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2020 Amendment to the Comprehensive Master Plan NIH Bethesda Campus January 13, 2020 Need for Projects

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2020 Amendment to the Comprehensive Master Plan NIH Bethesda Campus January 13, 2020 Need for Projects 2020 Amendment to the Comprehensive Master Plan NIH Bethesda Campus January 13, 2020 Need for Projects: Surgery, Radiology, Laboratory Medicine Addition (SRLM): The Clinical Center (CC) at the NIH leads the global effort in discovering tomorrow’s cures and training today’s investigators. It is essential that the CC has state-of-the-art patient care, treatment and diagnostic facilities that support this effort. The proposed project is focused on developing a facility that supports both NIH and new congressional medical research initiatives to improve the nation’s health and strengthen NIH’s biomedical research capacity in close proximity to the Clinical Research Center. The Ambulatory Care Research Facility (ACRF) opened in 1982 and houses the departments of Perioperative Medicine, Interventional Radiology, Radiology & Imaging Sciences and Laboratory Medicine. These departments involve some of the most advanced and technology dependent cutting- edge programs supporting NIH’s Translational Research initiatives. Since the ACRF opened, over 38 years ago, biomedical research and its supporting clinical programs have rapidly evolved, influencing the criteria for space and infrastructure systems. The rapid evolution of equipment (changing every 3-5 years) has also had a direct impact on both space requirements and the utility systems that support them. The existing facility has not kept pace with modern surgical, imaging, and clinical laboratory facility requirements. Hospital surgical suites are typically replaced every 20 years to keep up with the latest technological advancements in operating room equipment and techniques. The most recent “Building Condition Index” conducted by the NIH has the ACRF in the POOR category. Some of the major deficiencies include the following: 1. Functional space inadequacies/inefficiencies; 2. Inefficient routes of circulation; 3. Numerous limitations restricting the flexibility/adaptability to address growth and change; 4. Deficient and unreliable Infrastructure systems (major areas of concern include normal and emergency power, communication systems, heating, cooling, and ventilation) and 5. Structural problems (light steel structure) result in unacceptable vibration levels in some areas of the building. Spatial deficiencies severely impact the Operating rooms, Radiology suite, and Clinical Laboratory. Patients and staff lack sufficient support space as they undergo care and conduct treatment protocols. The distribution systems for electrical, ductwork and piping are degrading and require replacement, but this cannot be done while the space is occupied. The building’s floor-to-floor heights are deficient, by today’s utility requirements, and cannot contain the necessary utility distribution systems. A lack of utility capacity and control results in work environments that suffer from poor temperature and humidity control. These environmental factors can also negatively impact the patient samples that are being processed and tested. These deficiencies threaten to restrict the Clinical Center’s ability to maintain its pre-eminence in conducting the phases of Clinical trials essential to Translational Research and new initiatives. To further the NIH healthcare mission the NIH Clinical Center (NIH CC) has been tasked by the Advisory Committee to the Director, Long-Term Intramural Research Program Planning Working Group Report, December 12, 2014, with expanding its role as a center for development of precision medicine to diagnose and treat both rare diseases and common diseases that have been studied at the NIH for many years. In particular, NIH will pursue the goal of comprehensive phenotyping and genotyping to complement ongoing intramural and extramural genetic studies and thereby enable the development of more effective treatments. From 2008 to 2016, the NIH performed extensive analysis and studied numerous options (upwards of 11) for providing new space for the major hospital functions (Surgery, Radiology, and Laboratory Medicine). The NIH, along with specialized space planning consultants, initially considered re-location of existing operations to spaces that are currently vacant, followed by renovation of the existing facilities in place (in a round-robin renovation strategy). This option was rejected for the following reasons: • The currently available vacant spaces are not sufficient to support current operations; • Re-location to other spaces, even temporarily, would diminish the ability to serve patients even more than the current situation, and would exacerbate the inefficient routes of circulation; • Renovation of the ACRF would not resolve deficient issues related to the floor-to-ceiling height for the necessary utility systems, or the vibration associated with the light steel structure. Therefore, several options for an addition to the building were studied. The locations for the addition were all to the west of the CRC, for adjacency to the existing hospital areas (receiving, admissions, patient rooms, intensive care unit (ICU)). The final option was approved by the NIH leadership as being the most viable to maintain existing operations, while providing appropriate facilities to support the NIH mission. Utility Vault and Patient Parking garage (UVPPG): The new Utility Vault and Parking Garage, also referred to as MLP-15, and associated tasks are necessary to: ensure the reliability and long-term sustainability of the electrical power feeds to the 4.5M square foot hospital and biomedical research complex; to mitigate the security risk, personal safety risk, and liability risk associated with the existing underground parking garage and; to enable the new Surgery, Radiology and Lab Medicine Building addition (SRLM Bldg). 1) The Utility Vault will provide space for the future relocation of the primary switching station and the emergency generators feeding the entire clinical center complex (currently located in Buildings 59 and 59A, respectively). The equipment in B59/B59A is aging and will soon need replacement. During the replacement, the existing equipment must remain available to power the complex, and therefore the new equipment must be located in an alternate location, to minimize the switchover (down) time. The new vault will provide this alternate location. Additionally, the new vault will be a hardened concrete structure, designed for blast resistance, which will significantly mitigate the threat risk to this critical lifeline to the complex. 2) Currently, patient/visitor/staff parking is partially accommodated via an underground parking garage. This garage is below the ACRF tower and below surgery, radiology, and laboratory areas of the complex. Vehicles entering the garage are screened for explosives; however, the threat for terrorism still exists. Also, the existing garage has serious structural deficiencies, due to degradation of the concrete and corrosion of underlying (exposed) rebar, despite on-going maintenance. Repairs to the garage are expensive, due to patient occupancy on floors above. The concrete degradation and rebar corrosion resulted from years of salt and chemicals brought into the garage by the vehicle traffic. This condition poses a safety threat to users of the facility, and a liability threat to the government, due to the potential for falling pieces of concrete. 3) The new Utility Vault and Patient Parking Garage and associated tasks will enable the construction of the SRLM Building including: a) Electrical ductbanks to the vault from Building 63 (Pepco Substation) for future power service to SRLM; b) A portion of the parking area will be initially reserved for the SRLM Bldg construction project for contractor/PM offices and for material staging. Due to the limited space availability for staging for the major construction project, providing a closely located staging area will facilitate the project execution and thereby reduce the project bids/cost; c) Relocation of the Clinical Data Center generator, ICU generator, CO2 storage tank, and electrical duct banks that all currently fall within the footprint of the new SRLM building. Performing this work in advance will serve to provide a ‘clean’ site for the SRLM Building contractor. This will result in lower bids (due to removing the unknown/risk of the underground duct bank) and a shorter overall construction schedule (less chance of delays due to unforeseen conditions and CC power outage scheduling). Master Plan Impacts: This amendment will conform to the Planning Principles described in the 2013 NIH Bethesda Campus Comprehensive Master Plan. Street Setbacks: Exhibit 6.2.A Major Building Setbacks is revised in this amendment to show the proposed projects. The planned SLRM building façade is setback 18’ (minimum) from the road at the building corners, with deeper green areas providing an increased buffer zone, due to the stepped building footprint design. The planned UVPPG project façade is 15 ft. from Center Dr., which was the maximum that could be provided for the required building layout without removing the exterior privacy wall that is part of the historic convent (Building 64). A five-foot planting zone along the building, five-foot sidewalk, and a five- foot street tree buffer along the drive are utilized to separate the drive lane from the mass of the building, and to make the pedestrian experience more inviting. The west side of Convent Drive between Center Drive and South Drive does not have an existing sidewalk, so this planned accessible sidewalk is a needed improvement. NIH integrated a plaza
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