Translational Facilities Blend Research with Clinical Care
Mon, 05/05/2014 - 3:44pm
Basic research labs are being closely integrated with medical-based clinical facilities to accelerate the overall bench-to-bedside process.
Translational research is a “new” science concept intended to translate research findings in basic research to practical applications in the health, environmental and agricultural sciences, among others. The popular meaning in its most notable application—health science—is translating basic knowledge into the development of new medical treatments or meaningful health outcomes—or put more simply “bench-to-bedside.”
In the health sciences area, translational research has evolved in the past 15 years to more practically and efficiently define the transition from traditional basic research to applied research. Translational research is now a process performed by basic and clinical researchers working in multidisciplinary teams to solve problems relating to patient care. According to the National Cancer Institute’s definition, this translational continuum comprises a five-step flow of information from 1) basic science discovery to 2) early translation (Phase 1 to 2 trials) to 3) late translation (Phase 3 to 4 trials) to 4) disssemination (public disclosure) to 5) adoption.
The impact of this evolution on medical research buildings and laboratories has been to more closely integrate traditional research, animal research, imaging facilities and clinical labs within the same facility, often within sight of each other and even on the same floor. This integration is designed to encourage the cross-fertilization of ideas in new collaborative ways and minimize the possibility of a potential disconnect between bench researchers and clinical doctors. The integration of these facilities and labs is done to create efficient flows of people and materials while maximizing the utility, functionality, safety and security of each component. Obviously, there are unlimited ways in which this can be accomplished depending upon the specific research objectives, staffing and particular priorities of each facility. The following discourse identifies newly designed and constructed laboratories with strong translational capabilities.
The Albert Sherman Center at the Univ. of Massachusetts Medical School, Worcester, is a translational medicine facility that focuses on RNAi, stem cell and gene therapy research; it was built to strengthen and enhance connectivity to other facilities within the UMass Medical School Quad. The building is LEED Gold-certified and expected to operate with 25% less energy than the code-required baseline. The 477,000-ft2 nine-story facility has 255,000 ft2 of dedicated research area containing wet and dry labs, a large vivarium suite and an Integrated Center for Experiential Learning and Simulation (iCELS) for providing cross-disciplinary learning environments. iCELS comprises exam rooms for standardized patients/actors for doctors/nurses in training; simulated environments containing automated simulators as patients; and skills training labs for learning the basics of surgical and hospital ward environments.
The wet and dry labs are organized in flexible, open arrangements with movable table-based benches and overhead service panels. Fume hoods and sinks are on the perimeter of these labs, producing minimal fixed obstructions and maximum adaptability. A linear equipment room runs the length of the lab blocks (six of the nine floors), segregating the heat- and noise-generating equipment from the occupied lab space. The Center also houses a 15,000 cage rodent barrier facility for researchers.
The organization of the lab provides state-of-the-art lab spaces, and also adaptable procedure spaces that bring together departments and research groups that had been previously spread across the campus. All of this is designed to cater to both the university’s current and future lab needs.
A research neighborhood
The Research Institute at Nationwide Children’s Hospital (Research Building III, RBIII) in Columbus, Ohio, is located directly across the street from the main hospital, enabling the bench-to-bedside translational research that can make a direct impact on children’s lives. RBIII evolves NCH’s existing open lab planning strategy into a “neighborhood” concept, which integrates group workspace more tightly into the lab environment, even as it reduces the building’s overall mechanical load. Multi-story collaborative zones connect traditional wet labs to computational dry labs on adjacent floors to spur interaction and collaboration.
The research neighborhood concept in this 237,000-ft2 building has six floors above grade, a mechanical penthouse and a lower level vivarium. Each neighborhood contains clusters of lab benches for four principal investigators (PIs)—considered by NCH to be an optimal group size. Each of the clusters are surrounded by support areas, researchers’ offices, technician desks, lounges and collaborative zones. The neighborhoods were designed to be transparent to promote the highly interactive lab environment. RBIII was also submitted for LEED Gold certification.
Home for physician-scientists
The 11-story, 820,000-ft2 Advanced Health Sciences Pavilion (AHSP) at Cedars-Sinai Medical Center in Los Angeles integrates patient care, medical research and teaching in a collaborative environment. Designed to bridge the gap between discovery and patient care, the AHSP puts translational labs in close proximity to clinical settings so physician-scientists can transform medical care. The LEED Gold-certified AHSP also houses the Cedars-Sinai Heart Institute, neurosciences programs, stem cell research (Regenerative Medicine Institute), an education center with advanced simulation labs and two floors of procedural spaces. Outpatient facilities within the AHSP include waiting rooms, clinics, imaging suites and a pharmacy. There are also two cardio-catherization suites, two interventional radiology suites and six general procedure rooms. The building connects to the existing campus through the main lobby and a fifth floor skybridge.
Research labs for cardiology and neurobiology—already strong Cedars-Sinai research programs—are located together on the lab floors, supporting bench-to-bedside programs. During the design process, the designers employed building information modeling (BIM) systems to improve the design and delivery process, allowing Cedars-Sinai administration to take advantage of the integrated data to more effectively manage the facility.
Just as in RBIII, the traditional research labs in the AHSP are arranged in clusters of four to six PIs, with four of these neighborhoods on each of the 55,000-ft2 floor plates. Each neighborhood supports the research cluster and lounge areas. Meeting rooms are centrally located and shared by all groups.
The L.S. Skaggs, Jr. Pharmacy Research Building at the Univ. of Utah School of Pharmacy, Salt Lake City, is a translational research center for both the School of Pharmacy and the School of Medicine. Like most new translational research facilities, this 150,000-ft2 facility has also applied for LEED Gold certification. Its efficient use of space—64% net square footage/gross square footage—is noted for creating highly effective connections between the building’s wet and dry labs.
Here again, the Skaggs facility is based on a research neighborhood concept that fosters flexibility, innovation and growth within a easily adaptable, open-plan, plug-and-play infrastructure.
“Traditional silos that limit innovation in scientific research are a way of the past,” say Skaggs’ developers.
The Skaggs facility houses the full circle of scientific research that leads to new medicines and cures under one roof. PIs and faculty can interact in state-of-the-art laboratory environments. The Poison Control Center at Skaggs, for example, provides an external bridge that provides outreach to and gathers feedback from the public, thereby activating the Institute’s mission to bring new medicines to life.
Like most of these facilities, Skaggs integrates sustainable features into its design. It already anticipates 34% annual energy savings that amount to $7.5 million in reduced energy costs over 50 years. It also uses 56% less domestic water than a comparable building.
Location is everything
The recent renovation of the Comprehensive Cancer Center/Wallace Tumor Institute at the Univ. of Alabama at Birmingham (UAB) has resulted in a translational research facility that consolidates researchers and clinicians from more than 19 buildings into a rejuvenated home with state-of-the-art research spaces within the headquarters for the leading diagnostic and treatment group in the region, which serves a traditionally underserved population. The 150,000-ft2 facility has a redesigned laboratory floor plan that flows circulation into a single zone around a central atrium. This more efficient floor plan was appended with adaptable lab support core that are contiguous to the open laboratories to support more anticipated biology-based research. Like the Skaggs project, this project improves the net-to-gross efficiency ratio, removing redundant circulation routes.
The overall planning accommodates a range of research programs, supporting the translational research agenda of the Comprehensive Cancer Center. The planning allows co-location of like-minded research on a single floor, including cancer cell biologists, radiation biology, in vivo imaging experts, surgical neurooncologists and those involved in cancer pathology research.
The six-story facility contains a vivarium on the top floor, three levels of research laboratories, a level for administration, access to adjoining hospitals, and a lower level for clinical imaging that includes PET/CT (positron emission tomography and computed tomography) and a cyclotron. This state-of-the-art nuclear imaging facility is adjacent to the recently opened oncology treatment center. This particular cyclotron is currently the most powerful, medical-based research cyclotron of its kind in the U.S.
Adjacent to the cyclotron is a cGMP-compliant radiopharmacy suite. With an accompanying hot-cell suite, this facility can produce clinical imaging tracers for use in the Comprehensive Cancer Center and for rapid transport to adjacent UAB facilities. The location of the imaging facility is critical, as the powerful, yet short-lived isotope that the cyclotron produces allows imaging of cellular functions in tumor growth that are well beyond the mere detection capabilities of standard imaging isotopes.
The Cancer Center’s clinical imaging facility is an important component of cancer care for the southeastern region of the U.S., playing a key role in translational research efforts. With ease of access from the main floor lobby above it, the imaging facility provides space for multiple PET/CT imaging devices and expansion in the near term to PET/MRI modalities. The location of the imaging facility also permits the center to serve the UAB Hospital inpatient population through a corridor connection to patient elevators. A secondary link to the research labs and upper floor vivarium allows research use of the imaging suite through acceptable sanitation protocols.
The Gates Vascular Institute and Univ. of Buffalo Clinical Translation Research Center, Buffalo, N.Y., is a 476,000-ft2 integrated academic medical center. The facility combines the heart and vascular healthcare facilities of Kaleida Healthcare (the largest healthcare provider in western New York) with the Clinical Translational Research Center (CTRC) of the Univ. of Buffalo (UB). It also integrates a Biosciences Incubator and the Jacobs Institute of Neurobiology, both UB affiliates. The combined facility is planned to educate and attract world-class physicians and scientists who can accelerate major breakthroughs on the causes and treatments of diseases, and then spin-off new biotechnology businesses while raising the quality and speed of patient care.
The CTRC occupies the top half of the building, containing 170,000 ft2 of lab space, advanced imaging facilities, a bio-repository and clinical research center, biomedical labs, specialist research facilities for biomedical engineering, physiology and angiography and dry labs for epidemiology and biostatistics. It also houses a multi-animal, multi-environment vivarium. The concepts of flexibility, innovation and collaboration are infused throughout. Open-plan lab designs put researchers side-by-side, when traditionally they would be isolated in individual labs or silos. This new scientific workplace encourages the exchange of ideas and collaboration between researchers in different areas of inquiry.
The concept is designed to dissolve the walls between disciplines and blur the boundaries between discovery (basic research) and commercialization, while bridging geographies. New science is intended to catalyze innovation and collaboration to drive medical discovery.
The Gates Vascular Institute (GVI) contains a “hotel” comprising 62 private patient rooms arranged in four nursing pods—each capable of independent operation, but flexible enough to work together with adjacent pods over the ebb and flow of patient volume changes. This hotel concept is designed to create a more restive environment distinct from the active treatment areas. The GVI also features 59 exam rooms, five admissions offices, 16 intensive care beds and seven surgical suites, along with several patient and family amenities. The overall design of the GVI was accomplished with the help of 20 of the world’s best experts in the field, who brainstormed for several days on building, facility and lab design.
Sandwiched between the CTRC and the GVI is a collaborative core containing education and conference facilities, along with a 4,000-ft2 business incubator—which is part of the binder connecting doctors, researchers and entrepreneurs who can meet in a variety of dynamic situations to accelerate medical discoveries.