Post by 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.
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.
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.
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?