A Cancer Center Shines in Jordan

The King Hussein Cancer Center (KHCC) is a story of transformation and purpose- driven aspirations. And CCR's Samir Khleif, M.D., is a central reason for its success.

The KHCC treats more than 50 percent of Jordan’s cancer patients. About one quarter of its patients come from outside the country, mainly Syria, Iraq, the Palestinian Authority, Sudan, Libya, Algeria, and Yemen.

In 2002, this medical center, located in Amman, Jordan, and called the Al-Amal ("Hope") Center, had significant quality and safety problems. A large percentage of its patients did not know they had cancer. It was not even called a cancer center.

That year, the monarch, King Abdullah, asked NCI to help his country develop a high quality cancer center. Khleif—an NCI oncologist, cancer vaccine specialist, and Palestinian-American with a medical degree from the University of Jordan—moved to Amman to become KHCC's Director General and CEO.

Samir Khleif, M.D.

Today, remade at his hands and renamed for the late King Hussein, KHCC is the only comprehensive cancer center in the Middle East.

To transform the center, Khleif radically changed its culture and organization. The most important thing, he said, was implementing quality measures and building teams among the staff, thereby engendering a sense of commitment to the center's mission. "It became something of a jewel, a source of pride for the country," he said.

Khleif's leadership motivated KHCC staff to "make significant sacrifices that went beyond their own self-interest," according to a case study by Duke University researchers published in November 2007 in Globalization and Health. "There was a sense of purpose or vision-driven efforts to attend to the needs of patients and mid- and lower-level hospital staff…in an effort to rapidly raise the standard of care at KHCC."

The results, in terms of morale, performance, and outcomes, have surpassed all expectations. Staff retention is high ("They feel they are accomplishing things. They've shown they can improve healthcare," noted Khleif). KHCC residents now outrank those of top-tier American medical centers on the American College of Physicians' annual in-service exam (Jordan is one of only six countries outside of the U.S. and Canada that participate in this evaluation of resident performance). And in February 2006, KHCC received accreditation from the Joint Commission on International Accreditation (JCIA), a division of the U.S.-based Joint Commission on the Accreditation of Healthcare Organizations (JCAHO).

"We built a Western-style medical institution, introduced quality management in healthcare, and got JCIA accreditation, a very important accomplishment worldwide," Khleif said. "We established the first support groups, the first palliative care program, the first early detection unit, and the first smoking cessation clinic in the country. These actions changed the whole landscape of healthcare in the country."

Khleif returned to CCR and his laboratory in the Cancer Vaccine Branch the day after KHCC received JCIA accreditation. But his ties to Jordan remain strong. King Abdullah has asked for additional help to build a cancer and biotechnology institute. Khleif is again at the helm, traveling between Bethesda and Amman to guide the birth of a new hospital and laboratories for basic and translational research, a CCR in the desert.

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