Form and function

With light, nooks and meeting places, Saunders building promises to trigger collaboration and launch new era of translational research.

For the first time in almost 15 years, the faculty and staff of the University of Rochester Medical Center’s Department of Community and Preventive Medicine are working together in the same place, steps away from colleagues and collaborators, in the newly christened Saunders Research Building.

“Because we are now all together, there really is an excitement and an energy in the department that will produce major benefits,” said Susan G. Fisher, M.S., Ph.D, the department chair. “We have done tremendous work in the past 15 years, but because of this building, I expect us to be more creative and even more productive.”

The Seychelles Child Development Study group also has moved into the Saunders building from offices in the Medical Center and on Mt. Hope Avenue, ending a longstanding complaint that it often was easier to communicate with colleagues on islands in the Indian Ocean than with those in Rochester.

“We have been spread out all over the place,” said Philip W. Davidson, Ph.D., professor of pediatrics who has worked on the Seychelles study for 23 years. “Just trying to get together has been a major issue. For many reasons, the move to the Saunders building will really change and better our project.”

A dozen research programs and departments have settled in the $60-million Saunders Research Building, which immediately becomes the hub of clinical and translational medicine for the Medical Center and a network of researchers across New York state. It also is home to the Clinical and Translational Science Institute (CTSI), created in 2007 to provide researchers a comprehensive set of services, expertise and resources necessary to carry out all phases of translational research.

“Rochester has an overwhelming tradition of collaboration and collegiality,” said Thomas Pearson, M.D., Ph.D., M.P.H., director of the Institute. “That is what this building is about. The Saunders building is the physical manifestation of our commitment to team science, working with students, mentoring, cross-disciplinary work and unique partnerships.

“We have had a lot of clinical and translational science going on at the Medical Center but it has been scattered all over,” Pearson said. “We have done very well that way. Just think how we will do when a collaborator or a resource is down the hall.”

A promise fulfilled

In April, University of Rochester officials, joined by New York’s Lt. Governor and former Rochester Mayor Robert Duffy and New York State Assembly Speaker Sheldon Silver, officially opened the Medical Center’s new research building, which is dedicated to enhancing the process and cutting the time it takes to turn discoveries and new ideas into treatments and better care for patients.

ribbon-cutting at the Saunders Research Building

“While our understanding of disease and the role of behavior and the environment on health has exploded over the last several decades, the reality is that the application of this new knowledge does not happen as regularly or easily as we would like,” said Bradford C. Berk, M.D., Ph.D., the Medical Center’s chief executive officer. “This facility was created with the understanding that the future of medicine will be driven by institutions that assemble the teams and create the environment necessary to follow through on discoveries and make them relevant in terms of improving health.”

In the last 15 years, the Medical Center has made a $1-billion investment in fundamental research and, as a result, was the sixth fastest growing academic medical center in the nation between 2005 and 2010 in research funding, the Medical Center’s CEO said.

“We also have created upstate New York’s largest clinical care system,” Berk said. “Translational medicine is the bridge between the two and will have profound implications for both research growth and patient care. Our focus on translational medicine has already yielded results. Over the last five years, the Clinical and Translational Science Institute alone has been responsible for more than $90 million in new research funding.”

reception area The Saunders building is a promise fulfilled. In October 2006, the National Institutes of Health selected the Medical Center for a Clinical and Translational Science Award, one of the first 12 institutions in the nation to receive the new NIH award. The $40-million award is the largest in Medical Center history from the NIH.

In applying for the NIH award, Medical Center officials, led by David S. Guzick, M.D., Ph.D., then School of Medicine and Dentistry dean, and Pearson, emphasized the concept of an actual “academic home” for programs designed to accelerate the application of medical research. Soon after receiving the award, the University and the Medical Center committed to a building for clinical and translational science. In 2008, then-Governors Elliot Spitzer and David Paterson and the New York State Assembly proposed and ultimately approved $50 million for the project.

“For scientists who have spent most of their career at the lab bench, the process of translating their work into new therapies can be daunting,” said Mark B. Taubman, M.D., dean of the School of Medicine and Dentistry. “This building was constructed with the recognition that translational medicine is a completely different discipline and requires people with the knowledge and experience necessary to take new ideas, move them through the many stages of testing and evaluation, and bring them to the point where they will ultimately improve the lives of patients.”

About 60 percent of investigators, 60 percent of projects and more than 50 percent of total research funding at the Medical Center are clinical research projects that involve patients. The Saunders building houses a number of support services, experts in bioinformatics, human subject protection, regulatory affairs, technology transfer and trial recruitment. Research programs in cardiovascular disease, neurological disorders, cancer, pediatrics and emergency medicine, along with the Department of Community and Preventive Medicine and Department of Biostatistics and Computational Biology, have moved to Saunders as well.

“We’re happy with our balance of basic and clinical research,” Pearson said. “We think this balance is advantageous and our new building gives us another advantage.”

The building’s design maximizes exposure to daylight. Windows wrap around the upper floors. Individual offices are arranged in blocks that run perpendicular to the exterior windows, creating an open floor plan which brings more natural light into the interior of the building. The individual offices also have glass walls to allow in ambient light. The high ceilings enhance the suggestion of space.

“The Medical Center is a collegial place. People here feel comfortable trying out new ideas and collaborating. The building was designed with those concepts in mind,” Pearson said. “We could have built more classroom space. We could have boxed in more offices, but we chose not to do that. There are nooks and shared break rooms where people can meet. There are clusters of chairs in wide hallways that will inspire impromptu discussions within the groups and between the groups. We want to encourage interaction. Form follows function so this will be a great building because the form is there.”

The rewards of neighbors and space

Philip Davidson and his colleagues in the Seychelles Child Development Study group, including Gary J. Myers, M.D., professor of neurology, and Gene E. Watson, D.D.S., Ph.D. (PhD ’95), associate professor of dentistry and of environmental medicine, now track the Indian Ocean islands from a small corner of the second floor of Saunders.

stairway inside the building The group evaluates the development of children in the Seychelles and investigates whether the low levels of mercury in the fish diet can have an effect on the development of the children.

“Our study is a very good example of translational research in the flesh,” Davidson said. “The original concerns about mercury exposure in humans came from poisonings. Groups like ours put together longitudinal studies to define the risks of mercury in the diet and how they were modified by exposures to other things in a real human population.”

So far, the group has not found any adverse effects of mercury. In fact, the beneficial effects of the nutrients from the fish appear to be more significant than any negative impact from the mercury.

“We collaborate with biostatistics and epidemiology and they now are just a few steps away,” Davidson said. “The other really big advantage is the access to students, especially students in Community and Preventive Medicine’s epidemiology program. We need student person power to accelerate the progress of our project. There are many very interesting master’s and doctoral theses waiting in our data.”

The Saunders building also improves access to undergraduates from the River Campus who are interested in epidemiology.

“They all add to person power with little and no cost. This is huge for us,” Davidson said. “We have more than 25 years of data and more coming in all the time on the status of cohorts we are following. We have exquisite detail on what they eat and what they are exposed to and how they do on psychological tests and in school. There are still many questions that need to be answered. The opportunities for epidemiologists are enormous.”

Manish N. Shah, M.D., M.P.H. (M ’96, MPH ’06), associate professor of emergency medicine, is another one of the happy new tenants of the Saunders building. He gladly gave up free and easy parking at an off-campus office building to move the Emergency Medicine Research program he leads.

“We moved off-site to open space to create more beds in the Medical Center,” Shah said. “But then we could go weeks and sometimes months without seeing each other. That really affected us.”

Traumatic brain injury, the decision making of paramedics and emergency medical technicians and the quality and effectiveness of emergency care for older adults are some of the areas researchers in the group investigate.

“We are a diverse group reflecting a very diverse specialty that takes care of people from the youngest child to the oldest adult. And we are fundamentally multidisciplinary,” Shah said. “In Saunders, we are in a culture of research. There is something to be said for being able to go to seminars or to walk down the hall and chat with other researchers. These stimulate our ability to write grants and do studies. We all have had studies and papers from ideas developed out of talks in the hall.

“It will make a significant difference to be in this building, all under one roof, able to collaborate with people from other departments and able to leverage what the Clinical and Translation Science Institute can provide,” Shah said.

Gary R. Morrow, Ph.D., chief of behavioral medicine at the James P. Wilmot Cancer Center and a faculty member since 1975, also sees the rewards of space in the Saunders building.

His Cancer Control Program, a group of about 30 people, participates in hundreds of studies of side effects of cancer treatments and ways to alleviate them.

“This is the first time we will have enough space,” said Morrow. “We will have the space to properly interview patients and run studies. Our group had a large say in designing our area. They asked what we needed, what the building was supposed to do.”

Morrow also oversees a training program in clinical research.

“The new building allows proper space for junior faculty to actually run some of their work rather than borrow space,” he said.

The design of the building provides room to expand the Cancer Control Program.

“We now have space to add more people,” Morrow said. “We will be able to apply for more funding for additional projects. These are projects we would have liked to do, and probably could have arranged funding, but we would have needed more people and, before this building, we did not have room for more people. Also, we are all together, which is useful in itself.”

A room with quite a view

From her office in the Saunders building, Susan Fisher enjoys one of the best views the building offers—a sweeping look at the Medical Center, the historic original entrance to Strong Memorial Hospital, the Kornberg Research Building and even the tower of the Rush Rhees Library.

But Fisher and the 125 people in her Department of Community and Preventive Medicine relish the potential of the Saunders building even more.

“Our department, more than many other departments, needs to be collaborative,” Fisher said. “Our research is not limited to any diagnostic group or any age group so the work done in this department really needs to link with different departments in the Medical Center and the community groups.”

About half of the department’s members conduct community research. Many do classic translational research, studying bench-to-bedside and bench-to-community issues. Several department members serve as consultants to researchers through the Clinical and Translational Sciences Institute.

“We don’t want to be tucked away where we just think about what we do. For us, the Saunders building is a big deal,” Fisher said. “We will be with people with whom we already have collaborations. We can have face-to-face talks in the hall or walking up the steps. We will be much more accessible to other investigators. I expect this to lead to new ideas and new approaches. You have to hope that we not only will continue our current level of research but also, because of this new synergy, we will become even more productive.”

To Peter G. Szilagyi, M.D., M.P.H. (M ’81, R ’84, MPH ’87), professor of pediatrics, the Saunders Research Building stands as a “statement that elevates the importance of clinical and translational research.”

Almost 80 people from the Division of General Pediatrics have moved from the Medical Center to the Saunders building. They share the third floor with members of the Department of Community and Preventive Medicine with whom the division frequently collaborates.

Szilagyi and his colleagues have developed a practice-based research network of physicians from about 75 practices in the Rochester area that cares for 80 percent of the children and 30 percent of adults in Monroe County. Szilagyi plans to link researchers based in Saunders with physicians in the network to develop the best methods to bring optimal care to patients to improve health.

“I don’t think you need to look very far to see we are not the healthiest country in the world,” Szilagyi said. “We have had lots of scientific discoveries, lots of guidelines and lots of pronouncements about how to improve health yet there is this incredible gap between discoveries and actually getting better health care to people, and I mean all the people, who need it and when they need it.”

“We have had effective medications and national guidelines to manage childhood asthma for 20 years, for example. Yet we still have all these children suffering from asthma. There is this gap. Many of the things that determine our health are not in our genes and are not noted in test tubes but have to do with our lifestyle, our families, our social circumstances or the health care system. All things won’t be figured out in the basic science research lab. That is why we need to invest in this new kind of research and why we need the Saunders building.”