A HEALING JOURNEY NEW HANOVER REGIONAL MEDICAL CENTER
ZIMMER CANCER CENTER
We cannot direct
THE WIND,
but we can adjust
THE SAILS.
- author unknown
For those facing a diagnosis of cancer, new research, treatment protocols, and technology offer more hope than ever before. With leading-edge research and new therapies being discovered every day, the odds of healing and recovery after cancer are very optimistic. Improved treatment options offer hope and reassurance, but facing an illness is never easy. The design of our healthcare facilities can play a huge role in reducing fear and anxiety for patients and their families during a difficult time. We can provide comfort during an uncertain journey, and perhaps speed healing, provide support for caregivers, and create a space in which to breathe.
To address these important needs, New Hanover Regional Medical Center (NHRMC) planned a major addition and renovation project which would merge its existing hospital-based Zimmer Cancer Center with a local oncology practice. The resulting building provides a serene, comforting, daylight environment housing 51,000 SF of leading-edge treatment spaces. The program includes a reception and registration area, exam rooms, infusion bays, pharmacy, and Inspiration Center.
In an effort to understand the unique issues and priorities of the client, the design team engaged with healthcare providers, patients, and their families, facilitating several different focus groups for stakeholder input. Through this process, the nursing staff and a patient advisory committee generously shared their knowledge and personal stories to help the architects design the best possible spaces for healing. NHRMC has an in-house team focused on continuous improvement of operational efficiencies. This team led a Lean Design effort focused on 3-P planning which included the physicians, nursing and clinical staff, oncology support services, administrative managers, hospital facilities personnel, and the contractor. 3-P refers to “Production, Preparation, Process,” and the resulting patient-focused operational model which emerged from this series of intensive charrettes was reviewed and refined by the entire team in order to develop the best possible space and workflow for the clinical staff.
In planning for the infusion bays in the heart of the space, the patient advisory group shared firsthand knowledge of the chemotherapy experience and offered invaluable insight into space planning and design for this important program area. During user group meetings, the patients recommended a range of choices for the infusion bays along the full spectrum from private to open. Rather than cookie-cutter spaces with a clinical feel, the bays offer views to nature and abundant natural light and include private spaces, semiprivate bays with transparent enclosures, double bays for mutual support, and “fast track” areas in a more open environment. Engaging family caregivers in the treatment process is important for comfort and healing, and the infusion bays provide space to support these caregivers. The simple act of choosing the optimal space for treatment can be a comfort to patients in a situation which can feel beyond their control.
The nursing team also worked closely with the designers to refine the layout of the exam rooms and infusion bays from a healthcare provider’s perspective. The design team built full-scale mock ups for the nurses to test for circulation space, adjacencies, required equipment clearances, placement of IV lines, and casework locations. The team went through several iterations to make sure the clinical spaces were well organized and highly functional for the nurses’ work flows, and the resulting easy-to-use treatment areas are worth the effort.
Treatment days can be quite stressful for patients and their families. In order to reduce anxiety wherever possible, the design team considered every step of the experience and worked from the outside in. The building is the first one patients see when entering the campus, and the double-height entry serves as a landmark, particularly when illuminated at night.
A monumental curved “Journey Wall,” visible from the street, originates at the lobby and creates a circulation spine through the center. Based on an abstracted DNA pattern, the wall serves as a guiding presence through the lobby and treatment areas to an Inspiration Center at the far end. Generous windows throughout the building ensure that patients can always see the outdoors, both for wayfinding and for positive distractions; a serene palette of teal blues, wood, and stone creates a calming environment. The Journey Wall is a touchstone throughout the space. Visible from all program areas, the wall is both a wayfinding tool and a source of encouragement for patients and their caregivers.
The Inspiration Center also grew out of discussions with the patient advisory committee. This area includes a resource library, a classroom for programs such as nutrition and alternative therapy group classes, breakout conferencing rooms, counseling offices, and a quiet space for reflection and learning. Patients and family caregivers can use a variety of materials to learn on their own schedules throughout the process of diagnosis, treatment, and healing.
Though the journey through illness is intensely personal, NHRMC’s Zimmer Cancer Center creates an uplifting and supportive space where the patient experience and patient choice are touchstones, and clinical staff work in an environment that supports their mission to deliver the best treatment and care.
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