The Mark O. Hatfield Clinical Research Center at the National Institutes of Health in Bethesda, Maryland.

The Mark O. Hatfield Clinical Research Center at the National Institutes of Health in Bethesda, Maryland.

National Institutes of Health

NIH plans overhaul of clinical center leadership

The National Institutes of Health (NIH) is planning a leadership overhaul at its hospital after an outside review found widespread problems with patient safety.

The Washington Post reports today that NIH Director Francis Collins plans to replace the NIH Clinical Center’s 22-year director, John Gallin, with a new leadership structure similar to that found at most hospitals: a chief executive, a chief operating officer, and a chief medical officer. The changes come in response to a working group’s recommendations last month. Gallin will stay on during the transition, NIH said in a statement, adding: “NIH is deeply grateful to Dr. Gallin and his colleagues for their dedicated leadership, and will count on them over the next few months to move this effort forward with maximum energy and intensity.” 

With 240 inpatient beds, the clinical center is the largest hospital in the world devoted to research, NIH says. It specializes in rare diseases and in treating patients with life-threatening disorders.

The working group review was triggered last year by the discovery of fungal contamination in two vials from a pharmacy sterile production unit. Its report found “substantial operations issues” involving patient safety, regulatory compliance, and leadership. The hospital had lapsed into a culture in which patient safety “became subservient to research demands,” the report found. It blamed “fragmented governance” for some problems, referring to the fact that researchers working at the center report to leaders within their NIH institute, not the center’s leadership.  

Shortly before the report’s release, the agency also revealed that problems at two other NIH manufacturing facilities had led to the suspension of a brain imaging study and several trials using engineered immune cells to treat cancer.

In response, Collins announced a series of reforms, including a new compliance office and hospital board of mostly outside experts. NIH now says it will “begin a nationwide search for a physician CEO with proven experience in management of a complex inpatient and outpatient facility.” One challenge the agency’s recruitment effort may face is that salaries at NIH are well below what a hospital CEO would receive in the private sector.