Project: NICOE in Bethesda, Maryland

“I want to tell my story just once” is a common sentiment, and it was a theme in the design of the National Intrepid Center of Excellence (NICOE). Located at The Walter Reed National Military Medical Center in Bethesda, Maryland, NICOE is the U.S. Department of Defense’s source for psychological health and traumatic brain injury prevention and care.  
 
The mission: to provide imaging, assessment, diagnosis and treatment for mild to moderate traumatic brain injury (TBI) and other psychological health issues suffered by wounded U.S. soldiers returning from the wars in Iraq and Afghanistan. The center combines traditional and holistic medical approaches with highly advanced technologies (next-generation diagnostic imaging technologies with virtual reality treatment and research facilities, for example).
 
Here, says Brenna Costello, the lead medical planner and architect at SmithGroup JJR, everything is patient centered. “They first go through a patient-intake clinic where they meet with all their clinical-care coordinators from various disciplines (diagnostic, physical rehabilitation, behavioral health) in a comfortable lounge setting,” says Costello.
 
The building’s layout is derived from brain analysis: left represents organization and uniformity; right creativity and flexibility. So the L-shaped wing was designed to contain clinical, research and administrative functions, while the central “drum” was planned for the public, educational and rehabilitation centers.
 
“All the different clinical disciplines are co-located in a clinical hub so that the patient can more easily move between treatment appointments, and caregivers can collaborate on treatment plans much more effectively,” says Costello, who is the Detroit-based firm’s national expert on rehabilitation design.

NICOE is a prototype for similar centers worldwide, and will serve as the primary hub of a network of satellite clinics currently in development.