Connecting Cancer Care Centers with Nature

While there are many uncertainties in the world of healthcare, there are even fewer certainties in the world of design. We do, however, have a new and well-established “normal” for the integration of sustainable design and sustainable operation practices into healthcare facilities, few of which draw more attention than those dedicated to cancer care, diagnosis, treatment, and research.

This may be a result of new awareness of the linkages between the emergence of certain cancers and environmental factors, coupled with a growing patient and staff demand for new facilities that better address these sustainable concerns. This article will explore how several facilities—some recently completed and some still in the design stages—have incorporated sustainable design features.

From the early origins of construction, and before our current dependence on fossil fuels, people sought the ways and means to integrate buildings into the environment to improve aspects of habitation. During the emergence of modern healthcare in the 18th and 19th centuries, airy and light-filled wards were typical. Perched high on hills to catch the breeze or removed from cities altogether, hospitals and spas were seemingly at one with nature, seeking to ease stress and provide comfort.

With porches and garden views open to the air, early hospitals were designed to incorporate sophisticated ventilation systems to reduce infections. The daylighting schemes of today were prefigured by yesterday’s more straightforward solution: big, tall windows. In many ways our leading healthcare facilities are returning to these sustainable principles, using today’s techniques, materials, and aesthetics.

For just as long as we have been building buildings, cancer has been with us, too. The fossil record and Egyptian mummies show evidence of cancerous growths near the year 400 BCE; Hippocrates coined the terms carcinos and carcinoma to describe his observations of malignancies. Later, around the year 100, the Roman physician Galen began using the now familiar Greek root-word oncos in reference to the swelling of malignant tumors. Today’s physicians and scientists persist in their search to explain its causes and find better means to manage the disease, and the medical community continues to work with architects to create environments that foster the dignified delivery of care.

The three examples presented below are new cancer care facilities from academic medical centers that typify a range of the American experience: a rural setting, a small city, and a dense, urban downtown area. Two of the facilities are recently completed and one is in design, allowing us to explore what is possible to achieve in different settings.

Thomas Jefferson University Hospitals’ new Ambulatory Care Center (figure 1), when completed, will be the new home to outpatient clinics and infusion therapy for the Kimmel Cancer Center. Situated in Center City, Philadelphia, this new high-rise tower—in one of the oldest and densest of our cities—is a study in how integration of modest gardens and unseen sustainable measures makes an impact. The building itself will correct hundreds of years of site disruptions by reducing utility consumption with an aggressive “storm-water neutral” strategy that will protect the region’s waterways.

On the interior, however, a unique new plan configuration permits patients and staff to have direct (and visual) access to two pocket “sky-gardens” integrated into the infusion therapy clinic (figure 2). These brief respites from the concrete jungle will ease the stress of treatment (and a long day’s work). They fulfill a second, greater need as the locus of shared community space, where small groups of patients, families and friends, and staff join in fellowship and friendship in a lounge atmosphere to reduce the negative effects of isolated treatment bays.