performance

Panel

Organizational Performance

Customer InputEnvironmental &

Regulatory Drivers
Clinical Center Long-Range Goals

Core

Processes

Long-Range 

Goals

Annual

Goals

Outcome

Targets

Annual Performance

Evaluation

Clinical Center Strategic Pla

n

ning Frame

work

StrategicFramework

OperatingPlan

Vision Mission

Strategies

Performance

Panel

Organizational Performance

Customer InputEnvironmental &

Regulatory Drivers

Long-Rang

• define the strategic 

organization by brvision, mission, anwith action plans outcomes. 

•Support of distinctive, innovative research in multiple disciplines.•Development and application of innovative technologies.•Training of the next generation of clinical researchers.
Developing the CC Operating Plan -

Insti

Institute Planning Process

Every fall the CC Direct

or completes a series of planning meetings with individual Institutes. 

Atte

Scientific Directors, Institute Directors, and Clinical Center senior administrative and clinical staffChiefs and Clinical Center Department Heads. Following these meetings, the Clinical Center gener

areas in the intramural clinical research program. Institute leaders verify plans, review resource prsupport issues.The overall purpose of the planning process is to:

• obtain Institute plans for use of Clinical Center resources in the upcoming fiscal year and bey• review and develop new objectives for the Clinical Center strategic operating plan in alignme

Institute needs; and,

• elicit feed

b

ack from Institutes on the availability and q

uality of Clinical Center services.

CC Research Steering Committee

The Clinical Center Research Steeri

ng Com

mittee (CCRSC) consists of representatives from t

he larg

clinical activity as permanent members and rotating members from the remaining Institutes. The CDirector to provide “

user” feedback and advice relating to management policy, resource issues, and 

research at the Clinical Center.

Medical Executive Committee

The Medical Executive Committee advises the CC Director on clinical aspects of operations and devmedical care in the CC. The Medical Executive Committee meets twice monthly. The group consisInstitute a

nd other seni

or clinical a

nd a

d

ministrative represent

atives.
Developing the CC Operating Plan -

Instit

“What Are Institutes Telling Us?”

Themes from the FY 2004/2005 Clinical Center-Institute P

Institutes report a need for additional Clinical 

C

enter support in th

next two fiscal years (see following pages for additional details):

• Transitioning to the new Clinical Research Center –

Integrat

• Improving Outpatient Services

-

Outpatient Surgery

-

Clinic Redesign

• Offsite Clinical Activity• Clinical Consult Services
Transitioning to the New Clinical Research Center –

Inte

At the time of this year’s pla

nning meetings, the projected opening of the new Mark O. Ha

(CRC) was one year away. The Clinical Center, in collaboration with the Institutes, the NIthe general contractor, and an activation consultant, is leading

a robust process to activat

e 

inclu

des planning for the patient move (to occur over a weekend in early December 2004), 

teams to provide oversight for multi-Institute patient care units, orienting staff to the new new equipment and s

ystems, developing c

ommunication materials for staff and orientatio

implementing a new “concept of operations” for all aspects of patient care and support serOn opening day, the CRC will house 242 inpatient beds (including 22 beds in the intensive hospital stations. Over the past s

everal years, the CC has downsized the number of operat

costs and to “right size” the inpatient capacity for a smooth transition to the CRC. Curreninpatient average daily census of 153, which translates to an occupancy rate of 63%. Howehave emerged and patient activity is on the rise, giving indication that this occupancy rate Center actively manages peak census days that will res

ult in occupancy rates in the CRC o

78 –

8

0

%. With its state-of-the-art design 

a

nd s

p

a

cious facilities, the new CRC provides a

n 

and laboratory work, but at the same time, presents several new management c

hallenges d

Since the design of the new CRC i

n the late 1990’s, several clinical research programs have 

are currently in the startup phase. Although the hospital was designed with a flexible infrmodifications to be carried out on interstitial floors with only minimal disru

ption to the oc

clinical research programs is complicated and c

hallenging. Although the CC’s goal is to m

and pockets of capacity do exist on selected patient care units, new or expanding clinical rprese

nt themselves as requiri

ng s

cattered beds or day stations. Rather, new programs req

patient beds and a

djacent sup

port space for meeting the needs of the clinical research proc

needs for specific patient populations (e.g., patient testing, serial s

ampling, c

ooking and re

behavioral populations). Second, in the absence of a formal prioritization process for implCC works with all Institutes equally to accommodate t

heir programmatic needs. Finally, t

moratorium on renovation change orders by the Department of Health and Human Servicwas put in pla

ce i

n order to bring the construction process to closure, hinders the timely im

research programs bei

ng prese

nted by the Institutes in the planning meetings. 
Transitioning to the New Clinical Research Center –

Inte

New and Expanding ProgramsOne notable theme for an area of growth across several Institutes is in the area of behaviorneed for expande

d behavioral health activity.

In order to address the burgeoning problem of obesity in the US population, several ICs ar

collaborati

on to devel

op an improved understanding of the pathophysiology

of obesity. In 

attempt to provide a

dditional i

nsight into the prevention and treatment of obesity. The cu

problem at several levels (i.e., from the molecular level to the bedside). The goal of the nenew knowledge regardi

ng the pathophysiology, prevention and treatment of obesity and i

especially type 2 diabetes mellitus and its complications. The consortium believes these gocreating a magnet facility in the new CRC that inclu

d

es state-of-the-art laboratory, clinical 

capabilities that could support NIH-wide intramural s

cientists interested in obesity resear

foster multidisciplinary approac

hes to obesity research, inclu

ding metabolism, endocri

nol

hematolog

y, genetics and behavioral scie

n

c

es. The program would require a substantial b

clinical space in the new CRC as well as renovation of existing clinical s

pace to meet its ne

In ad

dition to the Obesity initiative, several other ICs are pla

nning to expand behavioral h

these program expansions is occurring in NIMH, especially in the

Mood and Anxiety Diso

NHGRI are also planning modest behavioral health program expansions.Two additional IC programs have requested clinical space for substantial program expansclinical aspect of its V

accine Research Center with a small outpatient facility o

n the 12th flo

asked for substantial flexible s

p

a

ce to accommodate a significa

nt expansion of the program 

the CRC to facilitate containme

nt studies for volunteers receiving live virus vaccines u

ntil 

reconfigured s

pace s

hould also be designe

d and configured to permit its use as a stepdow

serving as an isolation unit. The NCI Radiation Oncology Program has requested to be allowed to continue to operate as a Research and Development Center for its program. If implemented, this program exp

logistical issues (due to the dista

nce of the Building 10, B3 facility from the new CRC) and 

since clinical Radiation Oncology Programs will be present at two locations in the facility (and i

n the existing B3 facility). Clinical Center staff are already working with the leaders

h

Oncolog

y Program t

o delineate the details of CC support for the expanded program.
Improving Outpatient ServicesThe outpatient census has been steadily increasing and projections indicate continued growwith current and new protocols. Outpatient visits grew by 7.4% in FY 2003 and visits for t14.2% higher than last year at this time.Several Institutes commented on the need for improved utilization of the clinics, and with studies, had concerns about access to outpatient space. The Clinical Center will focus on iwith special attention to clinic redesign (access to clinic space for Institute programs and imof care for patients) and outpatient surgery.Clinic RedesignBased on the current use of the clinic space and scheduling practices, the clinic does not hathe increasing demand for clinic space. However, when the new CRC opens in December 

occupants of the Ambulatory Care Research Facility (ACRF) will relocate to the CRC. The provides the CC an opportunity to analyze the current scheduling practices, space utilizatipatient flow in the clinics. In concert with the reorganization/reallocation of clinic space, tunique opportunity to evaluate the manner in which care is provided to patients in the ouResults from recent patient and employee surveys, feedback from the Clinical Center Patiediscussions with several clinical investigators who provide care for patients in the outpatiephysical environment of the clinics as well as current care patterns and processes do not suapproach to care. For example, areas in need of improvements in the physical environmenand exit; waiting areas; hallways; exam rooms; consultation rooms; physician areas; conferradiology services; and proper eating facilities.

Outpatient SurgeryThe current Clinical Center surgical suite is the product of the 1983 consolidation of two suneurosurgery – into the Ambulatory Care Research Facility (ACRF). Twenty years ago, patwo days before their scheduled surgical procedure. This allowed ample time for completiwork-ups. Anesthetized patients were monitored in the Post Anesthesia Care Unit (PACU

routine recovery period was one to two hours due to the long acting anesthetics, sedatives 
Improving Outpatient Services (continued)

Outpatient Surgery (continued)The PACU and Anesthesia Section established a program for minor outpatient surgery (ssurgeon-administered local anesthetics without sedation) in 1984. A year later, monitored Currently, pre-operative and post-operative activities occur in the same PACU area. Pre-education are provided by surgery and anesthesia teams, but no truly standardized procefollow. The PACU staff performs both Phase I care that includes post-operative assessmeninpatients and outpatients, and Phase II care that encompasses the progression of patient including educating the patient and family about post-discharge activities for outpatientsThe PACU and outpatient clinic staffs have developed numerous workaround processes 

post-operative needs of patients in the limited space available.With advances in surgical techniques and anesthesia agents, and increased physician and surgery volume has continued to increase at the CC. During FY 2002, the Department of (DASS) performed 440 surgeries on outpatients and administered anesthesia to 152 outpathe Imaging Sciences, Cardiology or Radiation Therapy departments. Since 1988, there haoutpatient surgical procedures and a 74% increase in inpatient surgical volume, yet staff anumber of patients in the same space designed in 1983. In addition to this historical rate o

surgeons earlier this year projected approximately a 57% increase in outpatient surgeries improved. The six-bed PACU is no longer adequate for providing the expanding and div

inpatients and outpatients, and it compromises patient privacy and confidentiality. Quicksurgeries also contribute to the need for more recovery rooms per operating room. All of 

renovation of the physical space and the processes of care for outpatient surgery at the CC
Off-Site Clinical ActivityBeginning in the 1990’s, several Institutes developed new initiatives that involved ‘off-sitea variety of goals, among them: increasing access for minority and underserved patients to 

protocols, providing clinical researchers access to patients who have ‘acute diseases’ seen 

program expansions, increasing recruitment for specific clinical research protocols, and inand trainees to patients who have ‘bread-and-butter’ diseases. Several Institutes have reqactivities. For example, NIAID and NIAMS have organized highly successful HIV and rh

Cardozo community to reach out to the urban population in Washington, D.C. Several othinterest in joining NIAID and NIAMS in this clinic enterprise, including NHLBI, NIMH, Nhas organized a smoking cessation clinic in Rockville, and several other programs are conoff-site programs to supplement their existing clinical research portfolios and to increase dNIAMS is considering opening a second clinic in the Anacostia area of D.C. The Clinical Csome strategies to address the many significant regulatory, economic, and logistical issues in order to maintain the highest possible standard of care for the services it provides. Nonprograms are initiated, the CC must develop more effective strategies for capturing the acdetermining the extent of resources required for CC support of these varied activities.In FY 2004 and FY 2005 the Clinical Center will develop a data reporting mechanism to acactivity and to translate that activity to Clinical Center resource utilization.

Clinical Consult Services

Consultative services continue to be a focus for improvement activities in the Clinical Cenneed for continued improvement in access to, response by, and quality of clinical consult

Medical Executive Committee has been addressing this complex topic over the past three consult-evaluation process has been developed by a subcommittee of the Medical Executiimplemented in FY 2004. Several ICs identified deficiencies in consultative services that w

coming year. Services for which improvements will be sought in the coming year includegynecology, plastic surgery, vascular surgery, and a variety of pediatric subspecialty servprograms will require the concerted effort of CC leadership, the Medical Executive CommAdministrative Committee, and the ICs that have traditionally been involved in the provi
Developing the CC Operating Plan -

Pa

Patient Advisory Group

The Patient Advisory Group (PAG) was established in 1998 when a numbe

provide their perspectives on design of the new Clinical Research Center. Tto increase momentum with at least twenty patients a

nd/or family members 

meetings. These individuals represent patients who live locally,

as well as th

to participate in NIH clinical research studies. The meetings are open to an

members who would like to attend. The discussions from these meetings heand make recommendations that improve the Clinical Center’s efforts to proresearch and patient care services. Suggestions from this year’s meetings included: feedback on the newly devepacket, follow-up discussio

ns to the patient survey, plans for the Clinical C

celebration, input on the customer service and diversity outreach initiativesinvolving a dedicated patient entrance on campus, and future plans for outpPatients remain engaged in identifying improved processes for patient travthorough discussions on proposed patient-related services in the Mark O. H

Center. Excellent suggestions were received from group members on amenpreferred signage, and computerized bedside educational resources for patieparticipated in the Clinical Center 50th anniversary celebration held in July 
Developing the CC Operating Plan -

Pa

Patient Perception Survey

The Clinical Center conducted its second patient perception survey collaboration with the National Research Corporation/Picker Instisurvey were 1,379 patients –

a 62% response rate. Over 90% of C

perceived the quality of the care they received at the Clinical Centeexcellent. When compared to the national benchmarks, the Clinicaareas of respect for patient preferences, involvement of family and fsupport. The following key processes were targeted for study and the results of the survey: interdisciplinary care management, outpsurgery, and informed consent management.
Developing the CC Operating Plan –

Em

Employee Survey

The Clinical Center employee survey (total sample n=1,024) found th

at 9 out of 10 

satisfied with their jobs. There was no significant difference between employee and mareas related to job satisfactio

n. The largest predictor of job satisfaction among care 

their department to effectively meet customer/patient needs. Over 80% of all employees indicated they were usually or always treated with respe

co-workers. They similarly have trust and confidence in their co-workers. Supervis

for emplo

yee contrib

utions was the largest predictor of o

verall job satisfaction at the 

respondents said their supervisor usually valued their contribution. However, the fofurther in response to the survey: fair recognition, respect for

diversity, and opportu

into decisions. 

Customer Service Part 2: Creating A Culture of InclThe Clinical Center customer service initiative was launched in 2001. Over an 18 m

employees participated in customer service training. Since the training, many deparimprovement projects that have enhanced patient care and satisfaction. To sustain t

diversity management initiative to optimize our workforce talent and skills. A systediversity activities was completed in late 2003. Feedback from the employee and patIn early 2004, executive feedback on obstacles and issues faced by the Clinical Center The combined feedback of all employee 

g

roups will be used to develop new strategies 

inclusion.
Developing the CC Operating Plan –

A

Alignment with DHHS and NIH Goals

The goals and objectives contained within the Clinical Center’s plan were de

with Dep

artment of Health a

nd Human Servi

c

e

s (DHHS) and National Instit

and objectives: DHHS G

oals for 2003-2008:

Goal 1 Reduce the major threats to the health and well-being of Americ

Goal 2 

Enhance the ability of the Natio

n’s health c

a

r

e sy

stem t

o eff

ectiv

terrorism and other public health challenges.

Goal 3 Increase the percentage of the Nation’s children and adults w

ho 

health care and expand consumer choices.

Goal 4 

Enhance the capacity and productivity of the Nation’s health sci

Goal 5 Improve the quality of health care services.Goal 6 Improve the economic and s

ocial well-being of individuals, fami

especially those most in need.

Goal 7 Improve the stability and healthy development of our Nation’s cGoal 8 Achieve excellence in management practices.

NIH Mission & O

bjectives for FY 2004:

The NIH mission is to uncover n

ew knowledge that will lead to bet

t

e

r health 

Objective 1 Increase understandi

ng o

f nor

mal and abnormal biological 

Objective 2 Improve the prevention, diagnosis, and tre

atment of diseas

Objective 3 Promote development of a talent base of well qualified, hig

investigators capable of yielding the scientific discove

ries o

Objective 4 Secure facilities for research that are modern, effici

e

nt, and
• specify the Clinical C

strategic priorities onext year to support achievement of the l

Clinical Center 2004 Annual Goals

2004 Annual Go

Core

Processes

Long-Range 

Goals

Annual

Goals

Outcome

Targets

Annual Performance

Evaluation

Clinical Center Strategic Planning Framework

StrategicFramework

OperatingPlan

Vision Mission

Strategies

Performance

Panel

Organizational Performance

Customer InputEnvironmental &

Regulatory Drivers

Goals- Activate the Mark O. Hatfield Clinical Research Center. - Implement the Clinical Research Information System. 

- Establish a new curriculum for clinical research training.- Strengthen the infrastructure for clinical research support.- Improve outpatient services.- Implement a Clinical Center-wide cost-containment program.
Outcome Targets:

Strategies:

S

Annual Goal:Activate the Mark O. Hatfield Clinical Research Center.Leader: Maureen Gormley

Chief Operating Officer

Strategies:1) Continue active oversight of the construction/activation interface.2) Maintain involvement in planning for the A-sector science court.3) Manage the activation budget.4) Provide oversight of all activation activities.5) Expand Hospitality Services to the new NIH entrance for patients

and visitors.

6) Implement the eLearning education and website for patients.

1) Implement the core medical i2) Implement the nutrition serv3) Select a surgery system and a4) Continue the implementation 

ProtoType (under the directi

make available to other resea

5) Develop requirements for the 6) Develop requirements for an 7) Move and activate CRIS in th1) The new core medical inform

users for results retrieval, pla

clinical documentation.

2) The nutrition system will pro

foodservice and clinical nutri

3) ProtoType will be utilized by 

and by NIH IRBs to track pro

Outcome Targets:

S

Annual Goal:Implement the Clinical Research Leader: Steve Rosenfeld, MD

Chief, Department of Clin

Core

Processes

Long-Range

Goals

Annual

Goals

Outcome

Targets

Annual Performance

Evaluation

Clinical Center Strategic Planning Framework

StrategicFramework

OperatingPlan

Vision Mission

Strategies

Performance

Panel

OrganizationalPerformance

Customer InputEnvironmental &

Regulatory Drivers

Core

Processes

Long-Range

Goals

Annual

Goals

Outcome

Targets

Annual Performance

Evaluation

Clinical Center Strategic Planning Framework

StrategicFramework

OperatingPlan

Vision Mission

Strategies

Performance

Panel

OrganizationalPerformance

Customer InputEnvironmental &

Regulatory Drivers

1) Open the hospital in early December 2004.2) A-sector fully open and operational by hospital opening date.3) Activation budget comes in on target.4) Hospital opens in fully operational status (on time with all 

activation activities complete).

5) All patient volunteers and their families will have easy access to 

current information and education in the CRC through computerbased programming.

2004 Annual Goals
S

Annual Goal:Establish a new curriculum for clinical research training.Leader: Fred Ognibene, MD

Chief, Office of Clinical Research Training and Medical Education

Strategies:1) Develop draft for new curriculum in clinical research.2) Obtain approval for curriculum from the Medical Executive

Committee.

3) Request a proposal for development of curriculum tracking tool. 4) Develop and implement a communications plan, which will

involve the creation of a curriculum website and brochure with

the assistance of the Clinical Center Office of Communications. 

5) Announce the curriculum to the NIH community.

S

C or e

Processes

L ong-Range

G oals

Annua l

G oa ls

O utcome

Targets

A nnua l Perfor mance

E valuation

Clinical Cen ter S trategic Planning F rame work

Stra tegicFrame wo rk

Opera tingPla n

V ision M ission

Str ategies

Perfor mance

Panel

Orga niza tio na lPerforma nce

Customer InputEnvironmenta l &

Re gula tory Drivers

C or e

Processes

L ong-Range

G oals

Annua l

G oa ls

O utcome

Targets

A nnua l Perfor mance

E valuation

Clinical Cen ter S trategic Planning F rame work

Stra tegicFrame wo rk

Opera tingPla n

V ision M ission

Str ategies

Perfor mance

Panel

Orga niza tio na lPerforma nce

Customer InputEnvironmenta l &

Re gula tory Drivers

1) Establish a curriculum website.2) Develop and disseminate a curriculum brochure.3) Implement the curriculum tracking tool. 4) Establish baseline number of individuals fulfilling the

components and receiving certificates annually for futureassessment of program growth and performance. 

Outcome Targets:1) Develop a plan to provide physic

health initiatives.

2) Identify Clinical Center operation

health initiatives.

3) Develop resource estimates for th4) Contract arrangements for the pr

surgery consultative services will 

5) Identify biometric patient identifi

care processes.

Strategies:1) Implement trans-Institute high pr

a) Obesity initiativeb) Behavioral health initiativ

2) Assure access to critical clinical co

a) Plastic surgeryb) Vascular surgeryc) Pediatric sub-specialties

3) Continue implementation of patie

a) Provide results of initial pb) Complete end of shift surc) Implement biometric pat

Leader: David Henderson, MD

Deputy Director for Clinical C

Annual Goal:Strengthen the infrastructure for clin

2004 Annual Goals

Outcome Targets:
S

2004 Annual Goals

Leader: Clare Hastings, PhD, RN, FAAN

Chief, Nursing and Patient Care Services

Core

Processes

L ong-Range

Goals

Annual

Goals

Outcome

Targets

Annual Performance

E valuation

Clinical Center Strategic Planning F ramework

Stra tegicFramework

Opera tingPlan

Vision Mission

Strategies

Performance

Panel

Organiza tionalPerformance

Customer InputEnvironmental &

Regulatory Drivers

Core

Processes

L ong-Range

Goals

Annual

Goals

Outcome

Targets

Annual Performance

E valuation

Clinical Center Strategic Planning F ramework

Stra tegicFramework

Opera tingPlan

Vision Mission

Strategies

Performance

Panel

Organiza tionalPerformance

Customer InputEnvironmental &

Regulatory Drivers

1) Appoint a Task Force of CC senior 

approaches to reduce operating ex

a) Contractsb) Suppliesc) Operating expenses direct

Strategies: Strategies:1) Redesign Outpatient Surgery.2) Assess outpatient clinic space and patient flow activity to identify

improvements for optimizing patient access and for providing

more staff resources.

3) Develop new process for capturing and reporting offsite Institute

clinical research activity.

Leader: Lisa Lacasse

Chief Financial Officer

Annual Goal:Implement a Clinical Center-wide cos

Annual Goal: Improve outpatient services. 

Outcome Targets: Outcome Targets:1) Improved services for surgical outpatients and Principal

Investigators.

2) Improved utilization of outpatient clinic space and increased

patient satisfaction with access to clinic resources.

3) Improved accuracy and reporting of data collection of total

Institute clinical research activity.

1) Reduce the Clinical Center’s annu
Performance 

Two Levels of Asse

Core

Processes

Long-Range 

Goals

Annual

Goals

Outcome

Targets

Annual Performance

Evaluation

Clinical Center Strategic Planning Framework

StrategicFramework

OperatingPlan

Vision Mission

Strategies

Performance

Panel

Organizational Performance

Customer InputEnvironmental &

Regulatory Drivers

Annual P

Outcom

The Clinical Center’s Performance Panel is a set of measures used to assess and communicperformance. This panel will facilitate data-driven continuous improvement. Measures acomponents of the three CC core processes: clinical research, patient care, and operations. 

assess if, and how, new strategies impact core process outcomes and long-term goals. This Office of Management and Budget mandate that federal agencies provide increasing evideperformance. The measures within the performance panel are quantitative and qualitative. Targets (meanormal variation. If the measures indicate that outcomes are outside of established acceptato understand if there is a potential problem or a best practice developing. This year the Csoftware program to collect and present data from a centralized repository. This repositorexecutive leadership to review with opportunity to proactively respond.
Process Meas

Access to Clinical S

Quality of Clinical R

Services

Clinical Center Performance Panel

Clinical Research 

Support/

Patient Care

Dimensions

Inpatient & Outp

Satisfaction

Customer 

Satisfaction

Financial 

IT Support

Materials & Services I

Protocol Activ

Operational Management

Principal Investig

Satisfaction

Employee Satisfa

Workforce

Development

Employee Train

Clinical Research Ed

Workforce Manag
CC Planning and Budget Developmen

CC D

evelops Theme

s of 

Clinical Research Cha

nge

September/October Institute Planning Meetings

Timeline

CC D

epartment Heads Prepare Budget

Aligned with Themes November/December

CC Intern

al Budget Review & Draft of 

Annual Ope

rating Plan D

evel

CC Boa

Recommen

CC Research Steering 

Committee Review February/March

NIH F

u

n

ding Adviso

ry

Review Board Review 

April/Ma

y

IC Direct

o

rs Re

June

* This current p

rocess is subject to cha

nge with the new NIH govern

a

nce structu

re impl
Each year as the Clinical Center budget is developed, department heads consider ongoing costs in each of several categories of needs k

nown in the federal sector as 

‘object classes.’ For example, these categories include salaries and benefits, equipment, travel, supplies, training, and contracts. Although many of these ongoing costs (e.g., salaries and benefits, cost-of-living increases) are non-discretionary, the Clinical Center’s executivemanagement team evaluates each department’s submission at the ‘line ite

m’ level – taking a zero-based 

approach to budget development. This practice allows for evaluation of costs to identify opportunities forefficiencies and to facilitate realignment of resources to assure funding for new and expanding clinical research needs and critical management initiatives. 

Durin

g annual planning meetings with

Institutes, areas of emphasis for clinicalresearch within the intramural pro

gram

are identifie

d. The Clinical Center 

synthesizes the input and develops a thematic sum

mary of areas of change 

and growth due to new or expanding programs. This information is provide

d

to CC department heads who translate Institute research directions into resource requirements and related departmental budget nee

ds.

Hosare depareserespby tinclthe chanadverelaprogsoftwOfteand exisallowaspewith

Clinical 

Research 

Program Changes

Key Drivers to Development of CC Budget R

Hospita

Infrastruct

Require

me

Many of the drivers described in this plan impact b

udget requirements for the Clinical Center. The C

b

udget development process is organized in the context of three major categories: Commitment Base, 

Research Program Changes, and Hospital Infrastructure Req

uirements. This breakdown complies w

‘commitment base’ format req

uested by the NIH Funding Advisory Review Board and creates a fram

within which CC department heads can align requests.

Commitment

Base