How can the right team overcome programmatic challenges, last-minute changes, and logistical difficulties to achieve a calming, healing environment for patients and families struggling with cancer? Planning, communication, and working together (plus a few sleepless nights and long shifts) helped make the Emily Couric Clinical Cancer Center at the University of Virginia (UVA) move from dream to reality.
As a National Cancer Institute-designated facility, the Emily Couric Clinical Cancer Center provides patients with a beautiful and comforting environment where families can receive the support they need in their fight against cancer. The 150,000-square-foot facility is named for the late Virginia State Sen. Emily Couric.
The center is part of an overall campus modernization effort by UVA that also involves a hospital bed expansion and connective elements that will tie together the cancer center, bed expansion, and existing parking garages.
Designing a beautiful and healing space
The main goal of the facility was to be a warm, dignified placed for patients to receive treatment. UVA formed focus groups of clinical staff, department administrators, and some former patients who met with ZGF Architects to talk about the needs of patients and family members, as well as staff and physicians.
Administration and staff, along with the design team, toured multiple facilities to deliver a plan that captures a feeling of warmth and comfort. As a result, the interior of the building does not look institutional; it is a calming, inviting atmosphere that features cherry paneling and wood frames. There is a meditation and reflection room on the first floor.
The style of the building is radically different from anything else in the area, with its inverted (or butterfly) roof. UVA wanted a modern building that still spoke to the campus’s overall Jeffersonian style. Materials included brick, sandstone, and copper siding, which carry through to the connective elements. Everything is curved; columns are prevalent in the design, creating a modern space that still incorporates a lot of the Jeffersonian characteristics.
Under the direction of UVA and the project team, the facility was designed to achieve LEED Silver certification by the United States Green Building Council. With more than 21,000 square feet of glass, the building allows for a lot of natural light to enter and uses a color scheme that embodies nature. The center contains three reflective gardens, including a rooftop garden, and was constructed with natural materials, such as bamboo flooring and locally resourced wood.
In addition, 90% of all construction waste was recycled. The project team used local suppliers for all 207,000 bricks and 1,700 pieces of sandstone. While getting some of the materials was a challenge at times, the resulting healing environment has been well received.
Making room for cutting-edge technology
Construction of complex structures like the cancer center is never without surprises, and this project was no exception. Over the course of construction, there were major program changes to the radiation oncology and radiology departments that impacted the design of most of the procedure areas and changed much of the required equipment.
Three major changes made to the radiation oncology department, located on the ground floor of the building, included the relocation of the CT simulator room. Equipment was changed in tandem with the relocation and expansion of the HDR suite, which required a complete redesign and re-coordination of the space by the design and construction teams. Equipment changes also were made to two of the three linear accelerator vaults, resulting in major infrastructure changes that impacted the architectural and structural designs.
Equipment changes, such as the addition of a new radiation therapy system, are instrumental in the level of care the facility is able to provide. UVA is among the first cancer centers in the country to offer such advanced pieces of radiation oncology technology, which are designed to provide patients more accurate, fast, and convenient treatment.
Directly above the radiation oncology department, the radiology department underwent several major changes of its own. One procedure room was changed from an MRI to a PET CT scanner, which requires lead radiation shielding instead of the magnetic resonance-radio frequency shielding that was initially planned. This change to the functional program meant the patient treatment programs planned for the area were modified and additional lead shielding was added to multiple patient holding areas.
Construction crews had to retrofit the existing shielding to accommodate the new program. By using one-inch steel plates on the deck above and cast lead in some of the floors, builders were able to work with designers to find the least expensive and least intrusive means of accomplishing the task. Approximately halfway through construction, a diagnostic CT room was added to the program. Shielding needed to be added where it had never existed, and new equipment and furniture needed to be procured. There was a dedicated person working just with the equipment and furniture vendors, bringing in items while construction was still being completed. Even with all of the program changes, the team was able to complete the cancer center on schedule and within budget.
Two projects, one site
In addition to program challenges, there were also logistical challenges due to the hospital bed expansion project taking place directly across the street from where the cancer center was being constructed. Gilbane was selected for both projects in large part due to this significant construction coordination challenge. The entire project called for connective elements—a central circulation column with a curved bridge over the main road—to tie the three components together to look like one.
The expansion is scheduled to be completed at the end of 2011. The main road had to be kept open the entire time throughout construction. There were cranes on either side of the street, and both projects had to share ground space and air space with the connective circulation tower—same driveway, same contractors. Cranes worked on the expansion during restricted hours.
The street has remained open and will for all but one weekend, when the assembled air bridge will be placed over the road this fall, and the project team will avoid disrupting any home games for the UVA football team. Keeping that street functioning is a critical part of the project, as it provides the only patient access to the cancer center, as well as access to the main entrance of the hospital and the ambulance route.
Working together to get the job done
All involved agree that the successful opening of the cancer center was a result of the great collaboration among the project team—from the owner to the architect and its consulting team to the builder and subcontractors. There was a lot of open communication; a lot of “working things out.” It was a perfect case study of how well things can go when the construction manager and architect work closely together to make the right decisions for the client.
Without the teamwork and cooperation of the entire group, meeting the deadline would not have been a reality. It was truly a team effort—with everyone remaining clear about needs, expectations, and timeline. HCD
Heidi Jones-Huffman, LEED AP, is an Associate Partner at ZGF Architects LLP. She can be reached at firstname.lastname@example.org. Michael Poulin is Project Executive with Gilbane Building Co. He can be reached at email@example.com.