he need to simplify the patient journey and minimise the stress of treatment has become a catalyst for improvements in cancer treatment and care, prompting more creative approaches to cancer centre design.
Some of those inspirational cancer centre environments are in the UK, including Stantec project, the Guy’s Cancer Centre, which was opened by the Guy’s & St Thomas’ NHS Foundation Trust last year. There are many examples of cancer centre innovation and best practice further afield, including the Taussig Cancer Center at Cleveland Clinic in Ohio, which provides a model for simpler patient journeys and more collaborative approaches to care.
Developing the brief
Appointed as the healthcare architect for the Taussig Cancer Center, Stantec worked with Cleveland Clinic to develop the brief and explore service provision and layout requirements. The core vision was for treatment to be delivered by tumour type with interdisciplinary care.
The building was designed onto an elegant and simple plan, dividing the rectangular floor plate into north and south zones. The north zone is the location for the chemotherapy infusion suites, providing a relaxing treatment environment where patients benefit from natural light and views of green space, without over-exposure to the sun. Meanwhile, the south zone is taken up by the clinics, where patients have consultations with their clinical team. Sandwiched between the two zones, and running the entire length of the floor, are back-of-house staff and clinical support areas. The patient lifts, reception and waiting areas are located centrally in the plan with open views to both north and south, allowing for intuitive wayfinding along light-filled corridors.
Radiotherapy treatment and imaging are located on the lower ground floor, due to the weight and shielding requirements of the linear accelerators (linacs). The building design also incorporates natural light on the lower ground floor thanks to an all-glazed skylight above the linac circulation route. There is also an internal connection to the car park via the skyway, a high-level internal link between the Cancer Center and the rest of the campus buildings and car parks.
While there has been a concerted effort in the UK to move healthcare environments toward a more homely, reassuring look and feel, the Taussig Cancer Center’s ‘compassionate minimalism’ creates tranquillity, order and lightness of both structure and internal space.
Stantec worked with William Rawn Architects to deliver a building that is very contemporary and articulates a forward-focused, science-based approach to pioneering new treatments. The simplicity of the external envelope, the organised nature of the layout and the clean lines, and finishes of the interior create a sense of calm, security and order, inspiring confidence in the very highest standards of advanced treatment and care.
The colour palette is neutral and the finishes are extremely high quality, taking account of feedback from facility management teams on cleaning regimes and from clinical teams on elements such as storage space and workflows. Accents of wood complement the extensive use of glazing in the facades, developing the connection between indoor and outdoor space and enhancing the feeling of openness.
Artwork and individually chosen pieces play an important role in enhancing the minimalist interior spaces. These carefully curated artworks support wayfinding throughout the building, providing a sense of location against the blank canvass of the clean, white interior.
Indeed, a sense of place has been embedded into the design at every level. Both the chemotherapy infusion rooms and the consultation rooms have been designed on a standardised model with a consistent layout and specification for each. Identical rooms provide clear benefits, with clinical teams able to find everything they need instantly, reducing wasted time, disorientation and the potential for human error, while patients benefit from a sense of the familiar.
Collaborative treatment and care
The $276m, seven-storey, 37,000m² outpatient facility incorporates 126 exam/consultation rooms, 98 infusion treatment rooms, six linear accelerators, a Gamma Knife suite, a pharmacy and haematology lab services.
On the ground floor, there is a generous drop-off area with valet services and volunteers who man the main reception to help patients with wayfinding.
Patients and family have access to a number of public areas at main entry level and first floor, including a cafe and dedicated areas for spiritual and complimentary therapies, including yoga, music and art therapy, and a meditation centre. There is also an accessories boutique, operated by a licensed beautician, where patients can select a complimentary wig that they can take home with them the same day, benefit from a make-up service or select from a range of prosthetics, hats, scarves and accessories for both men and women. The 4th Angel Mentoring Program also operates from this location, enabling patients to drop in for support and advice from mentors who are living with cancer or have survived their cancer journey.
The ground floor also houses the core ancillary services that are key to every cancer patient’s journey, including the haematology laboratory service, which has 14 semi-private cubicle spaces, and a retail dispensing pharmacy.
The large number of clinics (126) and infusion bays (98) have been broken down into recognisable modules following the tumour model approach. The second floor provides the internal connection to the skyway; the patient services; a dedicated 10-bay clinical trials area monitored by specially-trained nurses and research assistants; and the haematology, bone marrow and apheresis clinics. Lung, head and neck, gastrointestinal and brain tumour clinics are located on the third floor, while genitourinary, skin, gynaecological and breast, including a breast imaging suite, are located on the fourth floor.
Each of the tumour clinics comprises a clinic and an infusion treatment module supported by multi-disciplinary workspaces and clinical support rooms, along with ‘touchdown’ spaces for social workers, pharmacists and other health-related disciplines that may be involved in the care, treatment or additional needs of individual patients.
Each clinic module includes 10 identical examination/consultation rooms grouped around the fully-glazed ‘team work’ room, where oncologists, surgeons, radiologists, palliative care providers, oncology nurses and advanced practice providers can review therapeutic decisions and treatment plans and provide decisions while the patient is still in the building.
Similarly, each infusion suite comprises 16 treatment stations: 10 private rooms with shared en-suites and six semi-enclosed bays.
A new model
Both aesthetically and with regards to organisation, the Taussig Cancer Center at Cleveland Clinic in Ohio pushes the boundaries of cancer centre design and creates a model where the layout of the building is central to the concept of collaborative care and a simpler, more familiar patient journey.
The project benefitted from involving the design teams from site selection right through to determining the finishes and furnishings, enabling the teams to put stakeholder consultation and the client’s desired outcomes at the heart of the design process.