Moving The Mark

While cancer deaths have dropped over the last several decades, attributed to a reduction in smoking as well as improvements in early detection and treatment for some types of cancers, it’s still the second leading cause of death in the United States. In fact, almost 1.9 million new cancer cases are expected to be diagnosed in 2021, according to the American Cancer Society’s report “Cancer Facts & Figures 2021.”

The prevalence of cases continues to create a competitive landscape and drive demand for new facilities, as organizations set out to deliver services that draw patients and establish a presence within new and existing markets. This need is increasingly being answered through facilities that offer comprehensive cancer services—from diagnosis, treatment, and clinical trials to wellness and survivor support services—together, under one roof. “In order to be competitive, you’ve got to provide a quality environment and the right delivery of care model,” says Saul Jabbawy, principal and regional director of design at EwingCole (Philadelphia).

At the University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center (UMGCCC) in Baltimore, director Dr. Kevin Cullen says clinical volumes have nearly quadrupled at the NCI-designated comprehensive cancer center since he joined the organization in 2004. “We now see specialty referral patients with leukemia, bone marrow transplant patients, and people who have complex care needs for solid tumors who are referred in from all over the region,” he says. Over the years, as the cancer center grew to become a regional care destination, delivering multidisciplinary care as well as a growing research practice, it continued operating in roughly the same footprint, which was spread out in multiple locations across its urban campus. Eventually, Cullen says, the organization decided that it needed to bring its physical facilities “up to match the level of care we were providing and the way to do that was to build a dedicated care facility,” he says.

Scheduled to break ground in spring 2022, the nine-story, 155,000-square-foot Roslyn and Leonard Stoler Center for Advanced Medicine will provide inpatient and outpatient cancer services. Working with HDR (Arlington, Va.), Cullen says it was important during planning and design to not only discuss how to meet increased patient volumes and design a facility that would be optimal for patients, families, and staff, but also address how cancer treatments are changing and anticipate future care needs. For example, he says, some bone marrow transplants, which have traditionally been done as inpatient, are increasingly being performed in an outpatient setting, while new infusion methods and new cellular therapies also are starting to gain traction. “We try to look not only at what our cancer patients’ needs are now but also anticipate where the field is going so we’ll be able to provide these novel treatments for our patients in a wonderful setting 10 to 15 years down the road,” Cullen says.

Building additions
As the cancer care sector focuses on delivering updated facilities to address evolving clinical approaches, several new treatment spaces are rising to the forefront. For example, UMGCCC’s new facility has expanded outpatient capabilities, including extended hours and increased monitoring support to meet the anticipated rise in transplant services in the outpatient environment, Cullen says.

Oncology urgent care centers are also being incorporated into more projects as a way to address the specific needs of cancer patients as well as help keep immune-compromised cancer patients out of the general emergency department, including at both UMGCCC and the Henry Ford Cancer Institute’s Brigitte Harris Cancer Pavilion in Detroit, which opened in January.

As these new spaces are introduced in more cancer centers across the country, existing care environments, such as infusion and exam rooms, also are evolving. For example, in infusion treatment spaces, Jabbawy says he’s seeing more facilities move away from a sea of bays with lower partitions to environments that support more privacy, allow patients to sit with family members, incorporate views to the outdoors, and give some control over the environment. “The whole notion of choice becomes important, and it’s driving significant square footage increases [in these departments],” he says.

At UMGCCC’s Roslyn and Leonard Stoler Center for Advanced Medicine, Cullen says the project team tested different designs and layouts for infusion before choosing to offer a mix of semiprivate cubicles with some private rooms for patients who are sicker or request a more private setting. Ann Kenyon, vice president and health studio leader at SmithGroup (Detroit), which provided medical planning, architecture, interior architecture, and engineering services on the Henry Ford project, adds that there’s also an emphasis on making infusion spaces feel less clinical in nature to deliver a more comforting setting. For Henry Ford, that meant designing the infusion bays with custom millwork to hide clinical elements, such as sharps containers and trash bins, from patients’ view.

As for exam room updates, at the Henry Ford cancer pavilion, rooms are designed for both care delivery and consultations, with the different members of the clinical team coming to the patient rather than the patient moving around to various locations to see clinicians. “Not only does that give the patient peace of mind and comfort, but it improves patient satisfaction. They can tailor the visit [to the patient’s needs],” she says.

Making a statement
While more projects continue to expand services and improve experience, they’re also implementing branded approaches to further help differentiate themselves from competitors. For example, Kenyon says that SmithGroup worked with the Henry Ford Cancer Institute to rebrand its interior environments, pushing to develop a patient-centric experience that has a less clinical and more hospitality-inspired aesthetic. The brand standards developed for the new cancer pavilion create an overall design vocabulary that covers everything from furniture and finishes to artwork, lighting, signage, donor walls, and plantings and will be used to inform future cancer care projects, as well.

A hallmark of that effort, Kenyon says, is a wood and blue wall located in the lobby called the “DNA wall,” which is designed to symbolize the human touch that’s involved with the cancer treatment process coupled with the innovation and high-tech treatment, with both materials laid out in a DNA pattern to identify the precision medicine that’s delivered at the facility. Similar blue colors and wood elements are featured in other areas of the cancer center, such as the infusion area and the Tumor Board Room, a multidisciplinary staff treatment planning area, creating a cohesive design statement that supports the overall branding. “Developing a design language fosters a common aesthetic and patient experience no matter which facility the patient is receiving treatment at,” Kenyon says.

Experts add that artwork, specifically, is becoming a more common layer in delivering a sense of comfort, as well—especially considering how much time people may spend in cancer centers, Jabbawy says. “Not just for infusion. Even if they’re coming for radiation therapy, it’s a recurring thing,” he says. “So there’s a level of trying to engage these patients and de-stress them.” But instead of using beige and warm wood tones, which may be associated with homey design, he says efforts should focus on creating positive visual elements that can help take patients out of their internalized stress. “There’s a level of color engagement, contrast, interest, and variety that you need to work on because not everything appeals to everyone,” Jabbawy says.

SmithGroup’s Kenyon agrees, adding that an art program can also help strengthen the connection between a facility and the population it serves. “It’s a difficult journey to go through, so any support that we can provide the patient as they are going through this challenging time is important,” she says.

Here’s a roundup of new and recently renovated cancer care facilities that are delivering thoughtful and holistic built environment solutions to respond to modern care needs.

Henry Ford Cancer Institute Brigitte Harris Cancer Pavilion, Detroit

Princess Margaret Cancer Centre, Toronto

Cedars-Sinai Ventana Cancer Care Clinic, Tarzana, Calif.

Bon Secours St. Francis Adolescent and Young Adult Cancer Center, Greenville, S.C.

Rutgers Cancer Institute of New Jersey Jack and Sheryl Morris Cancer Center, New Brunswick, N.J.

Samuel Oschin Cancer Center at Cedars-Sinai, Los Angeles

Solinsky Center for Cancer Care, Manchester, N.H.

Anne DiNardo is executive editor of Healthcare Design. She can be reached at anne.dinardo@emeraldX.com.

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