NIH Clinical Center: There’s No Other Hospital Like It
The 2011 recipient of the Lasker~Bloomberg Public Service Award from the Albert and Mary Lasker Foundation [disclaimer], the Clinical Center is a national resource that makes it possible to rapidly translate scientific observations and laboratory discoveries into new approaches for diagnosing, treating, and preventing disease. The NIH Clinical Center’s vision is to lead the global effort in training today's investigators and discovering tomorrow's cures.
History of medical milestones
At the NIH Clinical Center, clinical research participants—more than 480,000 since the hospital opened in 1953—are active partners in medical discovery, a partnership that has resulted in a long list of medical milestones, including development of chemotherapy for cancer; the first use of an immunotoxin to treat a malignancy (hairy cell leukemia); identification of the genes that cause kidney cancer, leading to the development of six new, targeted treatments for advanced kidney cancer; the demonstration that lithium helps depression; the first gene therapy; the first treatment of AIDS (with AZT); and the development of tests to detect AIDS/HIV and hepatitis viruses in blood, which led to a safer blood supply. Patients come from all 50 states and from around the world.
Currently, there are about 1,600 clinical research studies in progress at the NIH Clinical Center. About half are studies of the natural history of disease, especially rare diseases, which often are not studied anywhere else. What researchers learn by studying rare diseases often adds to the basic understanding of common diseases. Most other studies are clinical trials, which often are the first tests of new drugs and therapies in people. The clinical trials at the NIH Clinical Center are predominantly Phase I and Phase II, often first-in-human to test safety and efficacy.
Imagination and collaboration of specialists
Some 1,200 credentialed physicians, dentists, and PhD researchers; 620 nurses; and 450 allied health-care personnel work in patient care units and laboratories in numerous areas of clinical study. Specialists' research at the NIH Clinical Center include: musculoskeletal and skin diseases; cancer; dental and craniofacial disorders; eye disorders; heart, lung, and blood diseases; infectious diseases; medical genetics; mental health; and neurological disorders.
This plethora of expertise under one roof allows patients to see specialists in one week that it would take months, if not years, to see in other settings. The collaborative environment of the NIH Clinical Center makes it possible for investigators to make referrals for immediate testing and confer with peers across research interests to come up with the best approach for diagnosing and treating patients. The freedoms that the NIH Clinical Center affords encourage clinician-scientists to stretch their imagination and pursue the ideas that may lead to a medical discovery.
The NIH Clinical Center recognizes that a special patient population requires a special team of nurses. In 2010, Nursing and Patient Care Services completed a four-year initiative to define the specialty of clinical research nursing. In addition to providing and coordinating clinical care, clinical research nurses have a central role in assuring participant safety, ongoing maintenance of informed consent, integrity of protocol implementation, accuracy of data collection, data recording and follow up. The step to formalize their specialty led a recommitment to the principles of primary nursing and application of those principles in the current practice environment for nurses.
Support of patients and caregivers
The NIH Clinical Center sees 10,000 new research participants a year. There are two types of research participants: patient volunteers and healthy volunteers. Patient volunteers are people with specific diseases or conditions who help medical investigators learn more about their condition or test new medications, procedures, or treatments. A healthy volunteer is a person with no known significant health problems who plays a vital role in research to test a new drug, device or intervention.
Acknowledging the importance of a patient’s support system and comfort level, there are many programs in place to ease the clinical research process for both patients and their families.
Friends of Patients at the NIH [disclaimer] is a nonprofit organization that provides patients in need emotional and financial support while they receive care at the NIH. This can include shelter near the NIH during treatment, help keeping up with housing costs at home, family and caregiver travel costs back and forth to the NIH, and minor quality of life activities to reduce stress on patients.
Pediatric patients and their families stay at The Children's Inn [disclaimer], a 24-hours-a-day, seven-days-a-week, 365-days-a-year operation where kids can be kids for a while, instead of patients. Also to support children while at the NIH Clinical Center, there is a school (276 KB) teaching kindergarten through high school with a classroom and teachers who will go to the bedside.
For families and loved ones of adult patients, the Edmund J. Safra Family Lodge offers a home-like place of respite just steps away from the NIH Clinical Center, providing space for solitude, family meetings, and supportive fellowship.
Training for the next generation
Additionally, the NIH Clinical Center offers an extensive range of clinical research training to help prepare the next generation of clinician-scientists. The innovative curriculum includes courses in pharmacology, principles and practice of clinical research, and bioethics.
The NIH Clinical Center offers the Sabbatical in Clinical Research Management program for clinical investigators, health-care managers and administrators, and others who oversee clinical trials to learn about the foundational elements required to manage a clinical or translational research enterprise
Additionally, the NIH offers two programs-a collaboration between the Clinical Center, the Damon Runyon Cancer Research Foundation and the National Cancer Institute; as well as a partnership between the NIH and the Albert and Mary Lasker Foundation. These programs will bring external, early career investigators to the NIH Clinical Center for exposure to the hospital’s unique resources.
Adaptation to growing needs
The Mark O. Hatfield Clinical Research Center was opened in 2005. It was named in honor of Sen. Mark O. Hatfield of Oregon, who supported medical research throughout his congressional career. The facility houses inpatient units, day hospitals, and research labs and connects to the original Warren Grant Magnuson Clinical Center. The 870,000-square-foot Hatfield Building has 200 inpatient beds and 93 day-hospital stations. The highly flexible facility can be easily adapted to allow more inpatient beds and fewer day-hospital stations, or vice versa.
Together, the Magnuson and Hatfield Buildings form the NIH Clinical Center. They serve the dual role of providing an environment for both humane and healing patient care and the advancement of clinical science. The Clinical Center is part of the NIH's Intramural Research Scientific Program. The NIH is the medical research agency of the US government and part of the U.S. Department of Health and Human Services.