Penn Medicine Lancaster General Health

PENN MEDICINE LANCASTER GENERAL HEALTH | ANN B. BARSHINGER CANCER INSTITUTE

POST OCCUPANCY EVALUATION

EXECUTIVE SUMMARY In response to a growing need for Oncology services, the new Ann B. Barshinger Cancer Institute transforms and consolidates all services into a center for healing. Cancer is a traumatic and continuing illness where patients endure life altering diagnosis, iterative and prolonged treatment regimes, and increasingly life-mending healing. The client envisioned and environment that embodies tranquility, inspires hope and reinforces confidence for their patients. In response, the building design focuses on two primary concepts: 1. Interdisciplinary and patient centric approach to cancer care 2. Connection and relationship to natural systems and art as catalysts in the healing process Effectiveness of care is the Hospital’s top priority which is supported by the ability of the design to accommodate multidisciplinary teams implementing interdisciplinary concepts. An efficient layout and strong technology backbone contribute to the project’s success.

Ballinger conducted a Post Occupancy Evaluation of the Ann B. Barshinger Cancer Institute during the first quarter of 2015, approximately 20 months after occupancy of the new facility. The objective of the evaluation is to understand which planning and design intentions have been most successfully realized; and, where user adaptations have been made, and the reasons for change.

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METHODOLOGY

ONLINE + WRITTEN SURVEYS FOR PATIENTS AND STAFF

Data was collected through anonymous electronic survey of staff and patients, in-person staff interviews, and observation of staff and visitors.

Where appropriate, distinctions are made between feedback from the Medical Oncology, Radiation Oncology and Infusion departments.

The results of this study are presented within with suggestions for intervention in areas where functional requirements have evolved since the project was designed.

ONSITE OBESERVATIONS

REPORT LEGEND STAFF

PATIENT

ONSITE INTERVIEWS WITH STAFF

PROJECT SCHEDULE 2009

2010

2011

2012

2013

2014

2015

PLANNING + DESIGN APPROVALS + FUNDING

DESIGN + DOCUMENTATION

CONSTRUCTION

OCCUPANCY POST OCCUPANCY EVALUATION

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92%

KEY FINDINGS OF THE POST-OCCUPANCY EVALUATION The Iconic and integrated nature of the building has increased the ability of LGH to attract and retain talented Physicians and care givers, and with 92% of the patients applauding the facility as well, has increased patient volumes and patient satisfaction levels.

PATIENTS APPLAUD THE ICONIC NATURE OF THE BUILDING

Beginning with the initial vision to provide an extraordinary experience every time for the patients, the integration of nature into the building with the access to natural light dramatically improved the patient and staff experience within the building. By combining nature with the building amenities, patients spent 21% of their time in the building utilizing the amenities.

With the move to a more integrated care delivery team model, the clinical staff embraced the team rooms within the clinic, and have limited use for private offices.

The infusion bays are not functioning as designed, and would benefit from additional acoustic and visual privacy, along with integration of nature along brick curve.

80% REPORTED EXPERIENCE AS EXCELLENT

100%

100%

PATIENTS FEEL THE NEW BUILDING ALLOWS TREATMENT TO BE DELIVERED IN A TIMELY MANNER

As part of the move to a more integrated care delivery model, the clinical staff embraced a team model within the clinic. This has reduced the need for the private offices, which are often empty, and increased the number of staff electing to spend the majority of their time within the interdisciplinary team rooms in the clinic.

4% HEALING GARDEN 3% VIEWING ART 2% IMAGE RECOVERY CENTER

By providing the team space within the clinic, the clinicians expressed an improvement in their ability to communicate with each other, and an improved ability to coordinate patient care.

5% CAFE

This is evident in the patient satisfaction scores of both the patient experience at the facility and that 100% of patient reported the new building allowed them to receive treatment in a timely manner.

PATIENT

OF PATIENTS WERE SATISFIED WITH THEIR EXPERIENCE AT THIS FACILITY

2% OTHER 23% MEETING WITH HEALTHCARE PROVIDERS

VISIT TIME

5% MEDITATION ROOM

58% RECEIVING TREATMENT

STAFF

20% REPORTED EXPERIENCE AS GOOD

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ACKNOWLEDGEMENTS PENN MEDICINE LANCASTER GENERAL HEALTH Lou Papadoplos (F/G) Senior Director, Guest Services Dr. Randall Oyer Medical Director, Oncology Nikolas Buescher Executive Director of Cancer Services Melanie McCurdy (R) Administrative Director, Radiation Oncology & Gamma Knife Monique Stief and Denise Turoczi (R) RN Sheri Beamesderfer (R) Chief Radiation Therapist Rachel Holliday (ODM) Data Analyst, Oncology Data Management Jody Clark (ODM) Certified Tumor Registrar Emily Hershey (I) Manager, Oncology Outpatient Infusion Mary Hetrick, RN Holly Barlow,PtCA Julie Bolton, RN Susan Tollett, RN Alice Geib, RN

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Tina McKain, RN Fred Hershey Director Facility & Project Management John Hartman Senior Director for Facilities & Construction Management Tanya Todd (F) Supervisor Environmental Services Patti Roda (SS) Manager, Oncology Clinical Support Services Phyllis Fulkerson (SS) Marianne Gault (SS) Nurse Navigator Jennifer Sporay (SS) Julie McCormick (SS) Clinical Cosmetologist Amy Jo Pixley (SS) Nurse Navigator Kimberly Belboda (C) Erin Sutcliffe (SS) Genetic Counselor Rachel Pry (C) Renee Methax (C) Fannie Sue Martin Coding Specialist

Susan Leese (C) Vanessa Bramble (C) Director of Cancer Clinic Operations Christina Martin (P) Pharmacy Supervisor Melissa Messick (P) Pharmacy Supervisor Cynthia Vandermark (P) BALLINGER Louis Meilink, Jr., AIA, ACHA, ACHE Principal Amy Floresta, AIA, LEED AP Senior Associate, Project Manager Christina Grimes, AIA, LEED AP BD+C, EDAC Senior Associate, Healthcare Planner Whitney Wexler Associate, Communication Design

CONTENTS 1.0

PROJECT OVERVIEW

2.0

POST OCCUPANCY EVALUATION Respondent Profile Iconic Success Culture Shift Patient Experience

3.0

INSIGHTS + RECOMMENDATIONS

STAFF

PATIENT

PROJECT OVERVIEW LGH developed the following Principles and Objectives as part of the project definition, prior to the Planning and Design process.

CANCER CARE GUIDING PRINCIPLES:

LGH OBJECTIVES:

• Deliver care through a multidisciplinary care model

• Incorporate operational and spatial design so that the patient’s sense of well being is influenced by the environment, as well as efficient and effective processes, giving patients confidence in the quality and compassion of their care

• Ensure a personalized experience for all patients and their families • Strive for the best outcomes with a strong commitment to quality and safety • Incorporate innovation into treatments, technologies and processes • Select and develop a broad range of clinical and organizational partnerships to facilitate rapid translation of clinical research into practice

• Daylight and outdoor views or healing garden throughout the building • Where feasible, clini cal spaces must have daylight • Waiting patients and families have several choices of where to go for intimacy or seclusion; outdoor vistas where possible and meditation area • Patient destinations must be within sight of the main entrance door • Patients in gowns must never be seen except by physicians & nurses • Separate area for café or retail opportunities; i.e. boutique • Educational venues; no TV’s in waiting area • No equipment visible in public spaces • Art incorporated throughout design • Multidisciplinary clinic design must be patient centric including examination and procedure rooms, physician offices, patient & family consultation areas • Education and meeting space for patients and families, community and staff • Integrative medicine such as massage & stress management, cancer pain rehabilitation, and survivorship program elements

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VISIONING In the early stages of programming, several visioning questions were asked by the team. These questions fit into 3 categories which helped to identify the detailed goals of the plan.

IDENTITY + ICON How visible should the cancer center be?

Is there a desire for an iconic or signature building form?

MASTER PLANNING What relationship or connections should the cancer center have to the existing facility?

What are the demands for future growth and expansion strategies?

PROGRAM How will a multidisciplinary care model alter patient and staff interactions + experiences?

To what degree may patients have control over their environment?

How can treatment needs be balanced with social + biophilic needs of the patients?

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Patient flow was explored in detail in the programming phase and became an organizing feature in the building. The lower floor was dedicated to diagnosis, and the upper floor for treatment. The atrium and green space connection was placed in the center of the building to help alleviate patient stress, and encourage healing throughout every visit to the complete cancer care facility.

Drawing on the natural light as a way finding technique, the atrium is also the main waiting areas pre-visit, and a gathering space for patients and families between appointments.

The early planning goal of making an extrodinary experience for every visit, begins on the entry level, and is encouraged by the design of the patient flow and experience. The green wall acts as an directional and welcoming backdrop, with natural light as the patients begin the progression into the building and the clinic on the first floor.

As patients ascend to the second floor for treatment, either in the infusion or Radiation oncology areas, the garden and green wall connection becomes accessible and present. The second floor also houses the meditation area, image recovery boutique, cafe and Seraph conference center.

HEALING GARDEN

TREATMENT

ENTRY

DIAGNOSIS

STAFF

PATIENT

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MULTIDISCIPLINARY CLINIC 5 NEIGHBORHOODS 38 EXAM 1 PROCEDURE 9 CONSULT 5 TEAM ROOMS 6 PHLEBOTOMY

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INFUSION THERAPY 4 NEIGHBORHOODS 24 BAYS 7 PRIVATE ROOMS 2 FAMILY LOUNGES

RADIATION ONCOLOGYÂ 4 EXAM + 1 HOLDING AREA 6 RADIATION TREATMENT MODALITIES INCLUDING CYBERKNIFE 2 TEAM ROOMS

STAFF

PATIENT

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POST OCCUPANCY EVALUATION

ONLINE + WRITTEN SURVEYS FOR PATIENTS AND STAFF

To begin the evaluation, the team was comprised of both members of the original design team, and members who had not worked on the initial project to bring a level of unbiased opinion to the research. The team gathered both qualitative and quantitative data regarding the project from a diverse group within the building. Three methods for information gathering were selected: An on-line survey for the patients and staff, on-site interviews with staff, and on-site observations by the team. These varied collection points allowed the evaluation team to triangulate those issues which permeated the discussions from a variety of vantage points.

The results have been evaluated in 4 categories.

ONSITE OBESERVATIONS

• RESPONDENT PROFILE: Breakdown of staff and patient respondents by department, experience and age • ICONIC SUCCESS: Overall design of the building and perception of its spaces.

• CULTURE SHIFT: Understanding how the shifts in operations and procedure effect the patient and staff experience

ONSITE INTERVIEWS WITH STAFF

• PATIENT EXPERIENCE: Noting the perception of the patient experience and how they are and feel cared for

STAFF

PATIENT

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RESPONDENT PROFILE In addition to a broad range of staff from the Environmental Services Groups, Clinicians, and Administrative stakeholders, the respondent profile looked at the generational perspective of the respondents, as well as their department within the Facility. This allowed a variety of data sets to hone in on which issues were the most important to those in Infusion, Radiation Oncology, or the Medical Oncology Clinic module.

19%

RADIATION ONCOLOGY

24%

ADMINISTRATION

5%

FACILITIES

10%

STAFF RESPONDENTS

BY DEPARTMENT

MEDICAL ONCOLOGY

14%

ONCOLOGY SUPPORT SERVICES

24% 5%

INFUSION

CLINIC

RESPONDENTS BY GENERATION

5%

MULTIPLE DESTINATIONS

BOOMERS MILLENIAL

60% 22%

SILENT

45%

25% 30%

15% 3%

38%

INFUSION

PATIENT RESPONDENTS

BY DEPARTMENT

GEN X

8%

MEDICAL ONCOLOGY 14

50%

RADIATION ONCOLOGY

STAFF RESPONDENTS BY TITLE SENIOR ADMINISTRATION

10%

36%

NO OTHERS

GUEST SERVICES 5+ FACILITIES

10% 14%

10%

CLINICAL STAFF NURSING THERAPIST

52%

OF STAFF HAVE WORKED IN 1-2 OTHER FACILITIES

3-4 FACILITIES

MANAGEMENT PHYSICIANS

10+ VISITS 87.5%

10%

1-4 YEARS

14%

24%

5-9 YEARS

43%

10%

10-14 YEARS

14%

57%

15+ YEARS

29%

TIME IN HEALTHCARE INDUSTRY

5-9 VISITS

2.5%

1-4 VISITS

10%

VISITS TO LGH

TIME AT LGH

STAFF

PATIENT

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ICONIC SUCCESS Biophilic building design has been widely employed on the new Cancer Institute both for its proven impact on the healing process and for its positive influence on staff performance. Circulation through the building intentionally occurs on the building edges so occupants have continued access to light and natural views. While the Healing Garden offers a natural environment in a communal setting, a meditation pavilion sits within the garden and beckons those who prefer quiet, solitary reflection. These design elements all work together to create a facility with unparalleled cancer care.

100%

ARE SATISFIED WITH THE INTEGRATION OF NATURE IN THE PATIENT CARE EXPERIENCE

92% “It’s nice to have a beautiful place to go when you are not feeling your best”

PATIENTS APPLAUD THE ICONIC NATURE OF THE BUILDING

67%

STAFF FEEL VERY PROUD TO WORK IN THE NEW FACILITY

33%

REMAINING FEEL PROUD

STAFF

PATIENT

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4% HEALING GARDEN 3% VIEWING ART 2% IMAGE RECOVERY CENTER 5% CAFE

2% OTHER 23% MEETING WITH HEALTHCARE PROVIDERS

VISIT TIME

5% MEDITATION ROOM

The program for the 100,000 SF space of the ABBCI includes the clinical areas: exam/procedure rooms, physician offices and support staff workspace, patient/family consultation areas. In addition to the spaces for patient care the program incorporated resources to increase the patient experience which included: a cancer resource library, state-of-the-art conference areas, an imaging center, a patient boutique, an infusion center, a healing garden, a meditation room and a children’s play area.

These areas beyond the typical patient care areas were frequently used, and patients reported spending 23 % of their time in the building within the amenities areas. These spaces helped to support the mission of the institution to deliver exceptional patient care.

58% RECEIVING TREATMENT

“Healing garden + daylight views are amazing + bring inner peace” “ART WALL IS INTERESTING” “A BREATH OF FRESH AIR!”

“Looking forward to spring to see the garden”

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“THE PLANT WALL IS INVITING”

“The green wall and garden are very caliming and beautiful It’s great to have natural light throughout the center.”

“The amenities are great, [i like] the feel of bringing the outdoors in.”

66% 97% THERAPEUTIC FEEL OF ROOMS 66% 100% VIEWS TO NATURE 100% 100% ACCESS TO DAYLIGHT 70% 100% COLOR PALETTE

STAFF

PATIENT

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CULTURE SHIFT The building’s organization was determined based on a natural progression from diagnosis to treatment. The diagnostic floor, on the lower level, is where patients and families first learn that they must face this disease. The exam rooms are the quietest places in the building and have a feeling of being in the earth. To begin the battle with cancer, the patient ascends to the treatment floor, which has an airy, uplifting feel.

The Healing Garden is the focal point of this floor. The treatment spaces provide privacy combined with vast views of the fields and landscape that surround the building.

As part of the new patient flow and progression, the design team worked with the clinical staff about their operational shifts within the new building. The staff in the Medical Oncology department refined a new operational model utilizing team space rather than segregated offices.

The teams would work with triads, of a Physician, Registered Nurse and Medical Assistant seated together in the team space to increase their collaboration and patient care opportunities.

STAFF SUPPORT

96

36

36

36

CLINICAL SUPPORT

PATIENT CIRCULATION STAFF CIRCULATION

INFUSION

20

88%

STAFF FEEL THE SEPARATE CORRIDORS IMPROVED BOTH THE PATIENT + STAFF EXPERIENCES

12%

DISSATISFIED

95%

PATIENTS ARE SATISFIED WITH SEPARATE CORRIDORS

83%

24%

VERY SATISFIED ALL DISSATISFIED RESPONSES WERE FROM NON-CLINICAL STAFF

B

A

ARE SATISFIED WITH TRAVEL DISTANCE BETWEEN STAFF WORK AREAS + PATIENT CARE AREAS

70%

ARE SATISFIED WITH VISIBILITY BETWEEN THOSE AREAS

The new layout of the clinical spaces also focused on providing a quiet and calming atmosphere. As part of this goal, an on-stage clinical environment was separated from the off stage materials handling and staff circulation.

By separating these flows, the noise, traffic and disruption was taken out of the clinic, why also increasing the decentralization of staff supplies. This reduced staff fetching distances and increased their time with patients.

PATIENT CARE SPACES LAYOUT

64%

SATISFIED

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Early in the planning process a double sided exam room model was considered for both the Medical Oncology department and the Radiation Oncology exam rooms. The Medical Oncology rooms were not built with this configuration, but they were constructed in the Radiation Oncology area with a work core for off stage staff behind the exam rooms.

In this work flow arrangement, patients enter from the front public corridor, and staff from the back work core. The arrangement was met with mixed opinions from the staff and patients. One contributing factor is that the team work environment was not as fully realized in this department. The nursing staff are seated at the workstation on the patient side of the entry, while only the physicians are seated in the interior work core.

70% 50% FEEL DUAL ENTRY EXAM ROOMS FOR RADIATION ONCOLOGY PROVIDE ADDITIONAL BENEFITS

This separation of staff dilutes the effectiveness of the exam room placement, and encourages the pass through nature of the room due to the separation of the staff work areas.

ADMIN OFFICE PATIENT HOLDING/EXAM TREATMENT PLANNING ADMIN OFFICE WORKSTATION

Staff use them as a pass through

EXAM

ADMIN OFFICE

Neither door is wheelchair accessible, hard to get patients into the room

EXAM

ADMIN OFFICE EXAM

FILES/WORKROOM

RECEPTION DESK

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Good for physicians only, as nursing is not located on the other side of the exam room

40%

100%

40% 20%

PATIENTS FEEL THE NEW BUILDING ALLOWS TREATMENT TO BE DELIVERED IN A TIMELY MANNER

MEDICINE ADMINISTRATION IMPROVEMENT

MEDICINE STORAGE

biggest improvements were seen by infusion staff

As part of the design process through extensive flow mapping illustrated the importance of the time between the when a patient has their blood drawn, and the lab turnaround of the results, and then the subsequent Pharmacy Chemotherapy Preparation time were inextricably linked. The goal for improved patient satisfaction was to streamline the process and make same day infusions the typical patient experience.

28%

VERY SATISFIED

62%

SATISFIED

In order to accomplish this same day process the team investigated facilities infrastructure, and the location of the lab, pharmacy, and clinical care areas to streamline the process. The results had a dramatic impact on both the lab and pharmacy turnaround times, and increased the number of patients could have a same day Chemotherapy Infusion.

PRE-REGISTRATION / SCHEDULING

PATIENT DEPARTS UNTREATED

PATIENT DEPARTS TREATED

CANCER CENTER ARRIVAL

MEDICAL ONCOLOGY CHECK-IN

BLOOD DRAW

CONSULTATION ROOM

EXAM

PHARMACY TURNAROUND

LAB TURNAROUND

INFUSION 1. PRE-MEDS 2. TREATMENT

45

15-20

MINUTES

MINUTES

LAB

MD WORK AREA

PHARMACY

STAFF

PATIENT

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IMPLEMENTED UPDATES: TEAM ROOMS As part of the move to a more integrated care delivery model, the clinical staff was initially hesitant to embrace a complete team model within the clinic. Physicians were used to a private office model, and as such the plan and construction included both offices and touchdown space within the clinic.

With the staffing ratio to exam room, the 4 computers per room did not allow enough teams in each room. The furniture within the rooms was altered to remove the central gathering table and replace it with 4 more dedicated workstations, additional pedestal storage, and a more permanent allocation allows additional teams to work together within the clinic.

The concept of the planning model was non-dedicated touchdown space, and suggested that physicians and staff could use any team room on any given day based on rotating exam room assignment. After occupying the space a more dedicated model developed where a Physician, Nurse, and Medical Assistant would work out of a dedicated team room.

This has reduced the need for the private offices, which are often empty, and increased the number of staff electing to spend the majority of their time within the interdisciplinary team rooms in the clinic.

By providing the team space within the clinic, the clinicians expressed an improvement in their ability to communicate with each other, and an improved ability to coordinate patient care.

This is evident in the patient satisfaction scores of both the patient experience at the facility and that 100% of patient reported the new building allowed them to receive treatment in a timely manner.

REPLACING THE WORK TABLE WITH POWERED WORKSTATIONS ALLOWS FOR 4 ADDITIONAL SEATS

INITIAL DESIGN

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UPDATED DESIGN

PATIENT EXPERIENCE 80% REPORTED EXPERIENCE AS EXCELLENT

20% REPORTED EXPERIENCE AS GOOD

100% 100%

OF PATIENTS WERE SATISFIED WITH THEIR EXPERIENCE AT THIS FACILITY

In addition to many of the comments in the patient surveys regarding the facility itself, patients often commented on the quality of care they received.

This high level of satisfaction for the staff can not be attributed solely to design of the facility, but much research has shown that happier caregivers are able to deliver better, more compassionate care.

ARE SATISFIED WITH PATIENT + FAMILY AMENITIES

95% 90%

With the initial vision statement of the project to provide an extraordinary experience every time, the 80% of patients reporting their experience as excellent illustrates the realization of the goal. Patients responded highly to both the care they received, and the facilities throughout the evaluation.

The amenities throughout the building are not devoted only to the patients.

Staff frequently commented on using the garden area for lunch, or stopping in the meditation room for a moment of respite between patients. These spaces combine with the large light filled staff lounge, focus on natural light work to improve the staff environment as well as the patient experiences.

SAY THE AMENITIES IMPROVE THE EXPERIENCE

FEEL PATIENTS + FAMILY MEMBERS UTILIZE THE AMENITIES

“Image recovery staff are fantastic, julie goes above... she is awesome” STAFF

PATIENT

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WHILE

88% REPORT SATISFACTION

WITH DAYLIGHT, COMMENTERS STATE:

“SOME ROOMS GET TOO MUCH LIGHT”

97% 75%

97% RAD ONC

PATIENTS FEEL THERE ARE SPACES AVAILABLE TO COORDINATE PATIENT CARE WITH PERSONNEL

INFUSION MEDICAL ONCOLOGY

26

APPRECIATE THE ABILITY FOR PATIENTS TO CONTROL THEIR IMMEDIATE ENVIRONMENT

63%

ARE DISSATISFIED WITH SOUND TRANSMISSION

ONE DISSATISFIED PATIENT WAS IN INFUSION

100% 75%

ARE SATISFIED WITH THE ABILITY FOR PATIENTS TO INTERACT WITH EACHOTHER

98%

FEEL THE VARIETY OF FLEXIBLE SPACES FIT THEIR NEEDS STRONGLY AGREE

40 41

AGREE

OUT OF

PATIENTS FEEL THE VARIETY OF CARE AREAS ALLOW THEM TO INTERACT WITH OTHER PATIENTS OR SELECT PRIVATE AREAS AND REPORT FEELING COMFORTABLE.

The patient care areas throughout the project were designed to be flexible and accommodate the varying needs of patients, and encourage them to interact with caregivers, and other patients. The amenities throughout the building were valued by patients, families, and caregivers as opportunities of respite between the clinical spaces.

The same human centered care model was applied to the clinical spaces in an attempt to meet the needs of the clinicians and ensure that supplies, EMR access, and equipment they needed to provide exceptional care would always be located in close proximity to the point of use.

The clinical spaces and the amenities work in tandem to encourage interaction and collaboration, which contribute to the success and patient satisfaction throughout the institution.

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RECOMMENDED UPDATES: INFUSION Initial planning concepts centered around the patient maintaining a view to nature, and charting was anticipated at the decentralized station or with computer carts that were not planned in each room. Near the end of construction, the computers were added in each of the bays, and resulted in the chair being pushed to the window wall and facing towards the soiled holding instead of the window.

In order to accommodate the chair in its current location, and increase the privacy for patients, the recommendations are: • Add an additional glass or translucent wing wall for privacy (shown in orange) • Add acoustic panels on the walls of each bay above the drywall reveal (shown in red) • Add additional planters at the patient view level (shown in green) These recommendations would increase privacy, both visually and acoustically for patients and staff. The additional planters would build on the biophilic design established in the rest of the project, and bring additional interest into the infusion bays.

ACOUSTIC PANELS

ORIGINAL PROPOSED DESIGN

CURRENT UTILIZATION OF INFUSION BAYS, WITH ADDITIONAL WALL MOUNTED CHARTING AND RELOCATED PATIENT CHAIR

PLANTERS AT PATIENT VIEW LEVEL 28

WING WALLS FOR PRIVACY

RECOMMENDED UPDATES: INFUSION

Due to the immense growth in the program, the initial 30 infusion bays planned have not kept pace with the growth. While a larger expansion of the building is prohibitively costly, the team investigated an option to insert an additional 4 infusion bays within the current building envelope.

The footprint had 2 family lounge spaces for patients to gather either with each other, or to spend time with family members during their infusion. These spaces are often used, and have puzzles, knitting supplies, and magazines for anyone within the infusion area.

The proposed update investigated taking one of these lounges, and converting it to 2 semi-private infusion rooms for a total of 4 patient bays.

UPDATED DESIGN SEMI-PRIVATE INFUSION BAYS NEW WALL

FAMILY LOUNGE

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RECOMMENDED UPDATES: DAYLIGHT

The exam rooms and consult rooms on the ground level currently do not have shades on the glazed portion of the exterior wall. Many respondents enjoyed the natural light in the space, but suggested that the natural light cause problems with viewing when the light levels couldn’t be controlled. For the consult rooms, this is particularly problematic when patients need to view videos, or while staff are charting in the consult room.

As part of the infusion suggestions, planters at the upper level grating could provided additional shading in the rooms below. Or window shades could be supplied to allow greater modulation of the light when needed.

PLANTERS ABOVE PROVIDE NATURAL SHADING

WINDOW SHADES TO CONTROL DAYLIGHT

CURRENT EXAM ROOM

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TOP COMMENTS TOP NOTCH DOCTORS

PROXIMITY TO OTHER CLINICAL STAFF AND CLINIC/PHYSICIANS

EVERYONE IS CARING + POSITIVE

ACCESS TO THE GARDEN

TECHNOLOGIES AND SPECIAL SERVICES OFFERED TO PATIENTS

ABILITY TO REGULATE THE TEMPERATURE IN MY OFFICE

NURSES WHO CARE

STAFF WILLING TO HELP

STAFF

ICONIC DESIGN THEME TREATMENT AREA IS BRIGHT + CLEAN

CLEAN

PRIVATE STAFF CORRIDOR AND BATHROOMS CHEERFUL, CONSIDERATE PERSONNEL

DAYLIGHT ON UPPER LEVEL

CANCER CARE IN ONE AREA

FEEL I AM GETTING THE BEST CARE

CENTRALIZED LOCATION OVERALL DESIGN AND AMENITIES IN FACILITY SHORT WAIT TIMES PROVIDES MULTIPLE SERVICES IN ONE PLACE ACCESS TO SUPPORTIVE SERVICES GARDEN VIEW + LIGHT

VISIBILITY FOR OUR PATIENTS

COLOR, DECOR SPACE FOR PATIENTS GREAT STAFF MEDITATION ROOM VALUE YOUR PATIENT’S TIME HEALING GARDEN ADDITION OF THE NURSING ASSESSMENT AREA VISUALLY CLEAN COMFORT + WELCOMING AREAS PLANT WALL

BEAUTIFUL BUILDING

BRIGHT NATURAL LIGHT

WONDERFUL STAFF NEWNESS

ACCESS TO NATURE

PLENTY OF COMPUTER WORK AREAS SPACES FOR SUPPORT SERVICES

VARIETY OF SERVICES

ATTRACTIVE AND COMFORTABLE

CARING TEAM OF PEOPLE

SERVES A PATIENT POPULATION IN MY COMMUNITY

AMBIENCE, COMFORT, SERENITY, BEAUTY

EVERYONE IS CARING + POSITIVE

PLENTY OF MEETING SPACES

SERAPH CONFERENCE ROOMS

SEPARATION OF TREATMENT/ SERVICES ON FIRST FLOOR AND CLINIC VISITS ON GROUND LEVEL

INTEGRATION OF SERVICES AND WORK FLOW

BRIGHT ROOMS FOR TREATMENT

PICTURE ABOVE RADIATION TABLE

STAFF

PATIENT

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“THE INTERIOR GARDEN, THE LANDSCAPING, AND SITING OF THE BUILDING TO ALLOW JUST THE RIGHT LIGHT, CREATE THE CONNECTION BETWEEN THE INDOORS AND THE OUTDOORS AND THE DESIRED APPRECIATION OF NATURE.” DR. RANDALL OYER MEDICAL DIRECTOR, ONCOLOGY

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