James Horsley (9/2/2008)
It may be better to have a different index as the clustered index - obviously this might hurt performance elsewhere so it would require testing and a lot more info re data - but e.g. if you could cluster on say a user identifier column in the table then the contention for the clustered index page would only be against the same user's inserts.
If you decide to do that, pick a nice low FILL FACTOR or the page splits will be even more painfull than the hot spot.
--Jeff Moden
Change is inevitable... Change for the better is not.