Based on an urgent need to provide cancer care services for the greater Concord, New Hampshire, community, Concord Hospital developed a new comprehensive cancer program housed in an 84,000-square-foot, four-level freestanding addition to their hospital. The difficulty in the final selection of the building site was compounded by the limitations of available space within an overly congested hospital campus situated upon a steep terrain.

As an institutional icon, Concord Hospital has commanded its hilltop with an understated presence. In 1980, the original main entrance was relocated to the rear of the site. With the cancer center project came the opportunity to create a multistoried, identifiable, main entry volume that not only reestablishes a front door to the community, but also serves to provide a much-needed campus orientation space. This new octagonal atrium is grounded in the classic landscape notion of the garden pavilion that transfers nature inside to organize a multilevel circulation system.

The Payson Center for Cancer Care is located adjacent to the new hospital entrance with connections to various support departments. Featuring its own entrance and parking, the center offers a comprehensive array of services, including radiation therapy in mazeless vaults with a less intimidating ambience; medical oncology; and outreach programs, such as social and nutritional services, spiritual care, financial counseling, and a resource library. Empowering the patient is of primary concern, while balancing programmatic contradictions between technology and repose, open and private. Wherever possible, the patient and family zones—whether infusion bays, conference, education, or waiting—were pulled to the exterior window wall for healing natural daylight and distant views.

The Cardiopulmonary, Vascular Laboratory, Radiology, and Administration departments were expanded. The second floor features a new upscale cafá, as well as a retail fashion boutique for cancer patients.

The project's architectural expression is one of permanence, evoking the timeless brick buildings of Concord's past.

Project category: New construction (completed June 2003)

Chief administrator: Michael Green, Chief Executive Officer, (603) 225-2711, ext. 3003

Firm: TRO/The Ritchie Organization, (617) 969-9400

Design team: Douglas J. Strout, AIA, Principal-in-Charge; Chan Wook Byun, AIA, Design Principal; Joanne MacIsaac, IIDA, IFMA, Principal for Interior Design; James F. Newton, PE, Principal for MEP Engineering (TRO/The Ritchie Organization); Douglas J. Butler, Project Manager (Gilbane Building Company)

Total building area (sq. ft.): 90,000

Construction cost/sq. ft.: $247

Total cost (excluding land): $22,260,000