Post by Bob Humenn, AIA – Principal

 

Bob Humenn, AIA, Principal

Bob Humenn, AIA, Principal

It was not that long ago that cancer centers were found in the basements of hospitals. Linear accelerator vaults, comprised of four to six feet of concrete, were not conducive to being located on upper floors. Since grouping cancer services together was the most efficient strategy, an entire cancer program would be situated in dark, windowless rooms, often difficult to find.

Through the increased attention to evidence-based design and the accumulation of patient satisfaction surveys, we have recognized how important it is for healthcare facilities to become empathetic and accommodating to the patient experience. This “healing environment” approach has become the most essential element in designing cancer centers today.

Imagine leaving your doctor’s office with the diagnosis of cancer—an experience that more than 1.6 million people endure each year. Thankfully, with the help of advances in medical and technological practices, the cancer patient mortality rate is trending downward. But hospitals continue to treat more and more numbers of cancer patients each year, and their facilities must respond to the unique needs of these patients.

I am fortunate to have had the opportunity to design several dedicated cancer centers and begun to understand what these unique needs are. Through working with and learning from providers that share the goal to create a healing environment, we have developed buildings and suites that are responsive to patients’ physical, emotional, and spiritual wellbeing.

Winchester Hospital Center for Cancer Care

Winchester Hospital Center for Cancer Care

 

We often discuss three primary characteristics that shape the ideal patient experience: stress-free, seamless, and nurturing.

Stress-free – Imagine your first visit to your oncologist to discuss your treatment plan, and you can’t find the oncology department! Would that add stress to your visit?

By taking the cancer center out of the basement and creating a free-standing and identifiable structure, we have begun to address the clear accessibility that will reduce patient and visitor stress. Often accommodated with valet parking, these centers have concierge services in entryways that can assist patients to their treatment areas.

With an inviting, hotel-like lobby space, centers provide ambient music and clear way-finding paths that can direct patients to treatment areas with simplicity and ease. In today’s information age, cancer centers respond to patient expectations by providing high-tech education and resource areas that help patients to learn about their diseases and treatments.

Winchester Hospital Center for Cancer Care

Winchester Hospital Center for Cancer Care

Seamless – Many centers provide all cancer related programs within the same building, which may include laboratory and diagnostic imaging services required on the day of treatment, plus oncologist offices and exam rooms, patient education centers, patient navigators, and financial counselors.

Obviously, there are many operational initiatives to make these services seamless.  As such, I always recommend that information technology and registration areas are not held off to the end of the project, but integrated seamlessly into the planning and design of the space from the beginning.

Dana-Farber/Brigham and Women’s Cancer Center at Milford Regional Medical Center

Dana-Farber/Brigham and Women’s Cancer Center at Milford Regional Medical Center

Nurturing – This goal has the most opportunity for designer input, and much has been written about the healing environment, including the use of natural materials, windows for views to the outdoors and natural light, noise reduction, etc. The cancer patient experience in a hospital is unique compared to other experiences: treatment can last for many consecutive hours, several times a week; there are days when patients want to mingle and socialize, and others when they want to be left alone. Accordingly, the design of infusion areas should house treatment stations that provide privacy when desired and community spaces for interaction and support.

Cancer patients may feel a loss of control as the disease and treatment restrict their activities, so whenever possible the treatment area should allow the patient to control his or her personal environment, such as level of privacy, views, lighting, entertainment, heating and cooling.

A close friend of mine had her treatment at one of the cancer centers that I designed, and afterwards she told me what a positive effect the calming and meditative space had had on her healing process. Isn’t that what it’s all about?

The American College of Healthcare Architects (ACHA) has announced that Kirsten Waltz, Managing Principal of SBA’s Connecticut Office, has earned her Board Certificate in healthcare architecture. Waltz recently passed an accredited examination, which assesses the knowledge and understanding of architects who practice as healthcare specialists. She joins the ranks of over 400 ACHA colleagues in the US and Canada who have received this important architectural credential.

In order to even take the exam, applicants must submit data heavy portfolios outlining their range of experience, including six recommendation letters from clients and peers. The ACHA requires its certificate holders to work towards the improvement of healthcare architecture on behalf of the public, to practice in an ethical manner and to maintain the highest standards in the specialized field of healthcare architecture.

Go Kirsten!

Post by George Balsley, AIA

George has worked in the field of architecture for over 30 years in all types of building design, core & shell design, production and technical specifications.  His diversified background includes residential, educational, commercial and healthcare architecture.  Using his lifelong experience with deafness, he created a new specialty called Designing for the Deaf and has been involved in the field of universal design.  It’s a movement that calls for design for all inclusive or lifespan design. 

In my architectural work on deaf design and universal design, I encounter many different situations that call for many different solutions. When I move into the realm of deaf-blind facilities, for example, I often grasp for self-education, performing independent research and talking to deaf-blind individuals. I find that, like everything else, there is no one set of simple design principles or solutions, as it varies from project to project.

My research has put me in contact with institutions like the Helen Keller National Center in Sands Point, New York, and the Perkins School for the Blind in Watertown, Massachusetts. When I’ve asked these organizations whether they use certain design guidelines, both have said that there are none, except for a few common-sense ideas that help their occupants move around in space.

Unfortunately, there is currently no published literature to help architects design for the deaf-blind community. However, we do know what their basic needs are to get around. Below is a list of key considerations that I’ve gathered through my experience on previous projects. These basic environmental factors can help the deaf-blind community to function more independently and can help architects initiate conversations with their clients to derive the most effective design solutions for their constituents.

Key design considerations could include:

  • Using light/dark color contrasts, which can make doors and stairs easier for those who have partial sight capabilities. Contrasts help people define boundaries between edges and will enhance residual vision.
  • Selecting surfaces that reduce or avoid glare, such as non-skid, non-glare flooring and non-glare wax.
  • Choosing appropriate background colors. Stripes, plaids, and patterns could be visually confusing and over-stimulating as backgrounds for visual communication. Bright colors are encouraged.

Space planning strategies:

  • Avoid the use of curved walls, which can be disorienting.
  • Minimize the use of columns outside of walls. Since deaf-blind occupants will use walking sticks to feel along the wall’s base, if they run into a column it can confuse their spatial perception. At a project at Gallaudet, for example, we extended this base from the wall to the column so that individuals could feel their way around.
  • Closet and cupboard doors should be self-closing in order to minimize accidents. All doors should be fully opened or closed, never left halfway closed, in order to prevent accidents.
  • Bedroom closets should be well lit.
  • Nightlights should be used in bedrooms, hallways, and bathrooms.
  • Careful placement of light switches (from doorways and near beds) and electrical outlets should be considered.
  • Televisions should be kept away from lamps or windows.
  • Furniture should be placed away from main traffic pathways.
  • Bathroom features should be maximized for ease of sight and use, including: toilet seats in contrast with toilet (ex: a black seat); contrasting non-skid tape or a mat placed at bottom of the tub; and extra lighting over the tub or shower.

Furniture selection:

  • Edges of tables should be of contrasting color from the table surfaces.
  • Sofas and armchairs should have skirts that extend down to the floor, with no exposed legs. Shadows caused by legs can be confusing for deaf-blind residents.
  • Strong contrasts between edges of chairs to the floor.
  • Countertop colors should contrast with base cabinets so that countertops can be seen quickly.

Emergency alert systems:

While there is no set of guidelines for deaf-blind facilities, a few recommended solutions can help the owner, electrical and A/V consultants, and the architect develop the best possible system for the space:

  • For deaf-blind facilities, individuals should carry pagers that vibrate in response to fire alarm systems.
  • Bed vibrators should be tied to fire alert systems for when residents are sleeping.

The Baystate Children’s Specialty Center and the Mattapan Community Health Center have both been chosen by the Boston Society of Architect’s (BSA) 2014 Healthcare Facilities Design Awards Jury for recognition. Award winners will find out which level of award each project has received at the BSA’s annual awards gala in January. There are three levels of awards: Honor level, Award level, and Citation level.

The Mattapan Community Health Center is a new 50,000 square foot, ground-up construction, community health center located in the heart of Mattapan Square and will help lead the revitalization of the area. The 3-story center is seeking LEED Silver certification and includes several sustainable features, including a green roof. The design also maximizes natural light by keeping the central area of each floor open, so that light can pass from one end of the central transparent volume to the other.

Mattapan Community Health

Mattapan Community Health Center (MCHC) is a federally qualified independent health center affiliated with Boston Medical Center and Brigham and Women’s Hospital/ Partners Healthcare.

Mattapan Community Health

The ground floor of the center features the health center entrance, which is flanked by two retail spaces, a conference area, and an open stair between ground and first floors.

Mattapan Community Health

The first floor has dental services, lab space, WIC, building services, community function space and waiting rooms.

Mattapan Community Health

The second floor is occupied by clinical exam rooms, behavioral health, social services and additional waiting areas.

 

The Baystate Children’s Specialty Center was not simply engineered—it was “imagineered.” The design process kicked off with a charrette with former Disney Imagineers, which resulted in a whimsical and high-tech child-centered, interactive experience attractive to both young patients and older adolescents.

The design goal was to alleviate the sometimes negative connotations associated with visiting the doctor for families and patients by providing them with a fun and interactive environment. The project also had to conveniently organize all 15 of the pediatric specialties under one roof and put patients and families at the center of well-coordinated care. You can learn more about the Children’s Specialty Center by reading this blog post from April.

Joyful Diversions

The Children’s Specialty Center is filled with joyful diversions, such as the interactive fish pond, to distract from what could potentially be a stressful experience.

 

Children's Specialty Center

Baystate Children’s Specialty Center

 

Springfield, MA— The day started with donuts. Carpet flew from second story windows, invading brush was chopped down to the roots, and pizza was devoured at the Habitat for Humanity build day on Friday, Oct. 3rd.

Ten volunteers from SBA Connecticut’s office spent the day with Habitat for Humanity’s Construction Manager, Kristopher McKelvie, preparing an abandoned home for a revitalization of new finishes. SBA volunteers had jobs that ranged from removing carpet, to clearing out the basement filled with old toys and clothes, to removing faceplates of outlets and patching holes in preparation for paint.

Volunteers also worked on exterior landscaping, as the lawn and garden had overgrown and was invading neighbor’s yards. A great time was had by everyone involved.

Greater Springfield Habitat for Humanity services the Greater Springfield area in Western  Massachusetts.   To learn more about the organization, or to volunteer, please see the Greater Springfield Habitat for Humanity Website, www.habitatspringfield.org.

 

The whole crew!

The whole crew!

Habitat 2014

Interior designer Carly Shaver taking down the blinds.

Habitat 2014

Architect Derek Noble installing smoke detectors.

Habitat 2014

Interior Designer Paulina Martinczak poses by the window.

Habitat 2014

Architect’s George Balsley and Eddie Widofsky pose for a picture after cleaning out the basement.

Cleaning the Basement

Office Coordinator Jen McCarthy and Managing Principal Kirsten Waltz sorting trash from donations.