Johns Hopkins Health System

Johns Hopkins Hospital
Johns Hopkins Medicine
The hospital's Bloomberg Pavilion, hosting the Johns Hopkins Children's Center
Geography
Location	1800 Orleans Street[1], Baltimore, Maryland, U.S.
Coordinates	39°17′46″N 76°35′30″W / 39.2962°N 76.5918°W / 39.2962; -76.5918
Organisation
Funding	federal and private
Type	Teaching
Affiliated university	Johns Hopkins School of Medicine
Services
Emergency department	I
Beds	1,091[2]
Helipads
Helipad	FAA LID: 0MD3 and 17MD
Number Length Surface ft m 1 rooftop (concrete) 2 rooftop (concrete)
History
Opened	1889
Links
Website	hopkinsmedicine.org
Lists	Hospitals in U.S.
Other links	Johns Hopkins Bayview Medical Center
Johns Hopkins Hospital Complex
U.S. National Register of Historic Places
Location	601 North Broadway,[4] Baltimore, Maryland, U.S.
Area	8 acres (3.2 ha)
Built	1889
Architect	Cabot & Chandler, and others
Architectural style	Queen Anne style
NRHP reference No.	75002094[3]
Added to NRHP	February 24, 1975

The Johns Hopkins Hospital (JHH) is the teaching hospital and biomedical research facility of Johns Hopkins School of Medicine in Baltimore, Maryland. Founded in 1889, Johns Hopkins Hospital and its school of medicine are considered to be the founding institutions of modern American medicine and the birthplace of numerous famed medical traditions, including rounds, residents, and house staff.^[5] Several medical specialties were founded at the hospital, including neurosurgery by Harvey Williams Cushing and Walter Dandy, cardiac surgery by Alfred Blalock,^[6] and child psychiatry by Leo Kanner.^[7][8] Johns Hopkins Children's Center which serves infants, children, teens, and young adults aged 0–21, is attached to the hospital.

Johns Hopkins Hospital is widely regarded as one of the world's greatest hospitals and medical institutions.^[9] For 21 consecutive years from 1991 to 2020, it was ranked as the best overall hospital in the United States by U.S. News & World Report. In its 2019–2020 edition, U.S. News & World Report ranked the hospital on 15 adult specialties and 10 children's specialties; the hospital came in 1st in Maryland and third nationally behind the Mayo Clinic in Rochester, Minnesota and Massachusetts General Hospital in Boston. In 2021, the hospital marked 32 consecutive years of placing in the top five hospitals in the nation.^[10]

The hospital's founding in 1889 was made possible from a philanthropic bequest of over $7 million by city merchant, banker, financier, civic leader, and philanthropist Johns Hopkins, which at the time was the largest bequest in the history of the United States. The hospital is located at 600 North Broadway in Baltimore.

History

Founding

Johns Hopkins (1795–1873), a Baltimore merchant and banker, left an estate of approximately $7 million (US$173.84 million in 2022^[11]) when he died on December 24, 1873, in his city mansion on West Saratoga Street, just west of North Charles Street, at the age of 78. In his will, he asked that his fortune be used to found two institutions that would bear his name: "Johns Hopkins University" and "The Johns Hopkins Hospital." At the time that it was made, Hopkins' gift was the largest philanthropic bequest in the history of the nation.^[12]

Toward the end of his life, Hopkins selected 12 prominent Baltimore residents as trustees for the project. A year prior to his death, he sent each a letter telling them that he was giving "thirteen acres of land, situated in the city of Baltimore, and bounded by Broadway, Wolfe, Monument, and Jefferson streets upon which I desire you to erect a hospital." He wished for a hospital that "shall, in construction and arrangement, compare favorably with any other institution of like character in this country or in Europe" and directed his trustees to "secure for the service of the Hospital, physicians and surgeons of the highest character and greatest skill."^[12]

Hopkins instructed the trustees to "bear constantly in mind that it is my wish and purpose that the hospital shall ultimately form a part of the Medical School of that university for which I have made ample provision in my will." By calling for this integral relationship between patient care, as embodied in the hospital, and teaching and research, as embodied in the university, Hopkins laid the groundwork for a revolution in American medicine. Johns Hopkins' vision, of two institutions in which the practice of medicine would be wedded to medical research and medical education was revolutionary.

19th century

Initial plans for the hospital were drafted by surgeon John Shaw Billings, and the architecture designed by John Rudolph Niernsee and completed by Edward Clarke Cabot of the Boston firm of Cabot and Chandler in a Queen Anne style.^[13] When completed in 1889 at a cost of $2,050,000 (US$50.8 million in 2022^[11]), the hospital included what was then state-of-the-art concepts in heating and ventilation to check the spread of disease.

The trustees obtained the services of four outstanding physicians, known as the "Big Four," to serve as the founding staff of the hospital when it opened on May 7, 1889. They were pathologist William Henry Welch, surgeon William Stewart Halsted, internist William Osler, and gynecologist Howard Atwood Kelly.^[14]

In 1893, Johns Hopkins University was one of the first medical schools to admit women.^[15] The decision to begin coeducation was a result of a shortage of funds, as the Baltimore and Ohio Railroad stock that was supposed to cover cost was used up in building the hospital in 1889 and the medical school had not yet been built. Four of the original trustees' daughters offered to raise the money needed to open the school, but only if the school agreed to admit qualified women to the university. After several discussions, the trustees agreed to their terms and accepted the financial help of these four women with only one of the doctors, William H. Welch, resisting. Eventually, even Welch changed his views on coeducation, "The necessity for coeducation in some form," he wrote later, "becomes more evident the higher the character of the education. In no form of education is this more evident than in that of medicine ... we regard coeducation a success; those of us who were not enthusiastic at the beginning are now sympathetic and friendly."^[16]

Osler, the first chief of the Department of Medicine, is credited with originating the idea of a residency, in which recently graduated physicians receive advanced training in their specialty while treating patients under supervision; then, as now, residents comprise most of the medical staff of the hospital. He also introduced the idea of bringing medical students into actual patient care early in their training; at the time medical school consisted almost entirely of lectures. Osler's contribution to practical education extends to the creation of "grand rounds", the practice of leading physicians discussing the most difficult cases in front of assembled medical students, for the benefit of patients and students.^[17] The term “rounds” derives from the circular ward where bedside teaching occurred.^[18] He once said he hoped his tombstone would say only, "He brought medical students into the wards for bedside teaching."^[14]

Halsted, the first chief of the Department of Surgery, established many other medical and surgical achievements at Johns Hopkins including modern surgical principles of control of bleeding, accurate anatomical dissection, complete sterility, and the first radical mastectomy for breast cancer (before this time, such a diagnosis was a virtual death sentence). His other achievements included the introduction of the surgical glove and advances in thyroid, biliary tree, hernia, intestinal and arterial aneurysm surgeries. Halsted also established the first formal surgical residency training program in the United States.

Kelly is credited with establishing gynecology as a true medical specialty. He created new surgical approaches to women's diseases and invented numerous medical devices, including a urinary cystoscope. He was one of the first to use radium to treat cancer.^[14]

Welch was responsible for training many of the outstanding physicians of the day, such as Walter Reed. He also founded at Hopkins the nation's first Public Health school, now known as the Johns Hopkins Bloomberg School of Public Health.^[14]

A notable sight at the hospital is the marble statue Christus, a Carrara marble statue in the Billings Administration Building rotunda of the resurrected Jesus based on the 1833 original by Bertel Thorvaldsen, which was a gift by Baltimore merchant William Wallace Spence; it is a replica of the original by Danish sculptor Bertel Thorwaldsen in Copenhagen. Unveiled in 1896, the statue brings comfort to many, the hospital has said.^[19][20]

20th century

In 1903, Harriet Lane Johnston left a sum of over $400,000 at her death in 1903 to establish the Harriet Lane Home for Invalid Children as a memorial to two sons who had died in childhood. In October 1912 the Harriet Lane Home officially opened. It was the first children's clinic in the United States that was associated with a medical school, first run by John Howland. Eventually treating over 60,000 children a year, the Harriet Lane Home became a pioneer treatment, teaching, and research clinic, and the first to have subspecialties in pediatrics as created by Edwards A. Park.

In 1912, Diamond Jim Brady donated $220,000 to the hospital, which created the James Buchanan Brady Urological Institute.^[21] Ophthalmologist William Holland Wilmer opened the Wilmer Eye Institute at the hospital in 1925, and its building was completed four years later. Wilmer received a medical degree from the University of Virginia School of Medicine in 1885 and later worked in New York City, Washington D.C., and Baltimore, where he established the institute.^[22]

Between 1930 and 1963, Helen B. Taussig, who helped to develop the blue baby operation, headed the pediatric cardiac clinic. Child psychiatrist Leo Kanner did studies of autistic children. Lawson Wilkins established an endocrine clinic that developed procedures used universally to treat children with certain glandular disorders, including dwarfism. John E. Bordley and William G. Hardy made strides in detecting hearing impairments in very young children.^[23]

Achievements

Medical achievements at Johns Hopkins include the first male-to-female sex reassignment surgery in the United States that took place in 1966 at the Hopkins Gender Identity Clinic.^[24]

Two of the most far-reaching advances in medicine during the last 25 years were also made at Hopkins. First, the Nobel Prize-winning discovery of restriction enzymes gave birth to the genetic engineering industry. Second, the discovery of the brain's natural opiates has triggered an explosion of interest in neurotransmitter pathways and functions. Other accomplishments of the hospital include the development of HeLa by George Otto Gey, head of tissue culture research in 1951,^[25] the first and arguably most important line of human cells grown in culture, identification of the three types of polio virus, and the first "blue baby" operation, which was done by surgeon Alfred Blalock in collaboration with Helen Taussig, a Hopkins graduate specializing in pediatric cardiology and surgical technician Vivien Thomas that opened the way to modern cardiac surgery.^[16][26]

Contributions to heart surgery were brought on by the discovery of heparin and the Blalock-Thomas-Taussig Shunt.^[27] Johns Hopkins has also published The Harriet Lane Handbook, an indispensable tool for pediatricians, for over 60 years.

Operations

The hospital occupies approximately 20 of the 60 buildings on the Johns Hopkins Medical Campus. The complex has over 80 entrances and receives 80,000 visitors weekly. It houses over 1,000 beds and has a staff of over 1,700 doctors with over 30,000 total employees.^[28]

From 1982 to 1992, then CEO Robert Heyssel established the hospital's first Oncology Center, the Nelson Patient Tower, the Clayton Heart Center and the Johns Hopkins Outpatient Center which bears Heyssel's name.^[29] In May 2012, the Johns Hopkins Hospital opened two new towers as part of a major campus redevelopment effort. The opening of the new $1.1 billion Charlotte R. Bloomberg Children's Center tower and the new Sheikh Zayed Tower marked the highpoint of this effort. In addition to the main hospital, the system operates four other hospitals and several outpatient care facilities in the Baltimore and Washington metro areas and All Children's Hospital in St. Petersburg, Florida.^[30] In May, 2019, the hospital completed an $80 million expansion project at its Green Spring Station campus in Brooklandville, Maryland, offering out-patient surgery, imaging, and oncology treatment at the 3-story, 100,000-square-foot (9,300 m²) Pavilion III.^[31]

Johns Hopkins also provides remote consultations worldwide through the Grand Round platform, and uses the same platform to help patients find the ideal specialist for their unique needs.^[32]

Johns Hopkins Children's Center

Johns Hopkins Children's Center (JHCC) is a nationally ranked, pediatric acute care children's teaching hospital located in Baltimore, Maryland, adjacent to Johns Hopkins Hospital. The hospital has 196 pediatric beds^[33] and is affiliated with the Johns Hopkins School of Medicine.^[34] The hospital is the flagship pediatric member of Johns Hopkins Medicine and is 1 of 2 children's hospital in the network. The hospital provides comprehensive pediatric specialties and subspecialties to infants, children, teens, and young adults aged 0–21^[35][36][37] throughout Baltimore and the wider United States. Johns Hopkins Children's Center also sometimes treats adults that require pediatric care.^[38]

Johns Hopkins Children's Center also features one of the only ACS verified Level 1 Pediatric Trauma Centers in the state.^[39] The hospital is directly attached to Johns Hopkins Hospital and is situated near the Ronald McDonald House of Maryland.^[40]

Rankings

Johns Hopkins Hospital was ranked as the top overall hospital in the United States for 21 consecutive years by U.S. News & World Report until 2012, when it moved to second place behind Massachusetts General Hospital in Boston. In 2013, it was reinstated as the top hospital in the United States.^[41] In the 2016-2017 Best Hospitals edition, Johns Hopkins ranks 3rd nationally.^[42]

Concern over ethics and research methodologies

Johns Hopkins School of Medicine and Johns Hopkins Hospital have faced criticism over ethics and research methodologies.^{[44][45][46][47]}

See also

• Johns Hopkins All Children's Hospital
• Johns Hopkins School of Medicine
• Johns Hopkins University
• Hopkins television series
• Medical centers in the United States

References

Further reading

• Roberts, CS (2010). "H.L. Mencken and the four doctors: Osler, Halsted, Welch and Kelly". Baylor University Medical Center Proceedings. 23 (4): 377–88. doi:10.1080/08998280.2010.11928657. PMC 2943453. PMID 20944761.

External links

Wikimedia Commons has media related to Johns Hopkins Hospital.

• Johns Hopkins Hospital and Health System website
• Johns Hopkins Medicine official website
• Johns Hopkins Hospital on Google Street View
• Interview with Ronald Peterson about Johns Hopkins Hospital, C-SPAN, January 9, 2005