NIH Clinical Center

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2 The Mark O. Hatfield Clinical Research Center

Built for flexibility

Built for flexibility, the seven-story facility can easily adapt to changing research agendas. The hospital will open with 242 inpatient beds and 80 day-hospital stations, but patient rooms are large, and capacity can expand to 400 should the need arise. Patient care units on floors 1, 3, 5, and 7 alternate with floors of “interstitial” (in-between) space on floors 2, 4, and 6, which will permit rapid changes in the use of space and in air-handling systems and other infrastructure, without moving or disturbing the patients. This arrangement allows the hospital to open with 25 rooms with negative airflow (preventing air from exiting, to shield staff and other patients from exposure to highly infectious diseases such as SARS) and 30 rooms with positive airflow (blowing air out, to protect patients with severe immune deficiencies from exposure to infectious diseases).

The day-hospital stations will allow outpatients to participate in research studies — in new therapeutic approaches using gene therapy or stem cell therapy, for instance — without being admitted to an inpatient unit for overnight stays. A special pharmacy will enable the custom manufacture of small quantities of new drugs for initial evaluation in patients.

In the new center, several institutes are planning cross-institute collaboration on programs to address the problem of obesity. The plan is to address the problem at several levels, from molecular to behavioral. The goal: to generate new knowledge about the pathophysiology, prevention, and treatment of obesity and the conditions and diseases with which it is associated — especially type 2 diabetes and its complications.

The new facility will also contain a self-care unit to facilitate clinical trials of new vaccines and to allow containment studies of volunteers receiving live-virus vaccines. This reconfigured space will be designed in such a way that it can be used as a step-down unit for all institutes, when not serving as an isolation unit.

Several patient care units will support long-term studies of patients with behavioral-health diseases such as schizophrenia, depression, alcoholism, and obesity. The study and treatment of these diseases often requires longer patient stays, so these units contain special areas for dining, exercise, interaction, and group therapy — and other resources to help patients leave their homes and communities. The unique combination of special staff and facilities provides a spectacular opportunity for breakthrough observations.

To accommodate the building’s large footprint, horizontal orientation, and long distances, there are 36 elevators, to move people and materials up and down quickly. An extra-wide corridor in the basement runs around the whole building, along which small trucks pulling tugger devices can transport food and other materials.

There is space for informal gatherings throughout the new facility. Wide doors in the intensive care unit fold open so that beds and large equipment can pass through easily.
A stairway from the patient parking lobby connects to the main hospital level.
A stairway from the patient parking lobby connects to the main hospital level. Photograph:
Alan Karchmer©

Playground outside the pediatric unit.
Playground outside the pediatric unit.

Pediatric unit of Clinical Research Center.
Decor in pediatric units features cheerful colors with playful light fixtures, and child-oriented nurses’ stations.
Lingering nostalgia
Not that there aren’t regrets about leaving the Magnuson Center. “I will always have a warm place in my heart for the old building,” says Brianne Schwantes, a 24-year-old patient with osteogenesis imperfecta (brittle bone disease) who has been coming to the Clinical Center from Wisconsin since she was three months old. Brianne helped the Clinical Center’s rehabilitation department pioneer in the use of long-legged braces for children whose bones broke so easily that doctors used to recommend just letting them lie on a pillow, for safety’s sake. “That’s where I grew up. That’s where I made friends, and ran around in the playrooms and learned how to count by the numbers in the elevator. I loved the old building and knew every nook and cranny: where the fastest elevators were, and the cheapest vending machines, where the nicest nurses hung out for coffee breaks.”

And patients will be grouped differently in the new building. “In the old building so many floor units were just bursting with patients,” says Schwantes, “and everyone kind of felt at home in their own specific area. For instance, I am a 9-West girl and couldn’t dream of being any place else. Even when they tried to convince me, when I was 24, that I no longer was a child and had to move (gasp!) to 9-East. That’s just not home. It will be interesting to see how it is going to work out having all of the genetic kids, AIDS kids, cancer kids, and everyone else all together in one area. I guess time will tell.”

Schwantes does like the openness of the new hospital, “the building and gardens are beautiful, and there seem to be many beautiful places to hang out when you aren’t in appointments. The patients and families won’t feel so trapped in this new building and are going to really appreciate the open areas.”

Patient Brianne Schwantes.
Patient Brianne Schwantes, chats with Drs. Harold Varmus and Bernadine Healy, former NIH directors, and with Dr. Ruth Kirschstein, senior advisor to the NIH director, at the hospital’s dedication.

Patient Brianne Schwantes as toddler with Dr. Lynn Gerber, chief of rehabilitation medicine.
Patient Brianne Schwantes as toddler with Dr. Lynn Gerber, chief of rehabilitation medicine.
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