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Mission Bay BMT Facilities: A Wish Come True

Before the new Mission Bay hospital was built, the blood and marrow transplant (BMT) team was tasked with drawing up a "dream big" wish list — a list of innovative features and small touches that would make up the ideal BMT facility for patients, parents and staff alike. So Dr. Mort Cowan, chief of allergy, immunology and BMT at UCSF Benioff Children's Hospital San Francisco, gathered together parents, nurses and doctors for some extensive brainstorming.

To Cowan's surprise, the new BMT facility at Mission Bay has every item on their wish list. "I never thought we'd get it all because what we were asking for was a lot, but we did," says Cowan. "Our new BMT Unit is just fabulous."

Bigger Patient Rooms

BMT patients are in the hospital anywhere from four weeks up to three months, sometimes even longer. "The rooms become the kids' bedrooms, in a way," says Cowan. To make these temporary bedrooms feel less cramped and more personal, they were built much larger, with space for kids to decorate with posters, pictures and other personal items. Like all patient rooms at Mission Bay, they feature large windows with views of the gardens and green spaces outside.

Built for Parents, Too

Every patient room is built to house a parent, with a separate sleep area and a second private bathroom. "Parents have their own space, their child has their space and they each have their own bathroom," says Cowan. "Parents can sleep a little better and their child will be more supported."

Space to Get Out and Play

The BMT process temporarily wipes out patients' immune systems, making them very susceptible to all sorts of infections. Traditionally, BMT patients at this stage of treatment are confined to their hospital rooms until the immune system recovers — meaning two to four weeks of being stuck in their room. At Mission Bay, a separate play space just for BMT patients allows them to leave their rooms, play and socialize safely. "We wanted another environment — other than their room — that is safe," says Cowan.

A Safe Way to See Siblings

Previously, siblings weren't allowed in the BMT Unit for fear of bringing in infection. But BMT treatments can continue for months — a long time for brothers and sisters to go without seeing each other. At the new BMT Unit, an activity room with a windowed wall and phone allows siblings to connect face to face without fear of spreading germs. "It's a place they can go to talk to each other, and it's also another space patients can go outside of their rooms,” says Cowan.

Germ-Free Air

The hospital as a whole has 100 percent fresh air throughout the building, with no recirculation. But because of the heightened risk of infection, adding a highly efficient air filtration system was a top priority for the new BMT Unit. Special high-power fans were also installed that both move the fresh air through the air filtration system and also create higher pressure within the rooms than without — what's called positive pressure. This means that only the filtered air can enter the patients' rooms and none can enter from the hallways outside, providing even more protection from infection. "The air supply to the patients is essentially germ-free," says Cowan.

A Top-Tier Cellular Therapy Laboratory

Patients won't see the new state-of-the-art cell therapy lab at Mission Bay, but they will still benefit from it. "It's what's called a GMP (good manufacturing practice) facility, which is the highest level of cleanliness required by federal regulations for manufacturing drugs, et cetera," says Cowan. "That's not required for a BMT lab yet but may be in the future, and it's something we're including now to make it the safest lab possible."

Since BMT patients are highly susceptible to infections from any source, including the donor bone marrow stem cell graft, processing the donor cells in this GMP facility minimizes as much as possible the patients' risk of infection from the transplant itself. It also allows the lab to perform procedures that must be done in a GMP facility, such as gene therapy and isolation of highly purified cells for treating infections. The new lab will continue to process cells for other BMT programs as well as our own.

A Spot for Coffee Talk

Having a child undergo BMT is extremely stressful, and no one understands that stress better than other parents going through the same thing. During their brainstorming, Cowan and his team came up with the idea of a space for parents to gather, away from their kids but still close by, to take a breather and talk. The kitchenette on the new BMT Unit provides just that, letting parents take a break and connect without straying far from their kids. "Anything we can do to relieve parents' stress is better for everyone," says Cowan.